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Astonin (Astonin H)
Strengths: 0.1 mg
Active substance: fludrocortisone
Shelf life: long
Pack sizes: 100 pcs
Indications: treatment of primary adrenal insufficiency — hypofunction of the adrenal cortex (Addison’s disease, congenital adrenal hyperplasia); treatment of salt-wasting syndrome; short-term treatment of severe disturbances of blood pressure regulation in the upright position (hypoadrenergic orthostatic hypotension (dysautonomia)
Top medicines with the same components: Cortineff, Fludrocortisone, Astonin
Instructions for use: Astonin H (Astonin H)
Brief reference information compiled from official German sources (Gelbe Liste, Fachinfo, Apotheken Umschau). It does not replace a doctor’s consultation or the package insert. This is a prescription medicine — use it only as directed by a doctor.
Active substance
Fludrocortisone (Fludrocortison, fludrocortisone acetate) — a synthetic mineralocorticoid; regulates water-salt metabolism, retains sodium and water, increases blood volume and blood pressure
Available forms
- Tablets 0.1 mg (Astonin H 0,1 mg Tabletten), round with a score line and the engraving EM 59; the tablet divides into two equal doses
- Pack sizes of 50 and 100 tablets (plastic tube or blister)
- Manufacturer/marketing authorisation holder in Germany: Merck Healthcare Germany GmbH
Indications
- Replacement therapy for Addison’s disease (primary adrenal cortex insufficiency, hypocorticism)
- Replacement therapy for salt-wasting syndrome (including in adrenogenital syndrome)
- Short-term therapy of severe hypoadrenergic orthostatic hypotension (dysautonomia) requiring treatment — only if general and physical measures are insufficient
How to take
The dose is selected by the doctor strictly individually, and in replacement therapy — under control of the renin level. The usual range in replacement therapy is from 1/2 to 2 tablets (0.05–0.2 mg of fludrocortisone) per day; in Addison’s disease, on average 1–2 tablets per day in combination with hydrocortisone. In orthostatic hypotension in adults, treatment starts with 1–2 tablets of 0.1 mg per day; the duration of such therapy is, as a rule, no more than 2 months. Take after meals, without chewing, washed down with a small amount of liquid.
Contraindications
- Hypersensitivity to fludrocortisone or excipients
- Age over 65 years (does not apply to replacement therapy)
- Arterial hypertension (high blood pressure)
- Hypotension due to organic heart diseases
- Hypokalaemia (reduced potassium), metabolic alkalosis
- Diseases in which a rise in blood pressure or oedema is dangerous: coronary heart disease, aortic aneurysm, heart failure, liver cirrhosis, renal failure, pulmonary oedema, phaeochromocytoma
- Hypovolaemic shock
Possible side effects
- Increased blood pressure (hypertension)
- Oedema and weight gain
- Hypokalaemia (potassium loss) — risk of cardiac arrhythmias, muscle weakness, constipation, apathy
- Cardiac hypertrophy (with long-term use of high doses)
- Visual disturbances (blurred vision)
- Headache
- With replacement therapy at a correctly selected dose, side effects other than hypersensitivity are, as a rule, not expected
Special precautions
- Prescription medicine in Germany (verschreibungspflichtig)
- Careful individual dose selection and regular monitoring of weight, blood pressure and blood electrolytes (potassium, sodium) are required
- A low-salt diet and additional potassium intake (bananas, dried apricots, potatoes) may be needed
- In Addison’s disease and salt-wasting syndrome, treatment is permanent (lifelong) — do not discontinue or change the dose on your own
- In orthostatic hypotension, the course is usually no longer than 2 months
- Avoid regular consumption of liquorice (licorice) during treatment; caution with grapefruit
- If blurred vision appears — examination by an ophthalmologist
Sources: www.fachinfo.de, www.gelbe-liste.de, www.gelbe-liste.de, www.rote-liste.de, www.apotheken-umschau.de
