Deflazacort (Calcort) is a glucocorticoid drug primarily used for the treatment of Duchenne Muscular Dystrophy (DMD) as well as other inflammatory or autoimmune diseases. Although its therapeutic efficacy is well-established, long-term use may be accompanied by a variety of side effects, requiring strict monitoring.
What Are the Side Effects of Deflazacort (Calcort)?
Metabolic and Endocrine System Effects
Cushing's Syndrome Manifestations: Moon face, centripetal obesity, and water-sodium retention.
Elevated Blood Glucose: May induce or exacerbate diabetes; regular blood glucose monitoring is required.
Electrolyte Imbalances: Hypokalemia and hypertension (with an incidence of approximately 10%-20%).
Gastrointestinal Reactions
Increased appetite (common in children) and dyspepsia (5%-10%).
Long-term use may cause gastric ulcers (concomitant use of gastric mucosal protectants is necessary).
Effects on Bones and Muscles
Osteoporosis: Children and patients on long-term medication need supplementary calcium and vitamin D.
Exacerbated Muscle Weakness: For DMD patients, it is necessary to balance the therapeutic effects against the risk of worsening muscle function.
Other Common Reactions
Headache (5%-15%), mood swings (e.g., anxiety, depression), and thinning of the skin.
Severe Side Effects of Deflazacort (Calcort) That Require Vigilance
Adrenal Function Suppression
Sudden discontinuation after long-term use may lead to adrenal crisis (manifested as hypotension and shock).
Management Measures: The dosage must be gradually reduced for discontinuation; abrupt withdrawal is not allowed.
Increased Infection Risk
May mask infection symptoms, leading to the exacerbation of bacterial, fungal, or viral infections (e.g., pneumonia, herpes zoster).
High-Risk Populations: Immunocompromised patients or those receiving combined treatment with other immunomodulators.
Ocular Complications
Cataracts (with an incidence of approximately 5%-10% in pediatric patients) and glaucoma.
Monitoring Recommendation: Conduct an ophthalmological examination every 6 months.
Precautions for Deflazacort (Calcort) Use
Contraindications in Special Populations
Children: Close monitoring of growth retardation and changes in bone mineral density is required.
Pregnant Women: Should only be used when there is a clear medical need (FDA Pregnancy Category C).
Lactating Women: The drug may be excreted into breast milk; it is recommended to discontinue the drug or terminate breastfeeding.
Drug Interactions
CYP3A4 Inhibitors (e.g., clarithromycin): May increase the blood concentration of deflazacort, requiring dosage reduction.
Live Vaccines: Vaccination is prohibited during the medication period (as the immune response may be weakened).
Key Points for Long-Term Management
Monitoring Items: Conduct regular checks of blood pressure, blood glucose, bone mineral density, and electrolytes.
Evaluate the growth curve every 3-6 months (for pediatric patients).
Lifestyle Interventions: Adopt a low-salt, high-protein diet, and engage in moderate exercise to prevent muscle atrophy.
