Adults

Initial dose for inflammatory conditions typically 6-18 mg daily, adjusted based on clinical response. For Duchenne Muscular Dystrophy, approximately 0.9 mg/kg/day orally.

Elderly

Lower doses or careful titration may be required due to increased susceptibility to side effects. Monitor closely.

Renal_impairment

No specific dose adjustment is generally required for mild to moderate renal impairment, but caution and close monitoring are advised.

Onset

Varies depending on the condition being treated, generally within hours to days for anti-inflammatory effects.

Excretion

Excretion occurs primarily via the kidneys (approximately 70% in urine) and about 30% in feces, mainly as inactive metabolites.

Half life

The active metabolite (DDZ) has a mean elimination half-life of 1.1 to 2.4 hours.

Absorption

Rapidly absorbed after oral administration and converted to the active metabolite 21-desacetyl deflazacort (DDZ). Peak plasma concentrations of DDZ are reached within 1.5 to 2 hours.

Metabolism

Primarily hepatic metabolism. Deflazacort is converted to its active metabolite DDZ, which is then further metabolized.

Anticoagulants (e.g., Warfarin)

May alter the anticoagulant effect, requiring close monitoring of INR and possible dose adjustment of the anticoagulant.

NSAIDs (e.g., Ibuprofen, Naproxen)

Increased risk of gastrointestinal ulceration or bleeding.

Diuretics (e.g., Furosemide, Thiazides)

Increased risk of hypokalemia. Monitor potassium levels.

Antidiabetic agents (e.g., Insulin, Metformin)

Corticosteroids may increase blood glucose levels, requiring adjustment of antidiabetic medication dosage.

CYP3A4 inducers (e.g., Rifampicin, Phenytoin, Carbamazepine)

May decrease deflazacort plasma concentrations, potentially reducing its efficacy. Dose adjustment may be necessary.

CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir, Clarithromycin)

May increase deflazacort plasma concentrations, potentially increasing side effects. Dose reduction may be necessary.