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Corticosteroids are thought to actat least in partby controlling the rate of synthesis of proteinsAlthough there are a number of instances in which the synthesis of specific proteins is known to be induced by corticosteroidsthe links between the initial actions of the hormones and the final metabolic effects have not been completely elucidated.

BECAUSE OF ITS MARKED EFFECT ON SODIUM RETENTIONTHE USE OF FLUDROCORTISONE ACETATE IN THE TREATMENT OF CONDITIONS OTHER THAN THOSE INDICATED HEREIN IS NOT ADVISED

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Adequate animal reproduction studies have not been conducted with fludrocortisone acetateHowevermany corticosteroids have been shown to be teratogenic in laboratory animals at low dosesTeratogenicity of these agents in man has not been demonstratedIt is not known whether fludrocortisone acetate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacityFludrocortisone acetate should be given to a pregnant woman only if clearly needed.

The physiologic action of fludrocortisone acetate is similar to that of hydrocortisoneHoweverthe effects of fludrocortisone acetateparticularly on electrolyte balancebut also on carbohydrate metabolismare considerably heightened and prolongedMineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasmathey increase the urinary excretion of both potassium and hydrogen ionsThe consequence of these three primary effects together with similar actions on cation transport in other tissues appear to account for the entire spectrum of physiological activities that are characteristic of mineralocorticoidsIn small oral dosesfludrocortisone acetate produces marked sodium retention and increased urinary potassium excretionIt also causes a rise in blood pressureapparently because of these effects on electrolyte levels.

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