Deflazacort instructions, uses, functions and effects, usage and dosage, price?

Deflazacort Indications/Uses

Indicated for the treatment of Duchenne muscular dystrophy (DMD) in patients 2 years of age and older.

Function and efficacy

Duchenne muscular dystrophy is a rare genetic disease, clinically characterized by progressive muscle weakness and muscle atrophy. As a corticosteroid, deflazacort is converted into the active metabolite 21-desacetylflazacort in the body, which can enhance the patient's motor function by increasing muscle strength, prolong the time when the patient loses the ability to walk independently, and improve the patient's quality of life.

Deflazacort usage and dosage

1. Pre-medication assessment: Before starting, conduct all immunizations according to the immunization guidelines. Get a live attenuated or live vaccine at least 4 to 6 weeks before starting deflazacort.

2. Recommendation: The recommended oral dose of deflazacort is approximately 0.9 mg/kg/day, once a day. If using tablets, round to the nearest dose. If using an oral suspension, measure to the nearest tenth of a milliliter (mL).

3. Stop: If you have been taking deflazacort for more than a few days, your dose must be gradually reduced.

Dose adjustment for CYP3A4 inhibitors and inducers

1. CYP3A4 inhibitors: When diflazacort is combined with a moderate or strong CYP3A4 inhibitor, give one-third of the recommended dose. For example, when coadministered with a moderate or strong CYP3A4 inhibitor, the daily dose of 36 mg will be reduced to 12 mg daily.

2. CYP3A4 inducers: Avoid use with moderate or strong CYP3A4 inducers and deflazacort.

Dosage form and strength

1. Tablets:

1. 6 mg: white round shape with the word "6" debossed on one side.

2. 18 mg: white round shape with “18” debossed on one side.

3. 30 mg: White oval shape with “30” debossed on one side.

4. 36 mg: white oval, with “36” engraved on one side for oral suspension.

2. Oral suspension:

22.75 mg/ml: white suspension.

Contraindications

This drug is contraindicated in patients with known hypersensitivity to deflazacort or any of the inactive ingredients. Deflazacort is contraindicated in patients receiving corticosteroids who have experienced allergic reactions (including anaphylaxis) or who are allergic to any of the inactive ingredients.

Side effects

The most common side effects of deflazacort are increased appetite, upper respiratory tract infection, hirsutism, Cushingoid appearance, weight gain, cough, frequent urination and nasopharyngitis, and central obesity.

Measures for dealing with side effects

1. Upper respiratory tract infection: Patients should drink more water and can also be treated with antibiotics or antiviral drugs as directed by the doctor.

2. Weight gain: You should pay attention to a light diet and avoid eating greasy food. During treatment, you can monitor your weight. If obesity occurs, consult your doctor promptly and reduce the dose if necessary.

3. Cough: Patients can use antitussive drugs under the guidance of a doctor.

4. Other adverse reactions: If the patient develops severe hirsutism, Cushingoid appearance and other side effects, he should consult a doctor in time and deal with it under the guidance of a doctor.

Drug interactions

1. Neuromuscular blocking agents: Patients receiving deflazacort concurrently with neuromuscular blocking drugs (such as Pancuo) may have an increased risk of developing acute myopathy.

2. Moderate or strong CYP3A4 inducers: Combining deflazacort with rifampicin (a strong CYP3A4 inducer) can significantly reduce 21-desDFZ exposure. Avoid using strong (such as efavirenz) or moderate (such as carbamazepine, phenytoin) CYP3A inducers with deflazacort.

Special groups

1. Pregnancy: Corticosteroids should be used during pregnancy only when the potential benefit justifies the potential risk to the fetus. Infants born to mothers who received large amounts of corticosteroids during pregnancy should be carefully observed for signs of reduced epinephrine. There are no adequate and well-controlled studies of deflazacort in pregnant women to inform the risks associated with the drug.

2. Lactation period: Systemically administered corticosteroids appear in human milk and may inhibit growth, interfere with the production of endogenous corticosteroids, or cause other adverse reactions. The developmental and health benefits of breastfeeding should be considered together with the mother's clinical need for deflazacort and any potential adverse effects of deflazacort on the breastfed infant.

3. Children: The safety and effectiveness of deflazacort in treating DMD have been confirmed in patients 2 years old and above. However, the safety and effectiveness of this product in children under 2 years of age have not been determined.

Notes

1. Effect on bones: Deflazacort can cause a decrease in bone density. Before starting corticosteroid treatment, consider the patient's risk of osteoporosis.

2. Gastrointestinal perforation: Patients with certain gastrointestinal diseases (such as active or latent peptic ulcer, diverticulitis, fresh intestinal anastomosis and non-specific ulcerative colitis) are at increased risk of gastrointestinal perforation during use of corticosteroids. Symptoms of gastrointestinal perforation, such as peritoneal irritation, may be masked in patients receiving corticosteroids. Corticosteroids should be avoided if there is a possibility of impending perforation, abscess, or other purulent infection.

3. Behavioral and emotional disorders: Systemic corticosteroids may cause potentially serious psychiatric adverse reactions, including deflazacort. Symptoms usually appear within days or weeks of starting treatment and may be dose-related. Inform patients or caregivers of the possibility of behavioral and mood changes and encourage them to seek medical care if they develop psychiatric symptoms, especially if depressed mood or suicidal ideation is suspected.

4. Changes in endocrine function: Deflazacort can cause serious and life-threatening changes in endocrine function, especially when used for a long time. Monitor patients receiving deflazacort for the emergence of Cushing's syndrome, hyperglycemia, and adrenal insufficiency after discontinuation of deflazacort. Additionally, patients with hypopituitarism, primary adrenal insufficiency or congenital adrenal hyperplasia, altered thyroid function, or pheochromocytoma may be at increased risk for adverse endocrine events.

Drug Price

A box of 6mg*100 tablets of the German version of deflazacort costs about $600.

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