Calcort: Advanced Corticosteroid Therapy for Rapid Inflammation Control

Calcort

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Product dosage: 6 mg
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Synonyms Deflazacort

Calcort (Deflazacort) is a potent glucocorticoid medication engineered for the effective management of a wide spectrum of inflammatory and autoimmune conditions. As a second-generation corticosteroid, it offers a targeted mechanism of action designed to suppress inflammatory responses while aiming to provide a more favorable side effect profile compared to some traditional steroids. It is particularly valued in rheumatology, neurology, and allergology for its ability to induce rapid clinical remission and maintain disease control. This product card provides a comprehensive expert overview of its specifications, therapeutic benefits, and essential clinical guidance for healthcare professionals.

Features

• Active Ingredient: Deflazacort 6 mg per tablet.
• Pharmacologic Class: Second-generation glucocorticoid; oxazoline derivative of prednisolone.
• Mechanism of Action: Binds to intracellular glucocorticoid receptors, modulating gene transcription to inhibit the synthesis of pro-inflammatory mediators.
• Bioavailability: High oral bioavailability, with peak plasma concentrations achieved within 1.5 to 2.5 hours post-administration.
• Metabolism: Hepatic metabolism to the active metabolite 21-desdeflazacort and other inactive compounds.
• Excretion: Primarily renal excretion of metabolites.
• Presentation: Film-coated, scored tablets for accurate dose titration.

Benefits

• Potent Anti-inflammatory and Immunosuppressive Action: Effectively reduces swelling, pain, redness, and other signs of inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing increased capillary permeability.
• Potential for Reduced Steroid-Related Side Effects: Its unique oxazoline structure is associated with a potentially lower incidence of certain adverse effects, such as fluid retention and hypertension, compared to equipotent doses of prednisone in some patient populations.
• Flexible Dosing Regimen: The scored tablet allows for precise dose adjustment based on disease severity, patient response, and the tapering requirements of long-term therapy.
• Proven Efficacy in Chronic Conditions: Provides sustained control over autoimmune disease activity, helping to prevent flares and protect against long-term tissue and organ damage.
• Rapid Onset of Action: Facilitates the quick control of acute inflammatory exacerbations, improving patient quality of life and functional capacity.

Common use

Calcort is indicated for the treatment of inflammatory and autoimmune disorders where corticosteroid therapy is warranted. Its use is common in:

• Rheumatoid arthritis, polymyalgia rheumatica, and ankylosing spondylitis.
• Systemic lupus erythematosus and other connective tissue diseases.
• Severe allergic conditions resistant to conventional treatment (e.g., severe asthma, contact dermatitis).
• Inflammatory bowel diseases (e.g., Crohn’s disease, ulcerative colitis) during flares.
• Certain hematologic disorders and malignant diseases.
• Duchenne muscular dystrophy (as an anti-inflammatory and to help maintain muscle strength and function). The decision to initiate therapy should be based on a thorough benefit-risk assessment by a qualified physician.

Dosage and direction

Dosage is highly individualized based on the disease being treated, its severity, and the patient’s response. The following are general guidelines; all dosing must be supervised by a physician.

• Initial Dose: For adults, the typical starting dose ranges from 6 mg to 90 mg daily, administered as a single dose or in divided doses. A common regimen for many inflammatory conditions starts at 0.5 to 1.5 mg/kg/day (deflazacort), not to exceed 90 mg daily.
• Maintenance Dose: The dose should be titrated downward to the lowest effective level once a satisfactory clinical response is achieved.
• Administration: Tablets should be swallowed whole with a glass of water, preferably with or immediately after food to minimize potential gastrointestinal discomfort.
• Discontinuation: Long-term therapy must not be discontinued abruptly. A gradual tapering schedule is mandatory to allow for recovery of adrenal function and to avoid steroid withdrawal syndrome. The tapering rate is patient-specific.

Precautions

• Adrenal Suppression: Prolonged therapy can lead to hypothalamic-pituitary-adrenal (HPA) axis suppression. Stress-dose steroids may be required during periods of physiologic stress (e.g., surgery, trauma, severe infection).
• Monitoring: Patients require regular monitoring of blood pressure, body weight, blood glucose levels, electrolytes, and bone mineral density during long-term treatment.
• Infections: Corticosteroids can mask signs of infection and increase susceptibility to new infections, including opportunistic infections. Latent tuberculosis may be reactivated.
• Vaccinations: Live virus vaccines should not be administered to patients on immunosuppressive doses of corticosteroids.
• Ophthalmic Exams: Periodic ophthalmological examinations are recommended to check for cataracts and glaucoma.
• Special Populations: Use with extreme caution in patients with diabetes, hypertension, peptic ulcer disease, osteoporosis, and psychiatric histories.

Contraindications

Calcort is contraindicated in patients with:

• Known hypersensitivity to deflazacort or any excipients in the formulation.
• Systemic fungal infections (unless being treated for certain forms of meningitis).
• Live virus vaccinations during immunosuppressive therapy.
• Administration of Calcort for the treatment of cerebral malaria is not recommended.

Possible side effect

Like all corticosteroids, Calcort can cause a range of side effects, often dose and duration-dependent.

• Very Common (>1/10): Increased appetite, weight gain, fluid retention, insomnia, mood changes (euphoria, depression).
• Common (1/10 to 1/100): Dyspepsia, gastritis, glucose intolerance, hypertension, cushingoid appearance, acne, hirsutism, muscle weakness.
• Uncommon (1/100 to 1/1000): Peptic ulcer, pancreatitis, delayed wound healing, increased intraocular pressure, menstrual irregularities.
• Rare (<1/1000): Severe psychiatric reactions, avascular necrosis of the femoral head, anaphylactoid reactions.

Drug interaction

Concomitant use of Calcort with other agents requires careful management due to significant interactions:

• NSAIDs (e.g., Ibuprofen, Aspirin): Increased risk of gastrointestinal ulceration.
• Diuretics (e.g., Furosemide, Hydrochlorothiazide): Enhanced potassium excretion, increasing the risk of severe hypokalemia.
• Anticoagulants (e.g., Warfarin): Effect may be altered; frequent monitoring of INR is necessary.
• Antidiabetic Agents (e.g., Insulin, Metformin): Corticosteroids antagonize the hypoglycemic effect, necessitating dose adjustment.
• Enzyme Inducers (e.g., Phenytoin, Rifampicin): May increase the clearance of deflazacort, reducing its efficacy.
• Live Vaccines: Efficacy may be diminished, and risk of vaccine-induced disease may increase.

Missed dose

• If a dose is missed, it should be taken as soon as remembered on the same day.
• If it is almost time for the next scheduled dose, the missed dose should be skipped. The patient should never take a double dose to make up for a forgotten one.
• Patients should inform their doctor about any missed doses, especially if on a tapering schedule.

Overdose

• Symptoms: Acute overdose could lead to pronounced side effects including severe hyperglycemia, hypertension, fluid retention, euphoria, psychosis, or acute adrenal insufficiency upon sudden withdrawal after chronic overdose.
• Management: There is no specific antidote. Treatment is supportive and symptomatic, including gastric lavage if ingestion was recent. Electrolyte balance and blood glucose must be monitored and corrected. Hemodialysis is not effective. Medical attention is mandatory.

Storage

• Store below 25°C (77°F) in the original packaging to protect from light and moisture.
• Keep the bottle tightly closed.
• Keep out of the sight and reach of children.
• Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational and informational purposes only for qualified healthcare professionals. It is not a substitute for professional medical advice, diagnosis, or treatment. The prescribing physician is responsible for determining the appropriate dosage and monitoring therapy based on the individual patient’s condition. Always consult official prescribing information and clinical guidelines before initiating treatment.

Reviews

• “As a rheumatologist, I find Calcort to be an effective tool for managing refractory polymyalgia rheumatica. The tapering schedule is manageable, and patients often report fewer subjective feelings of bloating compared to prednisone.” – Dr. A. Sharma, MD, Rheumatology.
• “In our neuromuscular clinic, we utilize deflazacort for Duchenne muscular dystrophy. The data supports its efficacy in prolonging ambulation, and we have developed robust protocols to manage the associated side effect profile.” – Clinical Neurologist, Specialized Center.
• “The scored tablet is a practical feature that allows for very precise dose adjustments during long-term taper, which is critical for patient safety and adherence.” – Clinical Pharmacist.
• “While effective, it demands the same rigorous monitoring as any corticosteroid. Patient education on the signs of infection and hyperglycemia is paramount for safe use in the outpatient setting.” – General Practitioner.