Deflazacort (Calcort) is a glucocorticoid drug primarily used for the treatment of Duchenne Muscular Dystrophy (DMD) as well as other inflammatory or autoimmune diseases. As a hormonal drug that often requires long-term use, special attention must be paid to its medication safety and monitoring requirements.
Precautions for Deflazacort (Calcort) Use
Indications and Contraindications
Target Population: Patients with DMD aged 5 years and above (clinical assessment is required).
Other inflammatory diseases that require glucocorticoid treatment (e.g., rheumatoid arthritis, asthma).
Contraindications: Patients with uncontrolled systemic fungal infections.
Patients allergic to deflazacort or its excipients.
Dosage and Administration
Dosage Calculation: The recommended dosage for DMD patients is 0.9 mg/kg per day. The oral suspension must be shaken well before accurate measurement.
Administration Timing: It is recommended to take the entire daily dose at once in the morning to minimize inhibition of the hypothalamic-pituitary-adrenal (HPA) axis.
Special Adjustments: Dosage reduction is required for patients with hepatic impairment.
When used in combination with strong CYP3A4 inhibitors (e.g., ketoconazole), the dosage should be reduced by 25%-50%.
Medication Use in Special Populations
Children: Growth and development must be monitored (hormones may inhibit bone growth).
Pregnancy/Lactation: Risks should be weighed; this drug may increase the risk of fetal cleft palate, and its use should be avoided during lactation.
Elderly Patients: More prone to adverse reactions such as hypertension and osteoporosis.
Potential Risk Warnings
Immunosuppression: Increases the risk of infections (e.g., pneumonia, chickenpox). Screening for latent tuberculosis is required before medication.
Metabolic Effects: May cause hyperglycemia, hypertension, and hypokalemia.
Behavioral Abnormalities: Some patients may experience mood swings or insomnia.
Medication Monitoring for Deflazacort (Calcort)
Efficacy Monitoring
Regularly assess muscle strength and motor function (e.g., 6-minute walk test).
Monitor weight changes (hormones may cause rapid weight gain).
For patients with inflammatory diseases: Adjust the dosage based on the degree of symptom relief.
Laboratory Monitoring
Metabolic Indicators: Fasting blood glucose (once a week in the initial stage of medication, and once every 3 months after stabilization).
Serum potassium and serum calcium (tested every 6 months for patients on long-term medication).
Infection Markers: Urgently test C-reactive protein (CRP) when fever or cough occurs.
Bone Health Monitoring
Baseline bone mineral density testing (DXA scan) and annual re-testing thereafter.
Supplement with calcium and vitamin D (especially for children and patients on long-term medication).
