FLUDROCORTISONE

• Serious side effects (inform your doctor immediately)
  • change in skin appearance (e.g., color changes, thinning, fatty areas), easy bleeding/bruising, dizziness, slow wound healing, signs of infection (e.g., fever, persistent sore throat, skin sores), bone/joint/muscle pain, stomach/abdominal pain, puffy face, swelling of the hands/feet, severe tiredness, increased thirst/urination, unusual weight gain, muscle weakness, black stools, eye problems (e.g., pain, redness, vision changes), severe/continuous headaches, fast/pounding/irregular heartbeat, mental/mood changes (e.g., agitation, depression, mood swings), seizure, vomit that looks like coffee grounds.

• Severe allergic reactions are rare. Get immediate medical help if you notice the following:
  • Rash
  • Itching/swelling (especially of the face/tongue/throat)
  • Severe dizziness
  • Trouble breathing

Precautions

• Inform your doctor
  • Allergy to the medication or any allergies
  • Medical History of fungal infection in your blood (e.g., candidiasis, valley fever), bleeding problems, blood clots, brittle bones (osteoporosis), diabetes, eye problems (e.g., cataracts, glaucoma, infection of the eye), heart problems (e.g., congestive heart failure), high blood pressure, infections (e.g., herpes, tuberculosis), kidney disease, liver disease (e.g., cirrhosis), mental/mood disorders (e.g., anxiety, depression, psychosis), low blood minerals (e.g., calcium, potassium), stomach/intestinal problems (e.g., diverticulitis, peptic ulcer disease, ulcerative colitis), seizures, thyroid problems.

• Signs of infection may be masked therefore any injuires or signs of infection must be reported such as persistent sore throat/fever/cough, pain while urinating, skin sores) that occur during treatment.

• Do not receive any vaccines during or after treatment with fludarabine. Consult with your physician before receiving any vaccine.

• Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.

• Exposure to chickenpox or measles infection must be avioded while taking this medication unless you have previously had these infections (e.g., in childhood). If exposure is suspected, seek immediate medical attention.
• Limit alcoholic beverages while taking this medication to lower the risk of stomach/intestinal bleeding.

• This medication may slow down a child’s growth with prolonged use. Consult uour physician for more details.

• Should only be used when there is a clear need during pregnancy as it may harm an unborn baby. If you are planning to be pregnant or think you may be pregnant, discuss the risks and benefits of use with your doctor.

• Consult your doctor before breast-feeding as this medication passes into breast milk and may cause unwanted effects on your baby

Interactions

Taking multiple drugs may affect how medications work and/or cause unwanted side effects. List down all the medications you are taking and inform your physician and pharmacist. Do not take, discontinue, or alter any dose of medications without prior approval of your physician.

• Products that may interact with this medication include:
  • aldesleukin
  • digoxin
  • drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel
  • “blood thinners” such as dabigatran/warfarin
  • NSAIDs such as aspirin/celecoxib/ibuprofen)
  • hormones (e.g., androgens, birth control pills, estrogens)
  • immunosuppressants (e.g., cyclosporine)
  • mifepristone
  • vaccines
  • drugs affecting liver enzymes that remove fludrocortisone from your body (e.g., rifamycins such as rifampin/rifabutin, certain anti-seizure medicines such as barbituates/phenytoin).

If your doctor prescribed you low dose aspirin, continue to take it unless you are told otherwise

• If overdose is suspected, contact a poison control center or emergency room immediately.
• Symptoms of overdose may include high blood pressure, water retention, extreme weight gain, and muscle weakness.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and as soon as you remember, take a regular dose or if the time of the next dose is near, wait for it before taking another dose and resume your usual schedule. Do not increase the dose to compensate for the missed dose.

Storage:

• Different brands of this product have different storage needs.
• Check the product package for instructions on how to store your brand or ask the pharmacist.
• Do not store in the bathroom.
• Keep all medicines away from children and pets.