Fludrocortisone acetate

Fludrocortisone acetate

Clinical data
Pregnancy category	C
Routes of administration	oral
ATC code	H02AA02 (WHO)
Pharmacokinetic data
Protein binding	High
Metabolism	Hepatic
Elimination half-life	3.5 hours
Identifiers
IUPAC name 9-fluoro-11,17-dihydroxy-17- (2-hydroxyacetyl)- 10,13-dimethyl- 1,2,6,7,8,9,10,11,12, 13,14,15,16,17- tetradecahydrocyclopenta[a]phenanthren-3-one
CAS Number	127-31-1
PubChem CID	31378
DrugBank	APRD00756
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C21H29FO5
Molar mass	380.45 g/mol

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Fludrocortisone is a synthetic corticosteroid with moderate glucocorticoid potency and much greater mineralocorticoid potency. It is used primarily to replace the missing hormone aldosterone in various forms of adrenal insufficiency such as Addison's disease and the classic salt wasting (21-hydroxylase deficiency) form of congenital adrenal hyperplasia. It is the first line of treatment for orthostatic intolerance as well.

The brand name in the U.S. is Florinef. It is available in 0.1 mg tablets. Typical daily doses for mineralocorticoid replacement are between 0.05 mg - 0.2 mg. Renin plasma, sodium, and potassium is checked through blood tests in order to verify that the correct dosage is reached.

Chemically, its structure is identical to cortisone except for the substitution of fluorine in place of one hydrogen. Fluorine is a good bioisostere for hydrogen because it is similar in size. The major difference is in its electronegativity.

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