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Children who are on immunosuppressant drugs are more susceptible to infections than healthy childrenChicken pox and measlesfor examplecan have a more serious or even fatal course in children on immunosuppressant corticosteroidsIn such childrenor in adults who have not had these diseasesparticular care should be taken to avoid exposureIf exposedtherapy with varicella zoster immune globulinVZIGor pooled intravenous immunoglobulinIVIGas appropriatemay be indicatedIf chicken pox developstreatment with antiviral agents may be considered.
Elderly subjects may commonly have conditions that may be exacerbated by fludrocortisone therapy includingbut not limited tohypertensionedemahypokalemiacongestive heart failurecataractsglaucomaincreased intraocular pressurerenal insufficiencyand osteoporisissee WARNINGSPRECAUTIONS and ADVERSE REACTIONSElderly subjects may also commonly be taking concomitant drug therapy such as digitalis glycosidesoral anticoagulantsantidiabetic drugsoral agents and insulinand aspirin which may interact with fludrocortisonesee PRECAUTIONSDrug Interactions
Aspirin should be used cautiously in conjunction with corticosteroids in patients with hypoprothrombinemia.
Corticosteroids are contraindicated in patients with systemic fungal infections and in those with a history of possible or known hypersensitivity to these agents.
To avoid drug-induced adrenal insufficiencysupportive dosage may be required in times of stresssuch as traumasurgeryor severe illnessboth during treatment with fludrocortisone acetate and for a year afterwards.
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