Deflazacort (Calcort) is a glucocorticoid drug primarily used for the treatment of Duchenne muscular dystrophy (DMD) and other inflammatory or autoimmune diseases. As a hormonal drug that requires long-term use, its medication safety and monitoring requirements are particularly important.

Precautions for Administration of Deflazacort (Calcort)

Indications and Contraindications

Applicable Population: DMD patients aged 5 years and above (clinical evaluation is required).

Other inflammatory diseases that require glucocorticoid treatment (e.g., rheumatoid arthritis, asthma).

Contraindications: Patients with uncontrolled systemic fungal infections.

Patients hypersensitive to deflazacort or its excipients.

Dosage and Administration Route

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 Time: It is recommended to take the entire daily dose at one time in the morning to reduce the inhibition of the hypothalamic-pituitary-adrenal (HPA) axis.

Special Adjustments: Dose reduction is required for patients with hepatic impairment.

When used in combination with strong CYP3A4 inhibitors (e.g., ketoconazole), the dose should be reduced by 25%-50%.

Administration in Special Populations

Pediatric Patients: Growth and development must be monitored (hormones may inhibit bone growth).

Pregnancy/Lactation: The risks must be weighed; it may increase the risk of fetal cleft palate, and use during lactation should be avoided.

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).

Patients with Inflammatory Diseases: Adjust the dose according to 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: Emergency testing of C-reactive protein (CRP) when fever or cough occurs.

Bone Health Monitoring

Baseline bone mineral density testing (DXA scan) and annual re-testing thereafter.

Supplementary calcium and vitamin D (especially for children and patients on long-term medication).