Floricot
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Floricot?
Floricot is a fludrocortisone acetate 100 mcg (0.1 mg) tablet, the standard oral mineralocorticoid replacement used in primary adrenal insufficiency (Addison’s disease), congenital adrenal hyperplasia (salt-losing forms), and severe neurogenic orthostatic hypotension. Typical adult dose is 50–200 mcg once daily for adrenal replacement, and up to 400 mcg/day for neurogenic orthostatic hypotension. Fludrocortisone promotes salt and water retention, which raises blood pressure — it is not an antihypertensive.
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Floricot 100 mcg is an oral tablet containing fludrocortisone acetate, a synthetic steroid with potent mineralocorticoid activity and moderate glucocorticoid activity. It is on the WHO Essential Medicines List as the standard oral mineralocorticoid replacement.
Fludrocortisone is essentially a pharmacological substitute for aldosterone — the natural mineralocorticoid hormone produced by the adrenal cortex, which regulates sodium and potassium balance. When the adrenal glands cannot produce enough aldosterone (Addison’s disease, congenital adrenal hyperplasia), fludrocortisone is used to restore normal salt and water balance.
Because salt and water retention raises circulating blood volume, fludrocortisone raises blood pressure — which is also why it is used in selected patients with severe orthostatic hypotension who faint on standing.
What Is Floricot Used For?
- Primary adrenal insufficiency (Addison’s disease) — lifelong mineralocorticoid replacement, alongside a glucocorticoid (hydrocortisone or prednisolone)
- Salt-losing congenital adrenal hyperplasia (CAH) — paediatric and adult lifelong replacement, under endocrinology specialist
- Neurogenic orthostatic hypotension — autonomic failure (Parkinson’s disease, multiple system atrophy, pure autonomic failure, diabetic autonomic neuropathy)
- Chronic postural (orthostatic) hypotension — when non-pharmacological measures (increased salt and water, compression stockings, head-of-bed elevation) are not enough
- Refractory postural orthostatic tachycardia syndrome (POTS) — specialist cardiology use
- Severe recurrent vasovagal syncope — occasional off-label use
- Hyperkalaemic periodic paralysis — specialist neurology use
- Type IV renal tubular acidosis with hyperkalaemia — to promote potassium excretion
Note on the “BP” listing. Floricot raises blood pressure rather than lowering it — it is not a hypertension medicine. The BP category listing likely reflects its role in orthostatic hypotension (low BP on standing). For essential hypertension, thiazides, ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers are the appropriate classes.
How Does Fludrocortisone Work?
Fludrocortisone binds mineralocorticoid receptors in the distal tubule of the kidney and promotes:
- Sodium and water reabsorption — expanding circulating blood volume
- Potassium and hydrogen-ion excretion — lowering serum potassium and correcting acidosis
- Blood-pressure rise — via expanded intravascular volume and increased peripheral vascular sensitivity to endogenous catecholamines
Fludrocortisone also has weak glucocorticoid activity — about 1 mg fludrocortisone equals roughly 10 mg hydrocortisone for anti-inflammatory effect — but it is rarely used for that purpose because purer glucocorticoids are available.
Floricot Dosing
- Primary adrenal insufficiency (Addison’s): 50–200 mcg once daily in the morning
- Salt-losing CAH (children): weight-based, typically 50–300 mcg/day, under paediatric endocrinology
- Severe neurogenic orthostatic hypotension: start at 100 mcg once daily; titrate up to 400 mcg/day in divided doses as tolerated, monitoring supine BP, serum potassium, and for pedal oedema
- POTS, refractory vasovagal syncope: 100–200 mcg daily (specialist cardiology)
Take with food to reduce gastric irritation. Morning dosing mimics natural cortisol rhythm and is preferred. Swallow whole with water.
Dose adjustments: never stop abruptly in adrenal insufficiency — this will trigger an Addisonian crisis. Any dose change should be gradual and monitored.
Who Should Not Take Floricot?
- Known hypersensitivity to fludrocortisone or any excipient
- Systemic fungal infection
- Untreated severe hypertension (because fludrocortisone will worsen it)
- Uncontrolled heart failure (salt retention will worsen oedema)
- Severe osteoporosis (mineralocorticoid does not protect against steroid-induced bone loss)
- Use with caution in: diabetes mellitus (hyperglycaemia), renal impairment, peptic ulcer, psychiatric disease, glaucoma, cirrhosis
- Pregnancy — use only if necessary, under endocrinology supervision; essential in adrenal insufficiency
Side Effects
- Common (dose-dependent): fluid retention, ankle oedema, weight gain, raised blood pressure (supine hypertension), hypokalaemia (low potassium — leg cramps, muscle weakness), metabolic alkalosis
- Uncommon: headache, insomnia, mild glucose intolerance, easy bruising (glucocorticoid component)
- Rare but serious: heart failure aggravation (in pre-existing cardiac disease), severe hypokalaemia, osteoporosis (long-term), cataracts (very long-term), rarely severe hypersensitivity
For neurogenic orthostatic hypotension specifically, patients should be warned about supine hypertension — blood pressure when lying flat can rise excessively. Practical measures: elevate the head of the bed 10–15 cm; avoid dosing in the evening; discuss BP home monitoring with your doctor.
Monitoring on Floricot
- Supine and standing blood pressure (target: standing BP ≥ 90/60 mmHg without severe supine hypertension)
- Serum potassium (should stay 3.5–5.0 mmol/L)
- Serum sodium
- Body weight and ankle oedema
- In Addison’s disease: plasma renin (low plasma renin suggests over-replacement)
- Long-term: bone density, glucose tolerance, cataracts
Ordering & Delivery
MedsBase offers worldwide shipping on every order. Orders are dispatched in discreet packaging and arrive in branded manufacturer packs. If your preferred strength or pack size is out of stock, contact customer support for an ETA.
Medical disclaimer. The information on this page is provided for general education only. It is not a substitute for advice from your own doctor or pharmacist. Talk to a qualified healthcare professional before starting, stopping, or changing therapy.
Frequently Asked Questions
What is Floricot used for?
Floricot (fludrocortisone 100 mcg) is used for mineralocorticoid replacement in primary adrenal insufficiency (Addison’s disease) and congenital adrenal hyperplasia, and for the treatment of severe neurogenic orthostatic hypotension and postural orthostatic tachycardia syndrome.
Is Floricot a blood-pressure medicine?
Not in the usual sense — it raises blood pressure by promoting salt and water retention. It is used in patients who faint or feel dizzy on standing (orthostatic hypotension), not in patients with high blood pressure. For essential hypertension, entirely different classes are used.
Why must I take Floricot for life if I have Addison’s disease?
In Addison’s disease, the adrenal glands cannot produce enough aldosterone. Without mineralocorticoid replacement, sodium, water, and blood pressure fall, and potassium rises — progressing to potentially fatal Addisonian crisis. Fludrocortisone replaces what your body cannot make; lifelong therapy is essential, exactly like insulin for type 1 diabetes.
How long does Floricot take to work?
The first dose raises plasma volume within hours and improves orthostatic symptoms within 1–3 days. Full effect on standing blood pressure is usually seen within 1–2 weeks, as blood volume equilibrates at the new steady state.
Will Floricot make me gain weight?
Some weight gain from fluid retention is normal, particularly in the first 2–4 weeks. Rapid weight gain (> 2 kg in a week), ankle swelling, or shortness of breath may mean the dose is too high — contact your doctor.
Why am I getting muscle cramps on Floricot?
Cramps and weakness usually reflect low blood potassium (hypokalaemia). Fludrocortisone promotes potassium loss in the urine. If cramps are persistent, your doctor will check your electrolytes and may recommend a potassium-rich diet or supplement.
Can I stop Floricot suddenly?
No — particularly not in adrenal insufficiency. Abrupt withdrawal can trigger a life-threatening Addisonian crisis. Any dose change must be gradual and under specialist supervision.
Can I take Floricot in pregnancy?
In adrenal insufficiency, yes — continuation of fludrocortisone through pregnancy is essential. Dose adjustments may be needed, particularly in the second and third trimesters, under endocrinology supervision.
What happens if my blood pressure gets too high on Floricot?
This is a known dose-related effect. Your doctor will check supine and standing blood pressure at each visit. If supine BP exceeds 160/100 or you develop symptoms of heart failure, the dose will be reduced. Elevating the head of the bed at night and avoiding evening dosing can help.
Can I take Floricot with other blood-pressure medications?
Yes, but carefully. In adrenal insufficiency, antihypertensives are rarely needed. For orthostatic hypotension, fludrocortisone is sometimes combined with midodrine (a direct vasoconstrictor); the combination is effective but requires close BP monitoring.
Is Floricot a steroid?
Yes — fludrocortisone is a synthetic steroid with strong mineralocorticoid activity and weak glucocorticoid activity. It is not the same as anti-inflammatory steroids like prednisolone or dexamethasone — fludrocortisone is primarily a salt-retaining hormone replacement.
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| Strength | 100 mcg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
Floricot
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