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Details

Stereochemistry ABSOLUTE
Molecular Formula C21H29FO5
Molecular Weight 380.4504
Optical Activity UNSPECIFIED
Defined Stereocenters 7 / 7
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of FLUDROCORTISONE

SMILES

C[C@]12C[C@H](O)[C@@]3(F)[C@@H](CCC4=CC(=O)CC[C@]34C)[C@@H]1CC[C@]2(O)C(=O)CO

InChI

InChIKey=AAXVEMMRQDVLJB-BULBTXNYSA-N
InChI=1S/C21H29FO5/c1-18-7-5-13(24)9-12(18)3-4-15-14-6-8-20(27,17(26)11-23)19(14,2)10-16(25)21(15,18)22/h9,14-16,23,25,27H,3-8,10-11H2,1-2H3/t14-,15-,16-,18-,19-,20-,21-/m0/s1

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including http://www.2ndchance.info/addison's-florinef.pdf

Fludrocortisone acetate (approved as Florinef) is a synthetic adrenocortical steroid possessing very potent mineralcorticoid properties and high glucocorticoid activity. Main indications are Partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt losing adrenogenital syndrome.

Originator

Curator's Comment: refernce was retrived from https://www.researchgate.net/publication/284208027_Fludrocortisone_Acetate

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Target ID: P22199
Gene ID: 25672.0
Gene Symbol: Nr3c2
Target Organism: Rattus norvegicus (Rat)
1.07 nM [Kd]
Target ID: P08235
Gene ID: 4306.0
Gene Symbol: NR3C2
Target Organism: Homo sapiens (Human)
Target ID: P06536
Gene ID: 24413.0
Gene Symbol: Nr3c1
Target Organism: Rattus norvegicus (Rat)
Target ID: P04150
Gene ID: 2908.0
Gene Symbol: NR3C1
Target Organism: Homo sapiens (Human)
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
FLORINEF

Approved Use

Fludrocortisone acetate tablets USP, 0.1 mg are indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome.

Launch Date

1955
Primary
FLORINEF

Approved Use

Fludrocortisone acetate tablets USP, 0.1 mg are indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome.

Launch Date

1955
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
1241.1 pg/mL
0.1 mg single, oral
dose: 0.1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
0.19 μg/L
50 μg single, oral
dose: 50 μg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
3275.8 pg × h/mL
0.1 mg single, oral
dose: 0.1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1.25 μg × h/L
50 μg single, oral
dose: 50 μg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
2.57 h
0.1 mg single, oral
dose: 0.1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1.35 h
50 μg single, oral
dose: 50 μg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
30%
0.1 mg single, oral
dose: 0.1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUDROCORTISONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
0.3 mg 1 times / day multiple, oral
Highest studied dose
Dose: 0.3 mg, 1 times / day
Route: oral
Route: multiple
Dose: 0.3 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Other AEs: Serum potassium decreased, Rise in blood pressure...
Other AEs:
Serum potassium decreased (5 patients)
Rise in blood pressure (5 patients)
Sources:
AEs

AEs

AESignificanceDosePopulation
Rise in blood pressure 5 patients
0.3 mg 1 times / day multiple, oral
Highest studied dose
Dose: 0.3 mg, 1 times / day
Route: oral
Route: multiple
Dose: 0.3 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Serum potassium decreased 5 patients
0.3 mg 1 times / day multiple, oral
Highest studied dose
Dose: 0.3 mg, 1 times / day
Route: oral
Route: multiple
Dose: 0.3 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer

Drug as victim

Drug as victim

PubMed

PubMed

TitleDatePubMed
Clinical improvement in patients with orthostatic intolerance after treatment with bisoprolol and fludrocortisone.
2000 Oct
[Addisonian myopathy].
2001
Hypoadrenocorticism in a cat.
2001 Apr
Steroids in sepsis--more effective than activated protein C?
2001 Aug
Mechanisms underlying the impairment in orthostatic tolerance after nocturnal recumbency in patients with autonomic failure.
2001 Dec
Endothelial cell dysfunction in mice after transgenic knockout of type 2, but not type 1, 11beta-hydroxysteroid dehydrogenase.
2001 Dec 4
[An autopsy case of pure autonomic failure with pathological features of Parkinson's disease].
2001 Jan
Aldosterone synthase deficiency type I with no documented homozygous mutations in the CYP11B2 gene.
2001 Jan
Fludrocortisone acetate to treat neurally mediated hypotension in chronic fatigue syndrome: a randomized controlled trial.
2001 Jan 3
[Orthostatic intolerance syndromes].
2001 Jan-Mar
Dysautonomia and neurocardiogenic syncope.
2001 Mar
Orthostatic hypotension and chronic fatigue syndrome.
2001 Mar 21
Orthostatic hypotension and chronic fatigue syndrome.
2001 Mar 21
Insulin and mineralocorticoids influence on extrarenal potassium metabolism in chronic hemodialysis patients.
2001 Nov
Congenital hyperreninemic hypoaldosteronism unlinked to the aldosterone synthase (CYP11B2) gene.
2001 Nov
[Adrenal insufficiency caused by treatment with levothyroxine].
2001 Nov 29
[Increasing pigmentation in Schmidt syndrome (polyglandular autoimmune syndrome type II].
2001 Oct
Fludrocortisone treatment in a child with severe cerebral salt wasting.
2001 Oct
Adverse cardiac effects of salt with fludrocortisone in hypertension.
2001 Oct
Pharmacologic options available to treat symptomatic intradialytic hypotension.
2001 Oct
Serum cortisol and 17-hydroxyprogesterone interrelation in classic 21-hydroxylase deficiency: is current replacement therapy satisfactory?
2001 Oct
Pro/con clinical debate: are steroids useful in the management of patients with septic shock?
2002 Apr
Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.
2002 Aug 21
Hyperkalaemia and selective hypoaldosteronism in myotonic dystrophy.
2002 Feb
The aldosterone-renin ratio and primary aldosteronism.
2002 Feb
[Syncope - a systematic overview of classification, pathogenesis, diagnosis and management].
2002 Feb
Hyporeninemic hypoaldosteronism associated with Sjögren's syndrome.
2002 Feb 15
Corticosteroid supplementation for adrenal insufficiency.
2002 Jan 9
A footnote on the origin of fluorosteroids.
2002 Jul
Screening and diagnosis of primary aldosteronism.
2002 Jul-Aug
Structural basis for the glucocorticoid response in a mutant human androgen receptor (AR(ccr)) derived from an androgen-independent prostate cancer.
2002 Mar 28
Dysautonomias: clinical disorders of the autonomic nervous system.
2002 Nov 5
The mineralocorticoid receptor may compensate for the loss of the glucocorticoid receptor at specific stages of mammary gland development.
2002 Sep
A pilot randomized trial of induced blood pressure elevation: effects on function and focal perfusion in acute and subacute stroke.
2003
Sepsis clinical knowledge: a role of steroid treatment.
2003 Apr
Bench-to-bedside review: endothelial cell dysfunction in severe sepsis: a role in organ dysfunction?
2003 Apr
Diminished renal kallikrein responses to mineralocorticoid stimulation in African Americans: determinants of an intermediate phenotype for hypertension.
2003 Apr
Monozygotic twins with congenital adrenal hyperplasia: long-term endocrine evaluation and gene analysis.
2003 Apr-May
Association between supine hypertension and orthostatic hypotension in autonomic failure.
2003 Aug
Primary aldosteronism and hypertensive disease.
2003 Aug
Chronic fatigue syndrome and Addison's disease.
2003 Feb
Successful treatment of severe orthostatic hypotension with erythropoietin.
2003 Jan
Serum leptin levels in patients with 21-hydroxylase deficiency before and after treatment.
2003 Jan-Mar
Automated coupling of capillary-HPLC to matrix-assisted laser desorption/ionization mass spectrometry for the analysis of small molecules utilizing a reactive matrix.
2003 Jul
Neurologic complications following treatment of canine hypoadrenocorticism.
2003 Jun
Impact of smoking on the response to treatment of thyroid associated ophthalmopathy.
2003 Jun
[A 47-year-old man with "pure autonomic failure" and pernicious anemia].
2003 Jun 13
Combination therapy with hydrocortisone and fludrocortisone does not improve symptoms in chronic fatigue syndrome: a randomized, placebo-controlled, double-blind, crossover study.
2003 Jun 15
Stability of fludrocortisone acetate solutions prepared from tablets and powder.
2003 Mar
Blood pressure in children and adolescents with congenital adrenal hyperplasia (21-hydroxylase deficiency): a preliminary report.
2003 May
Patents

Sample Use Guides

0.05mg to 0.3mg FLORINEF (Fludrocortisone acetate) daily (depends on indication)
Route of Administration: Oral
In Vitro Use Guide
Unknown
Name Type Language
ASTONIN-H
Preferred Name English
FLUDROCORTISONE
HSDB   INN   MI   VANDF   WHO-DD  
INN  
Official Name English
fludrocortisone [INN]
Common Name English
FLUDROCORTISONE [HSDB]
Common Name English
FLUDROCORTISONE [VANDF]
Common Name English
9-FLUORO-11.BETA.,17,21-TRIHYDROXYPREGN-4-ENE-3,20-DIONE
Systematic Name English
NSC-11318
Code English
FLUDROCORTISONE [MI]
Common Name English
Fludrocortisone [WHO-DD]
Common Name English
ALFLORONE
Brand Name English
Classification Tree Code System Code
WHO-ATC S03CA05
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
WHO-ATC S01CA06
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
WHO-ATC H02AA02
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WHO-VATC QS03CA05
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
WHO-ATC S02CA07
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
WHO-VATC QS02CA07
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
NCI_THESAURUS C521
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
WHO-ESSENTIAL MEDICINES LIST 18.1
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
WHO-VATC QS01CA06
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WHO-VATC QH02AA02
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LIVERTOX 422
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
Code System Code Type Description
IUPHAR
2873
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
DRUG BANK
DB00687
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
SMS_ID
100000080700
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
WIKIPEDIA
FLUDROCORTISONE
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
MERCK INDEX
m5431
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY Merck Index
MESH
D005438
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PRIMARY
ECHA (EC/EINECS)
204-833-2
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PRIMARY
DAILYMED
U0476M545B
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
EPA CompTox
DTXSID7023061
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
NCI_THESAURUS
C71629
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
FDA UNII
U0476M545B
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
HSDB
3332
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PRIMARY
INN
460
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PRIMARY
EVMPD
SUB07684MIG
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PRIMARY
PUBCHEM
31378
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
RXCUI
4452
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY RxNorm
ChEMBL
CHEMBL1201010
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PRIMARY
CAS
127-31-1
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PRIMARY
CHEBI
50885
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY
NSC
11318
Created by admin on Mon Mar 31 18:34:43 GMT 2025 , Edited by admin on Mon Mar 31 18:34:43 GMT 2025
PRIMARY