Fludrokortizon

When ATH:
H02AA02

Pharmacological action.
Mineralocorticoid, glucocorticoid.

Application.

Primary and secondary adrenal insufficiency, congenital adrenal hyperplasia with marked loss of electrolytes; topically in ophthalmic practice: keratit, allergic diseases and eye injuries.

Contraindications.

Hypersensitivity, heart failure, hypertension, Hyper- and hypothyroidism, osteoporosis, of the liver and kidneys, systemic and local fungal infections, herpes, chronic infections, diabetes, peptic ulcer, diverticulitis, mental disorders, Pregnancy and breast-feeding; topical - fungal and bacterial eye damage.

Side effects.

Adrenal insufficiency, myasthenia, erosion of the gastrointestinal tract, increase the level of glucose, hyperkalemia, hypertension, headache, dizziness, euphoria, emotional lability, increased intraocular pressure (inside, locally), cataract formation (locally), menstrual irregularities, growth retardation in children, swelling.

Cooperation.

Increases efficiency (and toxicity) systemic gluco- and mineralocorticoid, It reduces - anabolic steroids (but increases their hepatotoxicity), oral antidiabetic drugs. It increases the likelihood of side effects in the appointment of cardiac glycosides, means, causing hypokalemia (Diuretic, amphotericin B). Against the backdrop of sodium-containing medicines increase the risk of edema and hypertension, acetylsalicylic acid and other NSAIDs - ulceration of the stomach lining. Psychotropic drugs and alcohol stimulates elimination.

Overdose.

Symptoms: arrhythmia, kaliopenia, hypertensive crisis, Eden, weight gain.

Dosing and Administration.

Inside - From 0,1 mg 3 twice a week to 0,2 mg 1 once a day. In chronic adrenal insufficiency, and adrenogenital syndrome - 0.1-0.2 mg / day together with hydrocortisone (10-30 Mg /), protractedly; eye ointment: lay behind the eyelid 1-3 times a day, no more 2 Sun.

Precautions.

A regular monitoring of blood pressure, Potassium and glucose levels in the blood. It should limit the intake of salt, prophylactically appoint drugs potassium, control the function of the adrenal cortex. The elongation rate is possible only at lower doses. After prolonged use of the abolition of the produce gradually (risk of adrenal insufficiency).

Cooperation

Active substance	Description of interaction
Akarʙoza	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; with a joint appointment is necessary to monitor the concentration of glucose in the blood.
Amphotericin B	FMR: synergism. Against the background of fludrocortisone increases the likelihood of side effects (kaliopenia, dysfunctional disorders of the myocardium).
Acetylsalicylic acid	FMR: synergism. Increases risk of side effects (ulceration and bleeding in the digestive tract).
Bumetanid	FMR: synergism. Increases (mutually) the likelihood of hypokalemia.
Warfarin	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened.
Gidroxlorotiazid	FMR: synergism. Increases (mutually) the likelihood of hypokalemia.
Glimepiride	FMR: antagonizm. Against the background of weakening the effect of fludrocortisone; It requires the combined use of glucose monitoring.
Glipizide	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; In sharing requires constant monitoring of blood glucose concentrations.
Digoxin	FMR: synergism. Against the background of fludrocortisone increases the likelihood of side effects (hypokalemia and hypomagnesemia, decrease of potassium and magnesium in the myocardium increases its sensitivity).
Insulin aspart	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; the combined use of increased insulin requirements.
Insulin dvuhfaznыy [human genetic engineering]	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; the combined appointment of insulin dose should be increased (under the constant control of blood glucose levels).
Insulin soluble [pork monocomponent]	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; joint application may need to increase the dose of insulin.
Metformin	FMR: antagonizm. Against the background of reduced effect fludrocortisone; with a joint appointment required constant monitoring of blood glucose.
Pioglitazone	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; Sharing requires constant monitoring of blood glucose levels.
Poliestradiola phosphate	FKV. Increases kortikosteroidsvyazyvayuschego globulin, It reduces the amount of free (active) blood fractions.
Protirelin	FMR: antagonizm. Against the background of reduced effect fludrocortisone (stimulating the secretion of thyroid-stimulating hormone).
Repaglinide	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; with a joint appointment is necessary to constantly monitor the concentration of glucose in the blood.
Rifampicin	FKV. Induces liver enzymes, accelerates biotransformation, increases clearance.
Rosiglitazone	FMR: antagonizm. Against the background of the effect of fludrocortisone weakened; combined use necessitates constant monitoring of blood glucose concentration.
Somatropin	FMR: antagonizm. Against the background of reduced effect fludrocortisone (stimulation of growth).
Phenytoin	FKV. Accelerates biotransformation (induces liver enzymes), increases clearance.
Phenobarbital	FKV. Accelerates biotransformation (induces liver enzymes), increases clearance.
Furosemid	FMR: synergism. Increases (mutually) the risk of hypokalemia.
Estradiol	FKV. FMR: antagonizm. Reduces effect (kortikosteroidsvyazyvayuschego globulin increases and reduces the plasma concentration of the free - active - faction).
Ethacrynic acid	FMR. Increases (mutually) the risk of hypokalemia.
Ethanol	FKV. It stimulates elimination.
Ethinylestradiol	FKV. Increases kortikosteroidsvyazyvayuschego globulin, It reduces the concentration of free active fraction of blood.