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Fludrocortisone + prednisolone is a combination of two corticosteroids, each with distinct but complementary pharmacological actions. Fludrocortisone is a synthetic mineralocorticoid primarily used to replace aldosterone in conditions like Addison's disease and salt-losing adrenogenital syndrome. It acts by promoting sodium retention and potassium excretion, thereby helping maintain electrolyte balance and blood pressure[5][6][10]. Prednisolone is a synthetic glucocorticoid with potent anti-inflammatory and immunosuppressive properties, widely used to treat autoimmune, inflammatory, allergic, and various other disorders[4]. The rationale for combining these agents lies in their ability to provide both mineralocorticoid (fludrocortisone) and glucocorticoid (prednisolone) effects—potentially allowing lower doses of each drug while maintaining efficacy for certain indications such as autoimmune or immune-mediated diseases (e.g., hearing loss), thus reducing the risk of side effects associated with higher doses of glucocorticoids alone[1]. Both drugs act via binding to their respective steroid hormone receptors—mineralocorticoid receptor for fludrocortisone and glucocorticoid receptor for prednisolone.
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