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 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 fluid retention.

Increased Blood Glucose: May induce or exacerbate diabetes; regular blood glucose monitoring is required.

Electrolyte Imbalance: Hypokalemia and hypertension (incidence of approximately 10%–20%).

Gastrointestinal Reactions

Increased appetite (common in children) and dyspepsia (incidence of 5%–10%).

Long-term use may cause gastric ulcers (concomitant use of gastric mucosal protectants is necessary).

Skeletal and Muscular Effects

Osteoporosis: Children and patients on long-term medication need supplementary calcium and vitamin D.

Exacerbated Muscle Weakness: For DMD patients, the balance between therapeutic effects and the risk of deteriorating muscle function must be considered.

Other Common Reactions

Headache (incidence of 5%–15%), mood swings (e.g., anxiety, depression), and thinning of the skin.

Severe Side Effects of Deflazacort (Calcort) That Require Vigilance

Adrenal Suppression

Sudden discontinuation after long-term use may lead to adrenal crisis (manifested as hypotension and shock).

Management Measures: The drug must be discontinued gradually by reducing the dose; abrupt discontinuation is not allowed.

Increased Infection Risk

May mask infection symptoms, leading to worsening bacterial, fungal, or viral infections (e.g., pneumonia, herpes zoster).

High-Risk Populations: Immunocompromised patients or those receiving concurrent treatment with other immunomodulators.

Ocular Complications

Cataracts (incidence of approximately 5%–10% in pediatric patients) and glaucoma.

Monitoring Recommendations: Ophthalmic examinations should be conducted every 6 months.

Precautions for Administration of Deflazacort (Calcort)

Contraindications in Special Populations

Children: Close monitoring of growth retardation and changes in bone mineral density is required.

Pregnant Women: Should be used only 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 plasma concentration of deflazacort, requiring dose reduction.

Live Vaccines: Vaccination is prohibited during medication administration (immune response may be weakened).

Key Points for Long-Term Management

Monitoring Items: Regularly check blood pressure, blood glucose, bone mineral density, and electrolytes.

Evaluate growth curves 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.