deflazacort: clinical use

Prescribing considerations

• Assess infection and vaccination status and provide clear advice about exposure to chickenpox, shingles or measles.
• Use particular caution in older people and in patients with diabetes, osteoporosis, hypertension, cardiovascular or gastrointestinal disease, psychiatric illness, epilepsy, glaucoma, liver failure or previous steroid myopathy.
• Consider tumour lysis syndrome risk in susceptible patients with haematological malignancy.

Contraindications and cautions

• Hypersensitivity to deflazacort or an excipient
• Untreated systemic infection
• Concurrent live-virus immunisation

Monitoring

• Clinical response, infection and features of adrenal suppression
• Blood pressure, weight, glucose control and potassium where clinically relevant
• Bone, eye and psychiatric adverse effects during sustained systemic exposure
• Growth in children and adolescents
• INR or prothrombin time when used with coumarin anticoagulants

Clinical pharmacology

Deflazacort is an orally absorbed glucocorticoid prodrug rapidly converted by plasma esterases to the active metabolite D 21-OH. It has anti-inflammatory and immunosuppressive activity and is extensively metabolised before elimination through urine and faeces.

Formulation and product differences

• The selected product is a round, white, uncoated, cross-marked tablet.
• It contains lactose and may be unsuitable for people with certain rare hereditary sugar-intolerance disorders.

Tablet

Route: Oral

Strengths: 6 mg