Fludrocortisone

  • Fludrocortisone works to increase volume expansion (and blood volume) by helping the kidneys retain water and sodium (Hasan et al., 2020).

  • As the kidneys retain more water and sodium, they eliminate more potassium, making it important for providers to monitor potassium levels (Grijalva et al., 2017). 

  • Although there can be some understandable downsides to taking systemic corticosteroids, it is important to weigh the risks and benefits when it comes to considering any medication for patients with POTS and other potential co-occurring conditions.

Sources:

Grijalva, C. G., Biaggioni, I., Griffin, M. R., & Shibao, C. A. (2017). Fludrocortisone is associated with a higher risk of all‐cause hospitalizations compared with midodrine in patients with orthostatic hypotension. Journal of the American Heart Association, 6(10). https://doi.org/10.1161/jaha.117.006848

Hasan, B., Almasri, J., Marwa, B., Klaas, K. M., & Fischer, P. R. (2020). Treatment of postural orthostatic tachycardia syndrome with medication: A systematic review. Journal of Child Neurology, 35(14), 1004–1016. https://doi.org/10.1177/0883073820948679