Which medication is indicated for lifelong replacement therapy in adrenal insufficiency?

Hydrocortisone is the standard medication indicated for lifelong replacement therapy in individuals with adrenal insufficiency. This condition results from the adrenal glands being unable to produce sufficient amounts of cortisol, a vital hormone that plays a crucial role in the body's response to stress, metabolism, and regulation of blood pressure.

Hydrocortisone mimics the effects of cortisol in the body and helps manage the symptoms associated with adrenal insufficiency, such as fatigue, weakness, and weight loss. The goal of replacement therapy is to restore normal levels of cortisol, thereby supporting overall health and preventing an adrenal crisis, which can occur during times of stress or illness if cortisol levels are too low.

Other medications listed, such as dexamethasone and prednisolone, are corticosteroids but are typically used for their anti-inflammatory properties rather than as replacement therapy. While fludrocortisone is a mineralocorticoid used to treat conditions related to aldosterone deficiency (which may be a component of adrenal insufficiency), it does not replace cortisol. Therefore, hydrocortisone is the most appropriate choice for managing adrenal insufficiency effectively over a lifetime.