Deflazacort (Calcort) is a glucocorticoid drug with anti-inflammatory and immunosuppressive effects. Clinically, it is mainly used to treat various inflammatory diseases and autoimmune diseases. The rational use of deflazacort requires consideration of the patient's specific conditions, the severity of the disease, and potential side effects.
How to Use Deflazacort (Calcort)
Route and Timing of Administration
Deflazacort is usually administered orally, and it is recommended to take the full daily dose at one time before 8 a.m.
This administration timing mimics the circadian rhythm of the body's natural cortisol secretion, which can minimize the inhibition of the hypothalamic-pituitary-adrenal axis.
For patients requiring high-dose treatment, the daily dose may also be divided into 2-4 administrations. However, administration after evening should be avoided as much as possible to reduce adverse reactions such as insomnia.
Precautions for Administration with Food
Deflazacort can be taken with food or on an empty stomach. To ensure a stable blood drug concentration, it is recommended to take it at the same fixed time every day or follow the doctor's specific instructions.
A high-fat diet may slightly increase the absorption of the drug, but it usually does not significantly affect the clinical effect.
For patients with gastrointestinal sensitivity, it is recommended to take the drug with food to reduce stomach discomfort.
Principles of Discontinuation
Deflazacort should not be discontinued suddenly after long-term use; instead, the dose should be gradually reduced.
Sudden discontinuation may lead to adrenal insufficiency, manifested as symptoms such as fatigue, hypotension, and hypoglycemia.
The dose reduction plan should be formulated based on the duration of medication and the dose level. Usually, the dose is reduced every 5-7 days until complete discontinuation.
Special attention to gradual dose reduction is required for patients who have used the drug for more than 2 weeks.
Dose Adjustment of Deflazacort (Calcort)
Adjustment During Treatment
During the treatment process, the dose should be adjusted according to the therapeutic effect and tolerance.
After the symptoms are controlled, the dose should be gradually reduced to the minimum effective dose.
If the therapeutic effect is not satisfactory, after ruling out other factors (such as compliance issues, drug interactions, etc.), an appropriate increase in dose may be considered.
The magnitude of each dose adjustment usually does not exceed 25-50% of the current dose, and the interval between adjustments is not less than 3-5 days.
Adjustment for Patients with Liver Dysfunction
Special attention is required when deflazacort is used in patients with liver dysfunction.
Since the liver is the main organ for glucocorticoid metabolism, liver function impairment may lead to slowed drug clearance and increased blood drug concentration.
For patients with mild to moderate liver dysfunction, it is recommended to reduce the initial dose by 20-50%.
Patients with severe liver dysfunction should avoid using the drug or use it with extreme caution, and closely monitor for adverse reactions.
Medication for Special Populations of Deflazacort (Calcort)
Pediatric Medication
Long-term use of glucocorticoids in children may affect growth and development, so the indications and course of treatment must be strictly controlled.
The lowest effective dose should be used, and growth indicators should be monitored regularly.
For children who must receive long-term treatment, alternate-day administration therapy may be considered to reduce the inhibition of growth.
Live vaccine vaccination for children should be postponed until at least 3 months after discontinuing glucocorticoids.
Geriatric Medication
Elderly patients using deflazacort are more prone to adverse reactions such as hypertension, diabetes, and osteoporosis.
It is recommended to start with the lower limit of the adult dose and closely monitor blood pressure, blood glucose, and electrolytes.
Attention should be paid to the risk of drug interactions, as the elderly often use multiple drugs simultaneously.
For elderly patients with cognitive impairment, special attention should also be paid to the management of medication compliance.
