Warnings Of Deflazacort

By Author: sudarshan singh
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Deflazacort can cause fluid and salt retention and so may oppose the effects of the following medicines:

* antihypertensive medicines used to treat high blood pressure
* diuretics, eg furosemide.

Calcort tablets[Deflazacort] should be taken in the morning to mimic the natural production of corticosteroids by the body. They should be taken after food to minimise irritation to the stomach.

* You must not stop taking this medicine suddenly if you have been taking it for more than three weeks. This is because long-term use of corticosteroids can suppress the natural production of corticosteroids by the adrenal glands, which means that the body becomes temporarily reliant on the medicine. When it is time to stop treatment the dose should be tapered down gradually, to allow the adrenal glands to start producing adequate amounts of natural steroids again. Follow the instructions given by your doctor or pharmacist. Your doctor may also want you to stop treatment gradually if you have been taking high doses (more than 48mg deflazacort daily) even if only for three weeks or less; if you have been treated ...
... with corticosteroid tablets or injections in the last year; if you had problems with your adrenal glands before treatment was started; or if you have been repeatedly taking doses in the evening.
* You will be given a steroid card with this medicine that you should carry with you at all times. Show it to anyone who treats you (eg doctor, nurse, pharmacist, dentist, anaesthetist). The card contains details of your prescriber, type of steroid, dose taken and the duration of treatment. It's purpose is to act as a reminder that your medicine should not be stopped suddenly, and to provide information of your treatment to other people treating you. This is important because the effects that corticosteroids have on the body may affect other medical treatment you may be given. If you have an accident the card contains information that could save your life. You should also show your steroid card to anyone who treats you for three months after you stop treatment with steroids.
* During times of physical stress, for example illnesses, trauma or surgery, your adrenal glands would normally produce more steroid hormones to cope. However, during long-term treatment with this medicine the action of your adrenal glands will be suppressed, so this increase in hormones won't happen naturally. As a result your steroid dose will normally need to be increased temporarily during these kind of events. Discuss this with your doctor.
* Corticosteroids decrease the body's natural immune and inflammatory responses. They may increase your susceptibility to infections and can also mask the symptoms of infections, making you think they are less serious than they are. For this reason, it is important to consult your doctor if you get any signs of infection during treatment.
* If you have never had chickenpox you could be at risk of severe chickenpox while having treatment with this medicine and should avoid close personal contact with people who have chickenpox or shingles (herpes zoster). You should also avoid contact with people who have measles. If you are exposed to people with these diseases either during treatment, or in the three months after stopping treatment, you should consult your doctor urgently, as you will need an injection of immunoglobulin to help you stop getting the diseases. This is very important as these diseases can be life-threatening in people treated with long-term corticosteroids.
* Corticosteroid treatment, especially with high doses, can alter mood and behaviour early in treatment. People may experience confusion, irritability, nightmares, difficulty sleeping, mood changes and depression, and suffer from delusions and suicidal thoughts. In a few cases these effects have also occured when corticosteroid treatment is being withdrawn. For this reason, it is important to let your doctor know if you notice any change in your mood or behaviour during treatment or when stopping treatment, particularly if you begin to feel depressed, or have any disturbing thoughts or feelings. Most of these problems go away if the dose is lowered or the medicine is stopped. However if problems do happen they might need treatment.
* Children and adolescents having long-term treatment with this medicine should have their growth regularly monitored.

Deflazacort should be used with caution in patients with adrenal supression and infection (prolong course of corticosteroid increase susceptibility to infection and severity of infection; clinical presentation of infection may also be atypical); children and adolescents (growth retardation possibly irreversible), elderly (close supervision required perticularly on long-term treatment); frequent monitoring required if history of tuberculosis (or X-ray changes), hypertension, recent myocardial infarction (rupture reported), congestive heart failure, liver failure, renal impairment, diabetes mellitus including family history, osteoporosis (post-menopausal women at special risk), glaucoma (including family history), severe effective disorders (perticularly if history of steroid-induced psychosis), epilepsy, peptic ulcer, hypothyroidism, history of steroid myopathy; pregnancy, pregnancy and breast-feeding.

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