Adults

Initial dosage varies depending on the condition. For most conditions, 6-90 mg orally once daily, adjusted based on patient response. The lowest effective dose should be used for the shortest duration possible.

Elderly

No specific dose adjustment is generally required, but close monitoring for adverse effects is recommended due to potential increased sensitivity.

Renal_impairment

No specific dose adjustment is usually necessary for patients with renal impairment, but caution is advised. Regular monitoring may be beneficial.

Onset

Clinical effects may be observed within a few hours to days, depending on the condition being treated.

Excretion

Mainly excreted in urine (about 70%) and feces (about 30%) as metabolites, with only a small fraction of unchanged drug.

Half life

The active metabolite (21-desacetyl deflazacort) has a plasma half-life of 1.5-2 hours.

Absorption

Well absorbed from the gastrointestinal tract following oral administration. Peak plasma concentrations are reached within 1.5 to 2 hours.

Metabolism

Extensively metabolized in the liver, primarily by CYP3A4, to its active metabolite 21-desacetyl deflazacort, which is responsible for most of its pharmacological activity.

Antidiabetic agents

May reduce the hypoglycemic effect; dose adjustment of antidiabetics may be required.

Anticoagulants (e.g., Warfarin)

Effects may be altered; monitor INR closely.

Diuretics (e.g., Thiazides, Loop Diuretics)

Increased risk of hypokalemia.

CYP3A4 Inducers (e.g., Rifampicin, Phenytoin)

May decrease Deflazacort levels, reducing efficacy.

NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

Increased risk of gastrointestinal ulceration.

CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir)

May increase Deflazacort levels, increasing risk of side effects.