U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C21H29FO5
Molecular Weight 380.4512
Optical Activity UNSPECIFIED
Defined Stereocenters 7 / 7
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of FLUDROCORTISONE

SMILES

C[C@@]12CCC(=O)C=C2CC[C@@]3([H])[C@]4([H])CC[C@](C(=O)CO)([C@@]4(C)C[C@@]([H])([C@@]31F)O)O

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

Molecular Formula C21H29FO5
Molecular Weight 380.4512
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 7 / 7
E/Z Centers 0
Optical Activity UNSPECIFIED

Description
Curator's Comment:: 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
Gene Symbol: Nr3c2
Target Organism: Rattus norvegicus (Rat)
1.07000000000000006 nM [Kd]
Target ID: P08235
Gene ID: 4306
Gene Symbol: NR3C2
Target Organism: Homo sapiens (Human)
Target ID: P06536
Gene ID: 24413
Gene Symbol: Nr3c1
Target Organism: Rattus norvegicus (Rat)
Target ID: P04150
Gene ID: 2908
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

-453600000000
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

-453600000000
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
[Normokalemic periodic paralysis].
2001
Orthostatic hypotension in patients with Parkinson's disease: pathophysiology and management.
2001
Postural tachycardia syndrome in syringomyelia: response to fludrocortisone and beta-blockers.
2001 Aug
Endocrine evaluation for muscle pain.
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
[Orthostatic intolerance syndromes].
2001 Jan-Mar
Index of suspicion. Case 3. Diagnosis: Acute primary adrenal insufficiency.
2001 Jul
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
Strategy for the management of vasovagal syncope.
2002
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
[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
Salt losing nephropathy simulating congenital adrenal hyperplasia in an infant.
2002 Jul
Screening and diagnosis of primary aldosteronism.
2002 Jul-Aug
Yoghurt biotherapy: contraindicated in immunosuppressed patients?
2002 Jun
Cortisol replacement for severe sepsis and septic shock: what should I do?
2002 Jun
Structural basis for the glucocorticoid response in a mutant human androgen receptor (AR(ccr)) derived from an androgen-independent prostate cancer.
2002 Mar 28
Orthostatic hypotension.
2002 May
Subjective health status in Norwegian patients with Addison's disease.
2002 May
A glucocorticoid-responsive mutant androgen receptor exhibits unique ligand specificity: therapeutic implications for androgen-independent prostate cancer.
2002 May
[Fatigue, weight loss and decline in general health in a young patient. Addison disease].
2002 May 8
Recently published papers: new evidence for old debates, new drugs and some timely reminders.
2002 Oct
Autonomic failure mimicing dopamine agonist induced vertigo in a patient with macroprolactinoma.
2002 Oct
A pilot randomized trial of induced blood pressure elevation: effects on function and focal perfusion in acute and subacute stroke.
2003
Bench-to-bedside review: endothelial cell dysfunction in severe sepsis: a role in organ dysfunction?
2003 Apr
Association between supine hypertension and orthostatic hypotension in autonomic failure.
2003 Aug
Primary aldosteronism and hypertensive disease.
2003 Aug
Recently published papers: a number of treatment controversies.
2003 Feb
Chronic fatigue syndrome and Addison's disease.
2003 Feb
[Investigation of hyperaldosteronism in the hypertensive patient. Why? When? How?].
2003 Jan
Drug treatment of orthostatic hypotension and vasovagal syncope.
2003 Jan-Feb
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
[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
Granulomatous interstitial nephritis.
2003 Mar
Congenital adrenal hypoplasia presenting as a chronic respiratory condition.
2003 Mar
Simultaneous quantification of budesonide and its two metabolites, 6beta-hydroxybudesonide and 16alpha-hydroxyprednisolone, in human plasma by liquid chromatography negative electrospray ionization tandem mass spectrometry.
2003 Mar-Apr
Hydrocortisone and fludrocortisone improved 28-day survival in septic shock and adrenal insufficiency.
2003 Mar-Apr
Patents

Sample Use Guides

0.05mg to 0.3mg FLORINEF (Fludrocortisone acetate) daily (depends on indication)
Route of Administration: Oral
Substance Class Chemical
Created
by admin
on Sat Jun 26 16:40:35 UTC 2021
Edited
by admin
on Sat Jun 26 16:40:35 UTC 2021
Record UNII
U0476M545B
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
FLUDROCORTISONE
HSDB   INN   MI   VANDF   WHO-DD  
INN  
Official Name English
FLUDROCORTISONE [INN]
Common Name English
ASTONIN-H
Brand Name English
FLUDROCORTISONE [HSDB]
Common Name English
FLUDROCORTISONE [VANDF]
Common Name English
FLUDROCORTISONE [WHO-DD]
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
Classification Tree Code System Code
WHO-ATC S03CA05
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
WHO-ATC S01CA06
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
WHO-ATC H02AA02
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
WHO-VATC QS03CA05
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
WHO-ATC S02CA07
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
WHO-VATC QS02CA07
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
NCI_THESAURUS C521
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
WHO-ESSENTIAL MEDICINES LIST 18.1
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
WHO-VATC QS01CA06
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
WHO-VATC QH02AA02
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
LIVERTOX 422
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
Code System Code Type Description
IUPHAR
2873
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY
DRUG BANK
DB00687
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
WIKIPEDIA
FLUDROCORTISONE
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY
MERCK INDEX
M5431
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY Merck Index
MESH
D005438
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY
ECHA (EC/EINECS)
204-833-2
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
EPA CompTox
127-31-1
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
NCI_THESAURUS
C71629
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY
FDA UNII
U0476M545B
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
HSDB
3332
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
INN
460
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
EVMPD
SUB07684MIG
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
PUBCHEM
31378
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY
RXCUI
4452
Created by admin on Sat Jun 26 16:40:36 UTC 2021 , Edited by admin on Sat Jun 26 16:40:36 UTC 2021
PRIMARY RxNorm
ChEMBL
CHEMBL1201010
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
CAS
127-31-1
Created by admin on Sat Jun 26 16:40:35 UTC 2021 , Edited by admin on Sat Jun 26 16:40:35 UTC 2021
PRIMARY
Related Record Type Details
ACTIVE MOIETY