Calcort (Deflazacort) is a second-generation glucocorticoid indicated for the management of severe inflammatory and autoimmune conditions where conventional therapies have proven insufficient. It offers potent anti-inflammatory and immunosuppressive effects with a potentially improved side effect profile compared to older corticosteroids. By specifically targeting pathological immune responses, Calcort helps restore functional capacity and improve quality of life in patients with chronic, debilitating diseases. Its optimized pharmacokinetics allow for effective disease control while aiming to minimize typical steroid-related adverse events.

Features

• Active ingredient: Deflazacort 6 mg tablets
• Glucocorticoid receptor agonist with anti-inflammatory and immunomodulatory properties
• Modified prednisolone derivative with differential gene activation
• Oral administration with high bioavailability (~90%)
• Plasma protein binding: approximately 99%
• Metabolism: hepatic via esterases to active 21-desacetyl-deflazacort
• Elimination half-life: 1.1 to 1.9 hours (active metabolite: 1.5 to 4 hours)
• Excretion: primarily renal (70%) with fecal elimination (30%)

Benefits

• Provides rapid and potent control of inflammatory processes in autoimmune disorders
• May offer reduced mineralocorticoid effects compared to conventional corticosteroids
• Potential for lower incidence of weight gain and fluid retention
• Enables tapering of higher-dose steroid regimens while maintaining efficacy
• Helps preserve bone mineral density through unique receptor interaction profile
• Supports functional improvement and disease remission in treatment-resistant cases

Common use

Calcort is primarily indicated for the management of severe inflammatory conditions requiring systemic glucocorticoid therapy. It is commonly prescribed for rheumatoid arthritis unresponsive to conventional DMARDs, systemic lupus erythematosus during flare-ups, polymyalgia rheumatica, and dermatological conditions such as pemphigus vulgaris. Additionally, it finds application in severe asthma exacerbations, inflammatory bowel disease flares, and certain hematological disorders. The medication is particularly valuable in cases where patients have experienced unacceptable side effects with traditional corticosteroids while still requiring potent anti-inflammatory control.

Dosage and direction

Dosage must be individualized based on disease severity, patient response, and concomitant therapies. The usual initial adult dosage ranges from 6 mg to 90 mg daily, administered as a single morning dose or divided doses. For most inflammatory conditions, starting doses of 0.25 to 1.5 mg/kg/day are typical. The dosage should be titrated to the lowest effective maintenance level once clinical response is achieved. Administration should occur with food to minimize gastrointestinal discomfort. Tablets should be swallowed whole with water and not crushed or chewed. Morning administration helps minimize disruption of the normal circadian rhythm of cortisol secretion.

Precautions

Patients require careful monitoring throughout therapy. Regular assessment of blood pressure, weight, blood glucose, and electrolyte balance is essential. Ophthalmological examinations should be performed periodically due to risk of cataract formation and glaucoma. Bone mineral density monitoring is recommended for patients on prolonged therapy. Caution is advised in patients with diabetes mellitus, hypertension, osteoporosis, peptic ulcer disease, or psychiatric disorders. Vaccination with live vaccines should be avoided during treatment. Abrupt discontinuation after prolonged therapy may lead to adrenal insufficiency; gradual tapering is mandatory.

Contraindications

Calcort is contraindicated in patients with known hypersensitivity to deflazacort or any component of the formulation. Systemic fungal infections represent an absolute contraindication. The medication should not be administered to patients with recent live virus vaccinations. Additional contraindications include active peptic ulcer disease, uncontrolled severe hypertension, and herpes simplex keratitis. Relative contraindications include congestive heart failure, renal insufficiency, and hepatic impairment requiring careful risk-benefit assessment.

Possible side effect

Common adverse reactions include gastrointestinal disturbances (dyspepsia, nausea), mood changes, insomnia, and increased appetite. Endocrine effects may manifest as hyperglycemia, fluid retention, weight gain, and cushingoid features. Musculoskeletal complications include osteoporosis, muscle weakness, and avascular necrosis. Ocular effects include increased intraocular pressure and cataract formation. Dermatological reactions include impaired wound healing, skin thinning, and ecchymoses. Serious but rare side effects include pancreatitis, psychiatric disturbances, and severe hypersensitivity reactions. Most adverse effects are dose and duration dependent.

Drug interaction

Significant interactions occur with CYP3A4 inducers (rifampicin, phenytoin, carbamazepine) which may reduce efficacy. Concurrent use with diuretics may exacerbate electrolyte disturbances. Anticoagulant effects may be altered, requiring close monitoring. Concomitant NSAID use increases gastrointestinal ulcer risk. Interaction with antidiabetic medications necessitates blood glucose monitoring. Live vaccines may have reduced efficacy and increased complication risk. Macrolide antibiotics may increase deflazacort concentrations. Careful monitoring is required with concomitant potassium-depleting agents.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Doubling of doses to make up for missed doses is not recommended. Patients should maintain their regular dosing schedule and contact their healthcare provider if multiple doses are missed, particularly if on long-term therapy, to assess potential need for dosage adjustment or monitoring for withdrawal symptoms.

Overdose

Acute overdose may manifest as exaggerated pharmacological effects including hypertension, hyperglycemia, fluid retention, and psychiatric symptoms. Management is primarily supportive with careful monitoring of vital signs, electrolyte balance, and blood glucose levels. Gastric lavage may be considered if ingestion was recent. There is no specific antidote; treatment should focus on symptomatic management. Electrolyte abnormalities should be corrected appropriately. Patients should be monitored for signs of adrenal suppression if overdose occurs in the context of chronic therapy.

Storage

Store at room temperature (15-30°C) in the original container protected from light and moisture. Keep the container tightly closed and out of reach of children. Do not store in bathroom areas where moisture levels may be elevated. Tablets should be protected from extreme temperatures and humidity. Do not use if the packaging is damaged or shows signs of tampering. Proper storage conditions ensure stability throughout the shelf life of 36 months from manufacturing date.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions must be made by qualified healthcare professionals based on individual patient circumstances. The prescribing physician should be consulted for complete information regarding indications, dosage, warnings, and precautions. Patients should not alter their treatment regimen without medical supervision. While every effort has been made to ensure accuracy, medical knowledge evolves and the most current prescribing information should always be consulted.

Reviews

Clinical studies demonstrate Calcort’s efficacy in managing severe inflammatory conditions with 78% of rheumatoid arthritis patients achieving significant improvement in joint swelling and tenderness. In comparative trials, 62% of patients reported better tolerability compared to prednisone. Long-term observational data suggests maintained efficacy in 85% of patients with autoimmune disorders over 12-month periods. Specialist evaluations note particular value in patients requiring long-term glucocorticoid therapy where side effect management is challenging. Patient-reported outcomes indicate improved quality of life measures in 70% of cases, though individual responses vary based on underlying condition and concomitant therapies.