Deflazacort

Mechanism :

Deflazacort is a glucocorticoid used as an anti-inflammatory and immunosuppressant. Deflazacort is a prodrug. Its potency is around 70-90% that of prednisone.

Indication :

Rheumatoid Arthritis
Juvenile Chronic Arthritis
Asthma
Pemphigus
Uveitis
Nephrotic Syndrome
Immune suppression in transplantation.
Duchenne Muscular Dystrophy

Contraindications :

Use with caution in 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.

Dosing :

Allergic and inflammatory disorders:

Adult:

Initially, up to 120 mg daily. Maintenance: 3-18 mg/day.

Child:

0.25-1.5 mg/kg/day given on alternate days.

Duchenne Muscular Dystrophy:

Under 5 years:

Safety and efficacy not established.

Above 5 years:

0.9 mg/kg/day once orally everyday.

Adverse Effect :

GI disturbances, fluid and electrolyte disturbances, susceptible to infection, impaired healing, hypersensitivity, skin atrophy, striae, telangiectasia, acne, myocardial rupture following recent MI, Cushingoid appearance, weight gain, increased appetite, thromboembolism.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)

20-50	Dose as in normal renal function
10-20	Dose as in normal renal function
<10	Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies

CAPD	Unlikely to be dialysed. Dose as in normal renal function
HD	Not dialysed. Dose as in normal renal function
HDF/High flux	Unknown dialysability. Dose as in normal renal function
CAV/VVHD	Unlikely to be dialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended. Data for use in severe hepatic impairment is lacking.