Therapies for adrenal insufficiency

Massimiliano Andrioli, Francesca Pecori Giraldi, Martina De Martin, Francesco Cavagnini

Research output: Contribution to journalArticlepeer-review


Adrenal insufficiency is a rare disorder in which the adrenal cortex fails to secrete sufficient amounts of steroid hormones. All adrenal hormones are affected in primary adrenal insufficiency, whereas only glucocorticoid secretion is deficient in secondary adrenal insufficiency. Low doses of hydrocortisone/cortisone acetate (20 mg and 25 mg daily, respectively) subdivided in thrice-daily administration approach the physiological cortisol profile and resolve clinical features. Clinical assessment is the mainstay for establishing adequacy of corticosteroid replacement therapy as no biochemical/hormonal marker is fully reliable. Glucocorticoid replacement has to be potentiated during stressful events (e.g., surgery, infection, delivery and trauma). Fludrocortisone (0.05 - 0.2 mg daily) is administered in order to normalise blood pressure and potassium levels, aiming for plasma renin activity in the upper normal range. Dehydroepiandrosterone (20 - 50 mg daily) may prove beneficial, but cannot as yet be recommended for routine clinical use.

Original languageEnglish
Pages (from-to)1323-1329
Number of pages7
JournalExpert Opinion on Therapeutic Patents
Issue number11
Publication statusPublished - Nov 2007


  • Adrenal crisis
  • Adrenal insufficiency
  • Dehydroepiandrosterone
  • Fludrocortisone
  • Glucocorticoid
  • Replacement therapy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology
  • Law


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