Deflazacort

The source recovered in this bundle is the UK SPC for 'Calcort 6mg Tablets' (eMC product 13999) — the page's own UK brand, oral, with general glucocorticoid posology. || VERBATIM §4.2, adults, in full: 'Adults For acute disorders, up to 120 mg/day deflazacort may need to be given initially. Maintenance doses in most conditions are within the range 3 – 18 mg/day. The following regimens are for guidance only. Rheumatoid arthritis: The maintenance dose is usually within the range 3 – 18 mg/day. The smallest effective dose should be used and increased if necessary. Bronchial asthma: In the treatment of an acute attack, high doses of 48 – 72 mg/day may be needed depending on severity and gradually reduced once the attack has been controlled. For maintenance in chronic asthma, doses should be titrated to the lowest dose that controls symptoms. Other conditions: The dose of deflazacort depends on clinical need titrated to the lowest effective dose for maintenance. Starting doses may be estimated on the basis of ratio of 5 mg prednisone or prednisolone to 6 mg deflazacort.' || GOVERNING PRINCIPLE, verbatim: 'Doses vary widely in different diseases and different patients. In more serious and life-threatening conditions, high doses of deflazacort may need to be given. When deflazacort is used long term in relatively benign chronic diseases, the maintenance dose should be kept as low as possible. Dosage may need to be increased during periods of stress or in exacerbation of illness. The dosage should be individually titrated according to diagnosis, severity of disease and patient response and tolerance.' || WITHDRAWAL — do not stop abruptly, verbatim §4.2: 'In patients who have received more than physiological doses of systemic corticosteroids (approximately 9 mg per day or equivalent) for greater than 3 weeks, withdrawal should not be abrupt. … If the disease is unlikely to relapse on withdrawal of systemic corticosteroids but there is uncertainty about HPA suppression, the dose of systemic corticosteroids may be reduced rapidly to physiological doses. Once a daily dose equivalent to 9 mg deflazacort is reached, dose reduction should be slower to allow the HPA-axis to recover. Abrupt withdrawal of systemic corticosteroid treatment, which has continued up to 3 weeks is appropriate if it is considered that the disease is unlikely to relapse. Abrupt withdrawal of doses up to 48 mg daily of deflazacort, or equivalent for 3 weeks is unlikely to lead to clinically relevant HPA-axis suppression, in the majority of patients.' §4.2 then lists the groups needing gradual withdrawal even after courses of 3 weeks or less: repeated courses of systemic corticosteroids particularly if taken for more than 3 weeks; a short course prescribed within one year of stopping long-term therapy; other reasons for adrenocortical insufficiency; doses greater than 48 mg daily of deflazacort or equivalent; and patients repeatedly taking doses in the evening. || ELDERLY, verbatim: 'In elderly patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary. The common adverse effects of systemic corticosteroids may be associated with more serious consequences in old age.' || US LABELLING IS ALSO IN THIS BUNDLE BUT WAS NOT USED FOR THIS FIELD: the openFDA provider carries a US label for 'Deflazacort Oral Suspension' (Zydus, 2026-07-23) that is licensed for Duchenne muscular dystrophy only, gives a single weight-based dose, and gives no fixed-milligram dosing for any inflammatory, allergic, rheumatic or immunosuppressive indication. The UK SPC above is the source for everything in this field. The US DMD figure is recorded, clearly attributed, in paedDose.notes.

⚠️ UNIT: mg/kg/DAY — a total daily dose given once daily, not a per-dose figure. VERBATIM §4.2 paediatric population, in full: 'There has been limited exposure of children to deflazacort in clinical trials. In children, the indications for glucocorticoids are the same as for adults, but it is important that the lowest effective dosage is used. Alternate day administration may be appropriate (see section 4.4). Doses of deflazacort usually lie in the range 0.25 – 1.5 mg/kg/day. The following ranges provide general guidance: Juvenile chronic arthritis: The usual maintenance dose is between 0.25 – 1.0 mg/kg/day. Nephrotic syndrome: Initial dose of usually 1.5 mg/kg/day followed by down titration according to clinical need. Bronchial asthma: On the basis of the potency ratio, the initial dose should be between 0.25 – 1.0 mg/kg deflazacort on alternate days.' || WHY dosePerKg IS 0.25: the SPC gives a RANGE (0.25 – 1.5 mg/kg/day) and no single figure, so the calculator is seeded with the label's own lower bound and the label's own upper bound is carried in maxDose. Nothing has been averaged, scaled or derived. Choose within 0.25–1.5 mg/kg/day by indication using the label's own bands above — juvenile chronic arthritis 0.25–1.0 mg/kg/day; nephrotic syndrome usually 1.5 mg/kg/day initially, then down-titrated; bronchial asthma 0.25–1.0 mg/kg on ALTERNATE DAYS (note the alternate-day schedule for asthma, which the calculator's daily figure does not express). || concentration is NULL because the UK source product is a 6 mg TABLET, not a liquid — this bundle contains no UK suspension strength, so no volume can be calculated. || THE 0.9 mg/kg/day FIGURE IS US LABELLING FOR ONE INDICATION ONLY and is NOT the UK general paediatric dose: the openFDA provider's US label for 'Deflazacort Oral Suspension' states 'The recommended oral dosage of deflazacort oral suspension is approximately 0.9 mg/kg/day once daily', licensed for Duchenne muscular dystrophy, in patients 2 years of age and older, at a suspension strength of 22.75 mg/mL, with a US instruction to give one third of the dose with moderate or strong CYP3A4 inhibitors and to avoid moderate or strong CYP3A4 inducers. It is recorded here for reference and clearly attributed; it must not be applied to asthma, croup, nephrotic syndrome, juvenile chronic arthritis or any other indication, and it is not the figure the calculator uses. || SAFETY: the SPC itself warns 'There has been limited exposure of children to deflazacort in clinical trials.' Verify any paediatric dose against a children's formulary and current prescribing references before prescribing.