fludrocortisone / Generic mfg. - LARVOL DELTA

Myxedema Coma with Cardiogenic Shock: Diagnostic Challenges and Risks of Amiodarone in Acute Thyroid Failure. (PubMed, HCA Healthc J Med) - "She subsequently experienced worsening encephalopathy, hypotension, and bradyarrhythmia, which required intubation, multiple vasopressors, IV levothyroxine, hydrocortisone, fludrocortisone, and mechanical ventilation. Although amiodarone is commonly used for ventricular arrhythmia management due to its acute electrical stabilizing properties, its effects on thyroid hormone metabolism warrant caution in patients with underlying thyroid disease. Early recognition and coordinated endocrine cardiac management are critical to improving outcomes in this high-risk population."

Journal • Breast Cancer • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Endocrine Cancer • Endocrine Disorders • Heart Failure • Hypotension • Nephrology • Oncology • Pulmonary Disease • Renal Disease • Solid Tumor • Ventricular Tachycardia

OMAHA-004: Phase 3 trial of the steroidogenesis inhibitor opevesostat versus androgen receptor pathway inhibitor (ARPI) switch in participants with metastatic castration-resistant prostate cancer after a prior ARPI (AUA 2026) - P3 | "Approximately 1314 pts will be randomized 1:1 to opevesostat 5 mg orally twice daily (BID) + dexamethasone 1.5 mg and fludrocortisone 0.1 mg orally once daily or abiraterone acetate 1000 mg orally once daily + prednisone 5 mg orally BID (if prior enzalutamide, darolutamide, or apalutamide) or enzalutamide 160 mg orally once daily (if prior abiraterone). Stratification factors are metastatic site (bone only vs liver vs other), AR ligand binding mutation (AR-LBDm) status (positive vs negative), and prior docetaxel treatment for HSPC (yes vs no)...Other secondary end points include time to initiation of first subsequent anticancer therapy or death, objective response rate and duration of response per PCWG3-modified RECIST v1.1 by BICR, time to pain progression; time to prostate-specific antigen (PSA) progression, PSA response rate, time to first symptomatic skeletal-related event, and safety and tolerability. Enrollment is ongoing."

Metastases • P3 data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Hormone Sensitive Prostate Cancer • Oncology • Prostate Cancer • Solid Tumor • Urology

PHASE 3 MK-5684-004 STUDY OF CYP11A1 INHIBITOR OPEVESOSTAT VERSUS NEXT-GENERATION HORMONAL AGENT (NHA) SWITCH IN PATIENTS WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER AFTER 1 PRIOR NHA (SUO 2024) - P3 | "Approximately 1500 patients (375 with, 1125 without AR-LBD mutations) will be randomly assigned 1:1 to receive opevesostat 5 mg PO BID + dexamethasone 1.5 mg and fludrocortisone 0.1 mg PO QD or abiraterone acetate 1000 mg PO QD (if prior enzalutamide/darolutamide/apalutamide) or enzalutamide 160 mg PO QD (if prior abiraterone). This abstract was previously presented at the 2024 ASCO Annual Meeting. ."

Clinical • Metastases • P3 data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Hormone Sensitive Prostate Cancer • Oncology • Prostate Cancer • Solid Tumor

1389: Critical Endocrinopathies in the ICU (CHEST 2026) - "Differentiate adrenal crisis, CIRCI, and appropriate corticosteroid regimens, including an appraisal of the debated role of fludrocortisone in septic shock...5. Evaluate emerging literature to inform clinical decision-making amid conflicting evidence in critical care endocrinology."

Endocrine Disorders • Septic Shock

Mucocutaneous Hyperpigmentation as the Diagnostic Clue to Autoimmune Polyglandular Syndrome Type 2: A Case Report. (PubMed, Cureus) - "Treatment with intravenous hydrocortisone and fluid resuscitation was followed by levothyroxine and fludrocortisone replacement, resulting in rapid clinical improvement, the normalization of biochemical abnormalities, and complete recovery. This case highlights the diagnostic value of meticulous physical examination in patients presenting with otherwise unexplained constitutional symptoms. Recognition of these characteristic physical findings may facilitate the early diagnosis of autoimmune primary adrenal insufficiency, enabling appropriate hormone replacement before progression to adrenal crisis."

Journal • Diabetes • Endocrine Disorders • Fatigue • Immunology • Metabolic Disorders • Nephrology • Pain • Rare Diseases • Renal Disease • Type 1 Diabetes Mellitus

Plasma renin levels, fludrocortisone dose and blood pressure in children 0-3 years of age with classic 21-hydroxylase deficiency congenital adrenal hyperplasia (ESPE 2026) - No abstract available

Clinical • Congenital Adrenal Hyperplasia • Endocrine Disorders

Comparative Safety of Midodrine versus Fludrocortisone in Hypotensive Heart Failure with Reduced Ejection Fraction: A Propensity-Matched Real-World Analysis (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Real-world • Real-world evidence • Cardiovascular • Congestive Heart Failure • Heart Failure

Persistent Elevation of Thyroid-Stimulating Hormone Despite Levothyroxine Therapy Revealing Autoimmune Adrenal Insufficiency in an Adolescent With Autoimmune Thyroiditis: A Case Report and Review of Literature. (PubMed, Horm Res Paediatr) - "Our case highlights the importance of considering AAI in children with autoimmune thyroiditis who have persistent elevation of TSH despite levothyroxine therapy, particularly when accompanied by suggestive clinical features or biochemical abnormalities. Although persistently elevated TSH is nonspecific and may have multiple explanations, including variable adherence or absorption, recognition of coexisting AAI is essential to avoid delayed diagnosis and potentially life-threatening adrenal crisis."

Journal • Endocrine Disorders • Fatigue • Immunology • Nephrology • Pain • Pediatrics • Rare Diseases • Renal Disease

Late Recognition of Aromatase Deficiency Following 16 Years of Misdiagnosis as Congenital Adrenal Hyperplasia: A Case with Coexisting Gonadoblastoma and Dysgerminoma. (PubMed, J Clin Res Pediatr Endocrinol) - "We describe a 20-year-old female with ambiguous genitalia at birth who was diagnosed in infancy with 21OHD and treated with hydrocortisone and fludrocortisone. To our knowledge, this is the first reported case of genetically confirmed aromatase deficiency with coexisting gonadoblastoma and dysgerminoma. Whether this coexistence represents a causal association or a coincidental finding remains uncertain."

Journal • Congenital Adrenal Hyperplasia • Endocrine Disorders • Germ Cell Tumors • Nephrology • Oncology • Renal Disease • Women's Health • CYP19A1

Granulomatous Hepatitis and Adrenal Insufficiency Revealing Disseminated Histoplasmosis (ACG 2026) - "Given the electrolyte abnormalities and adrenal enlargement, primary adrenal insufficiency was suspected, and hydrocortisone and fludrocortisone were initiated with clinical improvement. Prompt initiation of itraconazole resulted in normalization of transaminases and clinical improvement, emphasizing the importance of early recognition and targeted antifungal therapy for potentially reversible hepatic injury Figure: CT abdomen demonstrating bilateral adrenal enlargement in the setting of disseminated Histoplasmosis. Figure: Liver biopsy demonstrating granulomatous hepatitis with lobular granulomatous inflammation (H&E stain)."

Cardiovascular • Endocrine Disorders • Fibrosis • Heart Failure • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Nephrology • Renal Disease

Persistent Diarrhea and Orthostatic Hypotension; Uncovering the Impact of Diabetic Autonomic Neuropathy (ACG 2026) - "Gastroenterology consultation initially recommended incorporating high-dose cholestyramine, scheduled l omotil, imodium, and empiric rifaximin for possible small intestine bacterial overgrowth...Her blood pressure remained labile despite volume repletion, prompting the initiation of midodrine & fludrocortisone for support...Furthermore, in this patient, first and second line therapies were ineffective and led to longstanding diarrhea with severe volume loss. Earlier initiation of octreotide may be warranted in similar patient populations."

Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Neuropathy • Hypotension • Metabolic Disorders • Renal Disease • GAST

PALETTE: Adaptive Platform Trial for Personnalisation of Sepsis Treatment in Children and Adults: a Multi-national, Treatable Traits-guided, Adaptive, Exploratory, Bayesian Basket Trial (clinicaltrials.gov) - P2 | N=2000 | Recruiting | Sponsor: Assistance Publique - Hpitaux de Paris | Not yet recruiting ➔ Recruiting

Enrollment open • Infectious Disease • Septic Shock

Case Report: Low-dose mitotane in a case of recurrent adrenocortical carcinoma: a 20-year clinical perspective. (PubMed, Front Oncol) - "At the latest assessment, the patient remained in good general condition and continued hydrocortisone 40 mg/day, fludrocortisone 0.1 mg/day, and levothyroxine. This case documents sustained disease control during and after almost 20 years of individualized mitotane therapy following recurrent ACC. It emphasizes the importance of dose adaptation, therapeutic drug monitoring, careful endocrine replacement, and cautious interpretation of long-term benefit in a single patient."

Journal • Adrenal Cortex Carcinoma • Endocrine Disorders • Genito-urinary Cancer • Nephrology • Oncology • Renal Disease • Solid Tumor

Recurrent Syncope Due to Orthostatic Hypotension Following Lateral Medullary Infarction: A Case Report. (PubMed, Intern Med) - "Sequential treatment with midodrine, fludrocortisone, and droxidopa resolved the symptoms. Serial head-up tilt testing suggested a partial improvement in the orthostatic hemodynamic responses. Orthostatic hypotension should be considered in patients with lateral medullary infarction and positional symptoms, and serial head-up tilt testing may help document any changes in the orthostatic hemodynamic response."

Journal • Ataxia • Cardiovascular • Hypotension • Movement Disorders

Postural Orthostatic Tachycardia Syndrome (POTS): A Review. (PubMed, JAMA) - "Pharmacological therapies should be individualized and may include β-blockers, ivabradine, midodrine, fludrocortisone, and pyridostigmine, although evidence supporting many therapeutic interventions is limited by small studies and lack of large, randomized trials. POTS is a chronic autonomic disorder associated with functional impairment and reduced quality of life that is diagnosed based on characteristic orthostatic symptoms in the absence of orthostatic hypotension after excluding alternative causes of sinus tachycardia. Treatment involves nonpharmacological measures (such as increased fluid and sodium intake), lower-body compression garments, structured exercise training, and individualized pharmacological therapy."

Journal • Anorexia • Cardiomyopathy • Cardiovascular • CNS Disorders • Cognitive Disorders • Constipation • Endocrine Disorders • Epstein-Barr Virus Infections • Fatigue • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • Hypotension • Infectious Disease • Influenza • Musculoskeletal Pain • Nephrology • Novel Coronavirus Disease • Oncology • Pain • Pulmonary Disease • Renal Disease • Respiratory Diseases • Sleep Disorder • Solid Tumor

Perioperative Anesthetic Management of a Pediatric Patient with Severe Propionic Acidemia After Orthotopic Liver Transplant Undergoing a Combined Procedure (ASA 2026) - "Second, management of her post-OLT complications of adrenal insufficiency secondary to hyponatremia, requiring daily fludrocortisone, and hypertension secondary to immunosuppressant use. Third, the procedure duration; the longer the anesthetic, the higher the perioperative complication risk."

Clinical • Cardiovascular • Endocrine Disorders • Heart Failure • Hypertension • Hypoglycemia • Metabolic Disorders • Nephrology • Pediatrics • Renal Disease • Transplantation

Investigating a Mineralocorticoid Receptor Mediation of an Ultra-Short Feedback Loop Regulating Aldosterone Production in Humans. (PubMed, Clin Endocrinol (Oxf)) - P1 | "In humans, MR antagonist treatment led to a greater increase in aldosterone in response to cosyntropin stimulation as compared to placebo, but not after ANGII stimulation. Future studies are needed to investigate the presence of a MR-mediated ultra-short feedback loop at the level of the adrenal gland regulating aldosterone production in humans."

Journal • Cardiovascular

A Phase II, Multicentre, 2-part, Study of the Safety, Tolerability, and Efficacy of Intravitreal Fludrocortisone Acetate in Subjects with Geographic Atrophy Secondary to Age-related Macular Degeneration (ANZCTR) - P2 | N=9 | Completed | Sponsor: EyeCo Pty Ltd | Active, not recruiting ➔ Completed

Trial completion • Age-related Macular Degeneration • Dry Age-related Macular Degeneration • Macular Degeneration • Ophthalmology • Retinal Disorders

Primary Bilateral Adrenal Lymphoma Revealed by Adrenal Insufficiency: From Constitutional Symptoms to Crisis. (PubMed, Cureus) - "Biopsy demonstrated diffuse large B‑cell lymphoma consistent with PAL, and he was commenced on hydrocortisone and fludrocortisone replacement together with eight cycles of R‑CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride (hydroxydaunorubicin), vincristine sulfate (Oncovin), and prednisolone) and intrathecal methotrexate, achieving complete radiological remission sustained to 2016, with remission maintained until his death from sepsis and multi‑organ failure in 2023. This case illustrates the broad symptom spectrum of PAL, from B-symptoms to adrenal crisis, and underscores the importance of considering PAL in the differential diagnosis of bilateral adrenal masses with high attenuation. Early recognition of adrenal insufficiency and adrenal biopsy are critical to guide timely initiation of life-saving glucocorticoid replacement and lymphoma-directed therapy."

Journal • Anorexia • B Cell Lymphoma • B Cell Non-Hodgkin Lymphoma • Diffuse Large B Cell Lymphoma • Endocrine Disorders • Hematological Malignancies • Infectious Disease • Lymphoma • Musculoskeletal Pain • Nephrology • Non-Hodgkin’s Lymphoma • Oncology • Pain • Renal Disease • Septic Shock

Sepsis 2026: diagnosis and treatment (PubMed, Med Klin Intensivmed Notfmed) - "Key elements include obtaining blood cultures before antimicrobials, balanced crystalloids as first-line fluids, norepinephrine as the main vasopressor, and-if vasopressor requirements persist-adjunctive strategies such as vasopressin or hydrocortisone ± fludrocortisone depending on the clinical scenario. Prevention (infection prevention, antibiotic stewardship (ABS)/antimicrobial stewardship (AMS) programs) and structured follow-up aim to reduce long-term sequelae after sepsis."

Journal • Infectious Disease • Septic Shock

When Treatment Becomes the Trigger: Fludrocortisone-Associated Hypokalaemia in an Older Adult. (PubMed, Cureus) - "Following intravenous potassium replacement and discontinuation of fludrocortisone, with initiation of midodrine as an alternative therapy, the patient's potassium levels normalised and her symptoms improved. This case highlights the importance of medication review and regular electrolyte monitoring in older adults, particularly those receiving mineralocorticoid therapy."

Journal • Geriatric Disorders • Hypotension

The role of renin, fludrocortisone and hypertension in early childhood in patients with congenital adrenal hyperplasia. (PubMed, Eur J Endocrinol) - "Renin suppression in early childhood is associated with increased hypertension risk, whereas higher renin was not associated with growth or electrolyte abnormalities. These findings emphasize the importance of avoiding mineralocorticoid overtreatment and monitoring blood pressure carefully."

Journal • Cardiovascular • Congenital Adrenal Hyperplasia • Endocrine Disorders • Hypertension

Modified-release hydrocortisone (Efmody®) in children with congenital adrenal hyperplasia: a retrospective registry study. (PubMed, Front Endocrinol (Lausanne)) - "Replacement therapy for congenital adrenal hyperplasia (CAH) in childhood includes hydrocortisone and, in salt-wasting forms, addition of fludrocortisone. No adrenal crisis was observed. Twice-daily HMRC therapy can also improve CAH therapy in children and adolescents in terms of hormonal control and growth."

Journal • Retrospective data • Congenital Adrenal Hyperplasia • Endocrine Disorders

Hydrocortisone for septic shock: with or without fludrocortisone? (PubMed, Anaesthesiologie) - "In addition to presenting new results from clinical trials and meta-analyses, arguments for and against the additive use of fludrocortisone are discussed and the underlying pathophysiological mechanisms are elucidated. Finally, clinically relevant guidance regarding the practical application of steroids in sepsis is provided."

Journal • Review • Endocrine Disorders • Infectious Disease • Nephrology • Renal Disease • Septic Shock

Striking Scrotal Hyperpigmentation as an Early Clinical Sign of Familial Glucocorticoid Deficiency Type 2: A Case with Homozygous MRAP Variant. (PubMed, J Clin Res Pediatr Endocrinol) - "Hydrocortisone therapy was initiated promptly, and during follow-up, transient hyperkalemia and low-normal aldosterone levels necessitated short-term fludrocortisone supplementation, suggesting partial mineralocorticoid involvement. This case highlights striking neonatal scrotal hyperpigmentation as a potential early clinical clue suggestive of familial glucocorticoid deficiency in a patient with a homozygous MRAP variant. Importantly, even when newborn screening for CAH is normal, marked hyperpigmentation should prompt evaluation for other causes of primary adrenal insufficiency to prevent life-threatening adrenal crises."

Journal • Congenital Adrenal Hyperplasia • Endocrine Disorders • Nephrology • Renal Disease