Deflazacort
Indications
Deflazacort is used for:
Allergic and inflammatory disorders, Duchenne muscular dystrophy
Adult Dose
Oral
Allergic and inflammatory disorders
Adult:
Usual maintenance 3–18 mg daily (acute disorders, initially up to 120 mg daily).
Rheumatoid arthritis: 3-18 mg/day
Bronchial asthma: 48-72 mg/day.
Duchenne Muscular Dystrophy
Indicated for Duchenne muscular dystrophy (DMD)
0.9 mg/kg/day PO qDay
Hepatic impairment
Mild or moderate: No dose adjustment required
Severe: Not studied
Child Dose
Oral
Allergic and inflammatory disorders
Child 1 month–11 years: 0.25–1.5 mg/kg daily or on alternate days; up to 2.4 mg/kg (max.120 mg) daily in emergency situations.
Child 12–17 years: 3–18 mg daily or on alternate days; up to 2.4 mg/kg (max. 120 mg) daily in emergency situations.
Renal Dose
Renal impairment
Mild, moderate, or severe: No dose adjustment required
Administration
May take with or without food
Contra Indications
Systemic infection; live virus vaccines in those receiving immunosuppressive doses.
Precautions
Adrenal suppression and infection, child, adolescents, elderly, history of TB and steroid myopathy, hypertension, recent MI, CHF, liver failure, renal impairment, DM and glaucoma (including family history), osteoporosis, corneal perforation, severe affective disorders, epilepsy, peptic ulcer, hypothyroidism, pregnancy and lactation.
Pregnancy-Lactation
Pregnancy
Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus
Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism
Lactation
Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Interactions
Antacids, ACE inhibitors, acetazolamide, adrenergic neuron blockers, antidiabetics, aspirin, barbiturate, ?-blockers, calcium-channel blockers, carbamazepine, carbenoxolone, cardiac glycosides, clonidine, coumarins, diazoxide, diuretics, erythromycin, hydralazine, ketoconazole, methotrexate, methyldopa, mifepristone, minoxidil, moxonidine, nitrates, nitroprusside, NSAIDs, oestrogens, phenytoin, primidone, rifamycins, ritonavir, somatropin, ?2 sympathomimetics, theophylline, vaccines.
Side Effects
Side effects of Deflazacort :
GI disturbances, musculoskeletal, endocrine, neuropsychiatric, ophthalmic, fluid and electrolyte disturbances; susceptible to infection, impaired healing, hypersensitivity, skin atrophy, striae, telangiectasia, acne, myocardial rupture following recent MI, thromboembolism.
Mode of Action
Deflazacort, derived from prednisolone, is a corticosteroid with mainly glucocorticoid activity. An anti-inflammatory dose of 6 mg deflazacort is equiv to 5 mg prednisolone.