Drug/Small Molecule:
fludrocortisone

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PharmGKB contains no Clinical Variants that meet the highest level of criteria.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?
2D structure from PubChem
provided by PubChem

Overview

Generic Names
Trade Names
  • 9 .Alpha. Ff
  • 9 Alpha Ff
  • 9 alpha-Fludrocortisone
  • 9 alpha-Fluorocortisol
  • 9.Alpha.-Fluorocortisol
  • 9.Alpha.-Fluorohydrocortisone
  • Alflorone
  • Astonin-H
  • F-COL
  • F-Cortef
  • Florinef
  • Fludrocortisona [INN-Spanish]
  • Fludrocortisone Acetate
  • Fludrocortisonum [INN-Latin]
  • Fludrocortone
  • Fludrone
  • Fludronef
  • Fluodrocortisone
  • Fluohydrisone
  • Fluohydrocortisone
  • Fluorocortisol
  • Fluorocortisone
  • ZK5
Brand Mixture Names

PharmGKB Accession Id:
PA164743961

Description

A synthetic mineralocorticoid with anti-inflammatory activity.

Source: Drug Bank

Indication

For partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Fludrocortisone binds the mineralocorticoid receptor (aldosterone receptor). This binding (or activation of the mineralocorticoid receptor by fludrocortisone) in turn causes an increase in ion and water transport and thus raises extracellular fluid volume and blood pressure and lowers potassium levels.

Source: Drug Bank

Pharmacology

Fludrocortisone is a synthetic adrenocortical steroid possessing very potent mineralocorticoid properties and high glucocorticoid activity. It is indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome. The physiologic action of fludrocortisone acetate is similar to that of hydrocortisone. However, the effects of fludrocortisone acetate, particularly on electrolyte balance, but also on carbohydrate metabolism, are considerably heightened and prolonged. Mineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasma; they increase the urinary excretion of both potassium and hydrogen ions.

Source: Drug Bank

Food Interaction

Take with food to reduce irritation.|Avoid excess salt/sodium unless otherwise instructed by your physician.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic, some renal.

Source: Drug Bank

Protein Binding

High

Source: Drug Bank

Half-Life

3.5 hours

Source: Drug Bank

Toxicity

Effects of overexposure include irritation, cardiac edema, increased blood volume, hypertension, cardiac arrhythmias, enlargement of the heart, headaches, and weakness of the extremities.

Source: Drug Bank

Chemical Properties

Chemical Formula

C21H29FO5

Source: Drug Bank

Isomeric SMILES

C[C@]12CCC(=O)C=C1CC[C@@H]3[C@@]2([C@H](C[C@]4([C@H]3CC[C@@]4(C(=O)CO)O)C)O)F

Source: Drug Bank

[H][C@@]12CC[C@](O)(C(=O)CO)[C@@]1(C)C[C@H](O)[C@@]1(F)[C@@]2([H])CCC2=CC(=O)CC[C@]12C

Source: Drug Bank

Canonical SMILES

C[C@]12C[C@H]

Source: Drug Bank

Average Molecular Weight

380.4504

Source: Drug Bank

Monoisotopic Molecular Weight

380.199902243

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Drug Targets

Gene Description
NR3C1 (source: Drug Bank)
NR3C2 (source: Drug Bank)

Drug Interactions

Drug Description
fludrocortisone The corticosteroid, fludrocortisone, may decrease the effect of the salicylate, acetylsalicylic acid. (source: Drug Bank)
acenocoumarol The corticosteroid, fludrocortisone, alters the anticoagulant effect, acenocoumarol. (source: Drug Bank)
ambenonium The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, ambenonium. (source: Drug Bank)
amobarbital The barbiturate, amobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
anisindione The corticosteroid, fludrocortisone, alters the anticoagulant effect of anisindione. (source: Drug Bank)
aprobarbital The barbiturate, aprobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
butabarbital The barbiturate, butabarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
butalbital The barbiturate, butalbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
butethal The barbiturate, butethal, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
dicumarol The corticosteroid, fludrocortisone, alters the anticoagulant effect of dicumarol. (source: Drug Bank)
edrophonium The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, edrophonium. (source: Drug Bank)
ethotoin The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
fosphenytoin The enzyme inducer, fosphenytoin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
heptabarbital The barbiturate, heptabarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
hexobarbital The barbiturate, hexobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
mephenytoin The enzyme inducer, mephenytoin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
methohexital The barbiturate, methohexital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
methylphenobarbital The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
midodrine Increased arterial pressure (source: Drug Bank)
neostigmine The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, neostigmine. (source: Drug Bank)
pentobarbital The barbiturate, pentobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
phenobarbital The barbiturate, phenobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
phenytoin The enzyme inducer, phenytoin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
pyridostigmine The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
quinidine The barbiturate, quinidine barbiturate, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
rifampin The enzyme inducer, rifampin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
salicylate-sodium The corticosteroid, fludrocortisone, may decrease the effect of the salicylate, salicylate-sodium. (source: Drug Bank)
salsalate The corticosteroid, fludrocortisone, may decrease the effect of the salicylate, salsalate. (source: Drug Bank)
secobarbital The barbiturate, secobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
talbutal The barbiturate, talbutal, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
trisalicylate-choline The corticosteroid, fludrocortisone, may decrease the effect of the salicylate, trisalicylate-choline. (source: Drug Bank)
warfarin The corticosteroid, fludrocortisone, alters the anticoagulant effect of warfarin. (source: Drug Bank)
fludrocortisone The enzyme inducer, fosphenytoin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
fludrocortisone Increased arterial pressure (source: Drug Bank)
fludrocortisone The barbiturate, phenobarbital, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
fludrocortisone The enzyme inducer decreases the effect of the corticosteroid (source: Drug Bank)
fludrocortisone The enzyme inducer, phenytoin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
fludrocortisone The barbiturate, primidone, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
fludrocortisone The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
fludrocortisone The enzyme inducer, rifampin, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
fludrocortisone Tacrine and Fludrocortisone may independently exacerbate muscle weakness in myasthenia gravis patients. Monitor for additive muscle weakness effects. (source: Drug Bank)
fludrocortisone Trastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events. (source: Drug Bank)
fludrocortisone Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Fludrocortisone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy. (source: Drug Bank)

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
42291-529-01
DrugBank:
DB00687
ChEBI:
50885
KEGG Compound:
C07004
PubChem Compound:
31378
PubChem Substance:
46508616
9217
Drugs Product Database (DPD):
2086026
ChemSpider:
29111
Therapeutic Targets Database:
DAP001105
FDA Drug Label at DailyMed:
2e6ee871-d855-44c3-9319-8ea49035521b

Clinical Trials

These are trials that mention fludrocortisone and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.