Deflazacort

Systemic infection (unless specific anti-infective therapy is given). Concomitant administration with live vaccines (especially in patients with impaired immune response, or receiving immunosuppressive doses).

Patient with hypertension, cardiac disease or CHF (except in the presence of active rheumatic carditis), recent MI, thromboembolic disorders, gastrointestinal disease (e.g. gastritis, oesophagitis, diverticulitis, ulcerative colitis, fresh intestinal anastomoses, active or latent peptic ulcer, abscess or other pyogenic infections), diabetes mellitus (including family history), phaeochromocytoma, thyroid disease, active or latent TB, TB reactivity, ocular herpes simplex, glaucoma, strongyloidiasis, osteoporosis, myasthenia gravis, history of corticosteroid-induced myopathy, history of seizure disorder, emotional instability or psychotic tendency, existing or history of severe affective disorders (e.g. previous steroid-induced psychosis, depressive or manic-depressive illness); systemic sclerosis, haematological malignancies. Avoid exposure to chickenpox or measles. Patient subjected to stress conditions (e.g. trauma, severe infection, surgery). When used for Duchenne muscular dystrophy: Patient taking concurrent moderate or strong CYP3A4 inhibitors. Avoid abrupt withdrawal (particularly during prolonged therapy). Renal and hepatic (e.g. hepatic failure, cirrhosis) impairment. Children. Pregnancy and lactation. Monitoring Parameters Monitor blood pressure, blood glucose, electrolytes, weight. For prolonged use: Monitor bone mineral density, HPA axis suppression (e.g. ACTH stimulation test, morning plasma cortisol test, urinary free cortisol test), growth in children. Perform ophthalmic exam for >6 weeks therapy. Assess for signs and symptoms of infection, formation of cataract, elevated intraocular pressure, volume overload, and depressed mood or suicidal ideation.

Significant: Adrenal suppression (e.g. adrenal cortical atrophy, hypercortisolism, hypothalamic-pituitary-adrenal [HPA] axis suppression), immunosuppression (prolonged use), Kaposi's sarcoma (prolonged-use), visual disturbances (e.g. cataract, glaucoma, central serous chorioretinopathy, posterior subcapsular cataracts [prolonged-use], increased intraocular pressure), hypertension, electrolyte disturbance, salt and water retention, increased K excretion, left ventricular free wall rupture, thromboembolism, hyperglycaemia, acute myopathy, osteoporosis, tendonitis and tendon rupture, growth suppression (in children), psychiatric disturbances (e.g. depression, suicidal ideation, euphoria, insomnia, mood swings, personality changes), scleroderma renal crisis; toxic epidermal necrolysis, withdrawal syndrome. Rarely, anaphylaxis. Blood and lymphatic system disorders: Leucocytosis. Ear and labyrinth disorders: Vertigo. Eye disorders: Corneal or scleral thinning. Gastrointestinal disorders: Dyspepsia, abdominal pain, peptic ulceration, nausea. General disorders and administration site conditions: Oedema, impaired healing. Infections and infestations: Opportunistic infections, dormant TB recurrence. Investigations: Weight gain. Metabolism and nutrition disorders: Cushingoid appearance, increased appetite. Musculoskeletal and connective tissue disorders: Vertebral and long bone fractures, avascular necrosis. Rarely, muscle wasting. Nervous system disorders: Headache. Psychiatric disorders: Irritability, hallucination. Reproductive system and breast disorders: Amenorrhoea, irregular menstruation. Renal and urinary disorders: Pollakiuria. Respiratory, thoracic and mediastinal disorders: Cough, upper respiratory tract infection, nasopharyngitis. Skin and subcutaneous tissue disorders: Acne, skin atrophy, telangiectasia, hirsutism, erythema, striae. Rarely, bruising.
Potentially Fatal: Acute adrenal insufficiency, phaeochromocytoma crisis.

May increase risk of tendonitis and tendon rupture with quinolones. May antagonise the effects of hypoglycaemic agents (e.g. insulin), antihypertensives, diuretics. Enhances hypokalaemic effects of acetazolamide, loop and thiazide diuretics, β₂-agonists, xanthines and carbenoxolone. May enhance the therapeutic effect of coumarin anticoagulants. May lead to prolonged relaxation and acute myopathy when given with non-depolarising relaxants. May increase the renal clearance of salicylates. May increase deflazacort plasma concentration with oral contraceptives and estrogens. May have reduced bioavailability with antacids. Increased risk of systemic side effects with CYP3A inhibitors, including cobicistat-containing products. Decreased exposure to the active metabolite of deflazacort with moderate or strong CYP3A4 inducers (e.g. rifampicin, efavirenz, carbamazepine, phenytoin). Increased total exposure to deflazacort active metabolite with moderate or strong CYP3A4 inhibitors (e.g. clarithromycin, fluconazole, diltiazem, verapamil).

Corticosteroid Hormones

H02AB13 - deflazacort ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.