Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
PERCORTEN vs FLUIDIL
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Percorten (desoxycorticosterone pivalate) is a synthetic mineralocorticoid that binds to and activates the mineralocorticoid receptor (MR) in the renal distal tubule, leading to increased sodium reabsorption, increased potassium and hydrogen ion excretion, and water retention, thereby expanding extracellular fluid volume and increasing blood pressure.
Fluidil is a thiazide-like diuretic that inhibits the sodium-chloride symporter (NCC) in the distal convoluted tubule of the nephron, reducing sodium and chloride reabsorption and promoting diuresis.
Adjunctive therapy in adrenocortical insufficiency (Addison's disease) for mineralocorticoid replacement,Off-label: Treatment of orthostatic hypotension due to autonomic dysfunction
Hypertension,Edema associated with congestive heart failure,Edema associated with renal disease,Edema associated with hepatic cirrhosis
1-5 mg intramuscularly or subcutaneously daily with dose adjusted based on clinical response and electrolyte monitoring.
5 mg orally once daily.
Terminal elimination half-life is approximately 30-40 minutes. Clinically, the short half-life necessitates frequent dosing (e.g., every 6-12 hours) to maintain therapeutic effect in mineralocorticoid replacement.
Terminal elimination half-life: 1.5-2 hours (prolonged in hepatic impairment to 4-6 hours).
Primarily hepatic via reduction and conjugation; excreted in urine as metabolites. Desoxycorticosterone pivalate is a prodrug that is hydrolyzed to desoxycorticosterone, which is then metabolized.
Fluidil is extensively metabolized in the liver, primarily via glucuronidation and sulfation; cytochrome P450 enzymes play a minor role.
Renal (biliary/fecal negligible). Approximately 50-70% of a dose is excreted as metabolites in urine; <5% unchanged.
Renal: 60-70% unchanged; biliary/fecal: <5%; hepatic metabolism: 25-35%.
Approximately 90-94% bound to albumin and corticosteroid-binding globulin (CBG).
85-92% bound to albumin, alpha-1-acid glycoprotein.
Vd approximately 0.5-0.8 L/kg. Clinical meaning: Distributes primarily into extracellular fluid; low Vd indicates limited tissue penetration.
0.8-1.2 L/kg (extensive tissue distribution).
Oral: Approximately 50-70% (high first-pass metabolism). IM/SC: 100% (assumed).
Oral: 60-80% (first-pass metabolism).
No specific GFR-based dose adjustments established; use with caution in renal impairment due to potential for fluid retention and hypertension.
No dose adjustment required for GFR ≥30 m L/min. Not recommended for GFR <30 m L/min.
No specific Child-Pugh based dose adjustments; caution in severe hepatic impairment due to reduced metabolism and increased risk of adverse effects.
Child-Pugh Class A: no adjustment. Child-Pugh Class B: 2.5 mg once daily. Child-Pugh Class C: not recommended.
0.1-0.3 mg/kg intramuscularly or subcutaneously daily, divided every 12-24 hours, with titration based on clinical response.
Not established for pediatric patients <18 years.
Initiate at lower end of adult dose (1 mg daily) with careful monitoring for fluid overload and electrolyte disturbances due to age-related renal and cardiovascular changes.
No specific adjustment; use caution due to increased sensitivity.
None
No FDA black box warning has been issued for Fluidil.
May cause severe hypertension, edema, congestive heart failure, hypokalemia, or metabolic alkalosis. Monitor blood pressure, serum electrolytes, and body weight. Use with caution in patients with cardiac disease, renal impairment, or hepatic disease. Avoid excessive sodium intake.
Electrolyte imbalance (hypokalemia, hyponatremia, hypomagnesemia),Hypovolemia and hypotension,Hyperuricemia and gout,Azotemia and renal impairment,Sulfonamide allergy cross-reactivity
Hypersensitivity to desoxycorticosterone or any component,Severe hypertension,Hyperkalemia,Edema or fluid overload states,Congestive heart failure,Severe renal impairment
Anuria,Hypersensitivity to Fluidil or other sulfonamide-derived drugs,Hepatic coma or pre-coma,Severe electrolyte depletion
Avoid high-potassium foods (e.g., bananas, oranges, salt substitutes) as Percorten increases potassium retention. Limit sodium intake to manage fluid balance.
Avoid high-potassium foods (e.g., bananas, oranges, avocados, spinach, potatoes, salt substitutes with potassium chloride). Limit alcohol intake as it may worsen dizziness and dehydration. Grapefruit juice has not been reported to interact significantly, but caution is advised with other drugs. Maintain adequate fluid intake to prevent dehydration.
Percorten (desoxycorticosterone pivalate) is a mineralocorticoid. Data in pregnant women are limited. In animal studies, corticosteroids have been shown to be teratogenic. Use during pregnancy only if clearly needed. First trimester: Possible increased risk of cleft palate and intrauterine growth restriction. Second and third trimesters: Potential for adrenal suppression in the fetus/newborn.
FLUIDIL is contraindicated in pregnancy. First trimester: Associated with increased risk of major malformations, including neural tube defects and cardiac anomalies. Second and third trimesters: May cause oligohydramnios due to diminished fetal renal function; use may lead to fetal renal impairment, persistent ductus arteriosus, and craniofacial abnormalities.
Corticosteroids are excreted in breast milk in small amounts. Desoxycorticosterone pivalate specific data are lacking. M/P ratio not determined. At high maternal doses, monitor infant for signs of adrenal suppression. Use with caution.
Excreted in human milk; M/P ratio not established. Use is not recommended during breastfeeding due to potential for serious adverse reactions in nursing infants.
Pregnancy may increase clearance of corticosteroids, potentially requiring dose adjustments. However, specific pharmacokinetic data for Percorten are lacking. Use lowest effective dose and monitor clinical response and serum levels if available.
FLUIDIL is not indicated for use in pregnancy. No dosage adjustment recommendations are available for pregnant women; avoidance is mandatory.
Percorten (desoxycorticosterone pivalate) is a mineralocorticoid used for adrenal insufficiency. Monitor for hypertension, hypokalemia, and edema. Titrate dose based on blood pressure and serum potassium. Use with caution in heart failure or renal impairment.
Fluidil (a diuretic combination, e.g., hydrochlorothiazide and triamterene) may cause electrolyte disturbances; monitor potassium levels closely due to triamterene's potassium-sparing effect. Avoid use in patients with severe renal impairment (Cr Cl <30 m L/min) or hyperkalemia. Onset of diuresis occurs within 2 hours, peak effect at 4-6 hours. Administer in the morning to prevent nocturia.
Take exactly as prescribed; do not miss doses.,Report rapid weight gain, swelling, or shortness of breath.,Avoid excessive salt intake; follow a low-sodium diet if advised.,Do not stop abruptly; taper under medical supervision.
Take this medication in the morning to reduce nighttime urination.,Avoid potassium supplements or high-potassium foods (e.g., bananas, oranges, salt substitutes) unless directed by your doctor.,Monitor for signs of electrolyte imbalance: muscle cramps, weakness, irregular heartbeat, or excessive thirst.,Stay hydrated but avoid excessive fluid intake; drink water as needed.,Report any rash, difficulty breathing, or swelling of the face/lips immediately.,Do not drive or operate machinery if you feel dizzy or lightheaded, especially during the first few days of treatment.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about PERCORTEN vs FLUIDIL, answered by our medical review team.
PERCORTEN is a Mineralocorticoid that works by Percorten (desoxycorticosterone pivalate) is a synthetic mineralocorticoid that binds to and activates the mineralocorticoid receptor (MR) in the renal distal tubule, leading to increased sodium reabsorption, increased potassium and hydrogen ion excretion, and water retention, thereby expanding extracellular fluid volume and increasing blood pressure.. FLUIDIL is a Mineralocorticoid that works by Fluidil is a thiazide-like diuretic that inhibits the sodium-chloride symporter (NCC) in the distal convoluted tubule of the nephron, reducing sodium and chloride reabsorption and promoting diuresis.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between PERCORTEN and FLUIDIL depend on the specific clinical indication. These are both Mineralocorticoid agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of PERCORTEN is: 1-5 mg intramuscularly or subcutaneously daily with dose adjusted based on clinical response and electrolyte monitoring.. The standard adult dose of FLUIDIL is: 5 mg orally once daily.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between PERCORTEN and FLUIDIL in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. PERCORTEN is classified as Category C. Percorten (desoxycorticosterone pivalate) is a mineralocorticoid. Data in pregnant women are limited. In animal studies, corticosteroids have been shown to be teratogenic. Use duri. FLUIDIL is classified as Category C. FLUIDIL is contraindicated in pregnancy. First trimester: Associated with increased risk of major malformations, including neural tube defects and cardiac anomalies. Second and thi. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.