Clinical data
AHFS/Drugs.com Monograph
  • C
Routes of
By mouth
ATC code H02AA02 (WHO)
Legal status
Legal status
Pharmacokinetic data
Protein binding High
Metabolism Liver
Biological half-life 3.5 hours
CAS Number 127-31-1 YesY
PubChem (CID) 31378
DrugBank DB00687 YesY
ChemSpider 29111 YesY
UNII U0476M545B YesY
KEGG D07967 YesY
ChEBI CHEBI:50885 YesY
ECHA InfoCard 100.004.395
Chemical and physical data
Formula C21H29FO5
Molar mass 380.45 g/mol
3D model (Jmol) Interactive image
 NYesY (what is this?)  (verify)

Fludrocortisone (also called 9α-fluorocortisol or 9α-fluorohydrocortisone) is a synthetic corticosteroid with moderate glucocorticoid potency and much greater mineralocorticoid potency. Therapeutically, it is used for its mineralocorticoid activity and not for its glucocorticoid activity.

The brand name in the EU, USA, and Canada is Florinef. It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]

Medical uses

Fludrocortisone has been used in the treatment of cerebral salt wasting syndrome.[2] 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. Due to its effects on increasing Na+ levels, and therefore blood volume, fludrocortisone is the first line of treatment for orthostatic intolerance and postural orthostatic tachycardia syndrome (POTS).[3] It can be used to treat low blood pressure.

Fludrocortisone is also a confirmation test for diagnosing Conn's syndrome (aldosterone producing-adrenal adenoma), the fludrocortisone suppression test. Loading the patient with fludrocortisone would suppress serum aldosterone level in a normal patient, whereas the level will not be altered in a Conns patient.

Side effects


Renin plasma, sodium, and potassium is checked through blood tests in order to verify that the correct dosage is reached.

Chemical properties

Chemically, fludrocortisone is identical to cortisol 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.


  1. "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
  2. Taplin CE, Cowell CT, Silink M, Ambler GR (December 2006). "Fludrocortisone therapy in cerebral salt wasting". Pediatrics. 118 (6): e1904–8. doi:10.1542/peds.2006-0702. PMID 17101713.
  3. Freitas J, Santos R, Azevedo E, Costa O, Carvalho M, Falcão de Freitas A (2000). "Clinical improvement in patients with orthostatic intolerance after treatment with bisoprolol and fludrocortisone". Clinical Autonomic Research. 10 (5): 293–299. doi:10.1007/BF02281112.
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