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Long Term Florinef Use: Dose Escalation Required?


Annaliese

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I have been on florinef now since July I want to say. I started on .1 and it didn't seem to help much, I was moved to .2 shortly after. If anything, since time has passed, it seems like the florinef is working better. It took over a month to begin working. This could also have to do with disease course improvement, but my bp is going up and my hr is going down. Additionally, my blood sodium levels popped way up, so I know it is working. I took a beta blocker before florinef and it seemed like my body got used to it and that I would progressively need more. So I kind of understand what you mean by tolerance, but haven't had that yet with the florinef. In fact, I am considering reducing mine soon.

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Yes, I have wondered the same. I don't want to have to be on it forever but when i reduce the dose my symptoms return slightly. At the moment I only take .033mg - a third of a tablet. It seems to be the right does for me as it pushes my bp up too much otherwise. The other problem for me is it is causing slight depression - i think this is quite unusual.

So like you Annaliese I want to know how easily people increase and decrease doses.

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I'm currently doing the Florinef dance (see my other posts). I was put on it in Jan. 2011 because I was having breakthrough hypotensive episodes (turns out my main bp med was changed to a generic w/o my knowledge). I'm now in the process of trying to wean down / off, because it gives me really bad headaches and brain fog that I can't shake. I was on .1 for about 6 months, then .15 for about another 4 months. Once I was back on the brand of my main bp med, my bp went back up enough points that doc was ok with tapering down.

I went to .1 in October and stayed there for a few months while we were monkeying with other things. Now I'm on a schedule to reduce by .025 every 4-6 weeks. I tried it faster in January (.05 every 2 weeks), but I crashed and burned. Once you are on florinef for awhile (more than a couple of months), you need to taper slowly b/c your adrenals have atrophied. That seems to be what has happened to me. As I've tapered, I've kept religious track of my bp 3 x a day, and it has been consistently ~105/65 (which is a good target for me) even when I have reduced. I'm optomistic that this shows that my adrenals are "healing!" When I tried to go faster, I got into the low 90s/mid-50s, which is presyncope for me!

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It's been a godsend but has anyone not been able to get their adrenals to start back up again? I don't know what the long term use side effects are?

However when I reduce the dose i remember absolutely why I take it and continue on my normal dose 1/3 Tablet a day.

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Emma, I think when you ask about adrenals not "starting up" again, it begs the question of whether there is some underlying adrenal insufficiency for that particular patient. If adrenals aren't working in the first place, don't think you could get them to "start up" again. But, assuming there isn't, I haven't seen anything to suggest that the adrenals don't start working again (I had that question as well). I've been on Florinef 3 separate times -- in 2007 for about 4 months, in 2008 / 2009 for about 6 months, and this time around we're at about 14 months. Both times before my adrenals recovered, and doc doesn't think it will be any different this time, but we just have to go slow. I don't have any underlying adrenal insufficiency that I've been diagnosed with. She's a PCP, not an endocrinologist, so take that with a grain of salt! I'd be interested in what endos have said.

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