How do I install the Enda Fludrocortisone Aldosterone Deficiency skill?

Run npx skillmds@latest add dromlakhani/enda-fludrocortisone-aldosterone-deficiency in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Enda Fludrocortisone Aldosterone Deficiency safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: docs only. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Enda Fludrocortisone Aldosterone Deficiency?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Enda Fludrocortisone Aldosterone Deficiency free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Enda Fludrocortisone Aldosterone Deficiency?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Enda Fludrocortisone Aldosterone Deficiency by dromlakhani

Name: Enda Fludrocortisone Aldosterone Deficiency
Rating: 4.5 (4 reviews)
Author: dromlakhani

Enda Fludrocortisone Aldosterone Deficiency

Recommends initiating fludrocortisone 50–100 µg daily for mineralocorticoid replacement in adults with confirmed aldosterone deficiency (e.g., low aldosterone, elevated renin) and no salt restriction. Use when aldosterone deficiency is confirmed in a patient with primary adrenal insufficiency (PAI) presenting with salt craving or postural hypotension.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Initiate Fludrocortisone for Aldosterone Deficiency with Specific Starting Dose

STEP 1 — Gather Information

Confirm primary adrenal insufficiency (PAI) diagnosis; measure morning plasma aldosterone and renin to demonstrate low aldosterone with elevated renin; assess for symptoms of mineralocorticoid deficiency (salt craving, postural hypotension, hyponatremia, hyperkalemia); ensure no concurrent salt restriction; review blood pressure for hypertension.

STEP 2 — Rule In / Rule Out

Is aldosterone deficiency confirmed (low aldosterone with inappropriately normal or high renin)?

Yes → Proceed to STEP 3.
No → Do not initiate fludrocortisone; reassess etiology.

STEP 3 — Classify or Stratify

Is the patient an adult (≥18 years)?

Adult → Use starting dose 50–100 µg daily.
Pediatric → Refer to pediatric dosing (e.g., 100 µg/d for children, infant salt supplements).

STEP 4 — Decide

Initiate fludrocortisone at 50–100 µg once daily in the morning; counsel patient not to restrict salt intake; schedule follow‑up in 2–4 weeks to assess symptoms, blood pressure, and electrolytes.

Clinical Guardrails / Mimics / Pitfalls

Avoid in patients with uncontrolled hypertension or edema; monitor for signs of over‑replacement (hypertension, supine edema, hypokalemia); do not combine with licorice, grapefruit juice, or potent CYP3A4 inducers that may alter fludrocortisone metabolism; fludrocortisone is not indicated for secondary adrenal insufficiency; if hypertension develops, reduce dose before adding antihypertensives.

Concrete Clinical Example

A 34‑year‑old woman with newly diagnosed PAI (low cortisol, high ACTH) has serum aldosterone 2 ng/dL (low), renin 45 mIU/L (high), reports salt craving and occasional light‑headedness on standing. She is normotensive. Start fludrocortisone 100 µg daily, advise liberal salt intake, and re‑evaluate in 3 weeks.

Source: Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-1710

TODO: consider adding scripts/calc.py for the enda-fludrocortisone-aldosterone-deficiency calculator

---name: enda-fludrocortisone-aldosterone-deficiencydescription: Recommends initiating fludrocortisone 50–100 µg daily for mineralocorticoid replacement in adults with confirmed aldosterone deficiency (e.g., low aldosterone, elevated renin) and no salt restriction. Use when aldosterone deficiency is confirmed in a patient with primary adrenal insufficiency (PAI) presenting with salt craving or postural hypotension.---# Initiate Fludrocortisone for Aldosterone Deficiency with Specific Starting Dose## STEP 1 — Gather InformationConfirm primary adrenal insufficiency (PAI) diagnosis; measure morning plasma aldosterone and renin to demonstrate low aldosterone with elevated renin; assess for symptoms of mineralocorticoid deficiency (salt craving, postural hypotension, hyponatremia, hyperkalemia); ensure no concurrent salt restriction; review blood pressure for hypertension.## STEP 2 — Rule In / Rule OutIs aldosterone deficiency confirmed (low aldosterone with inappropriately normal or high renin)? - Yes → Proceed to STEP 3. - No → Do not initiate fludrocortisone; reassess etiology.## STEP 3 — Classify or StratifyIs the patient an adult (≥18 years)? - Adult → Use starting dose 50–100 µg daily. - Pediatric → Refer to pediatric dosing (e.g., 100 µg/d for children, infant salt supplements).## STEP 4 — DecideInitiate fludrocortisone at 50–100 µg once daily in the morning; counsel patient not to restrict salt intake; schedule follow‑up in 2–4 weeks to assess symptoms, blood pressure, and electrolytes.## Clinical Guardrails / Mimics / PitfallsAvoid in patients with uncontrolled hypertension or edema; monitor for signs of over‑replacement (hypertension, supine edema, hypokalemia); do not combine with licorice, grapefruit juice, or potent CYP3A4 inducers that may alter fludrocortisone metabolism; fludrocortisone is not indicated for secondary adrenal insufficiency; if hypertension develops, reduce dose before adding antihypertensives.## Concrete Clinical ExampleA 34‑year‑old woman with newly diagnosed PAI (low cortisol, high ACTH) has serum aldosterone 2 ng/dL (low), renin 45 mIU/L (high), reports salt craving and occasional light‑headedness on standing. She is normotensive. Start fludrocortisone 100 µg daily, advise liberal salt intake, and re‑evaluate in 3 weeks.**Source:** Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-1710> **TODO:** consider adding scripts/calc.py for the enda-fludrocortisone-aldosterone-deficiency calculator

Frequently asked questions