Calcort: Advanced Glucocorticoid Therapy for Rapid Inflammation Control
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Synonyms | |||
Calcort (Deflazacort) is a second-generation glucocorticoid medication designed to provide potent anti-inflammatory and immunosuppressive effects with a potentially improved side effect profile compared to traditional corticosteroids. It is indicated for the management of a variety of inflammatory and autoimmune conditions, offering physicians a valuable tool in modulating the body’s immune response. Its unique chemical structure contributes to its therapeutic efficacy while aiming to minimize certain adverse effects commonly associated with long-term steroid use.
Features
- Active ingredient: Deflazacort 6 mg or 30 mg tablets
- Belongs to the glucocorticoid class of corticosteroids
- Modified prednisolone derivative with an oxazoline ring
- Oral administration with high bioavailability
- Metabolized to active 21-desacetyldeflazacort
- Plasma half-life of approximately 1.1-1.9 hours (active metabolite: 1.5-4 hours)
- Excretion primarily renal (70%) and fecal (30%)
Benefits
- Provides rapid and effective control of inflammatory processes
- May offer reduced mineralocorticoid effects compared to conventional corticosteroids
- Demonstrates potentially lower impact on glucose metabolism in some patient populations
- Supports management of chronic inflammatory conditions with established dosing protocols
- Enables flexible dosing regimens tailored to specific clinical indications
- Facilitates tapering schedules to minimize adrenal suppression during discontinuation
Common use
Calcort is commonly prescribed for the management of various inflammatory and autoimmune disorders including rheumatoid arthritis, systemic lupus erythematosus, dermatological conditions such as severe psoriasis and eczema, allergic states that are unresponsive to conventional treatments, asthma and other respiratory conditions requiring systemic corticosteroid therapy, certain hematological disorders, and management of exacerbations in multiple sclerosis. It is also used in the management of certain ocular inflammatory conditions and in some cases of organ transplantation rejection prophylaxis.
Dosage and direction
The dosage of Calcort must be individualized based on the specific condition being treated, disease severity, and patient response. For anti-inflammatory/immunosuppressive effects, the usual initial dose ranges from 6 mg to 90 mg daily, depending on disease activity. The dosage should be titrated to the lowest effective level once clinical control is achieved. Administration should preferably occur with food to minimize gastrointestinal discomfort. Tablets should be swallowed whole with water and not crushed or chewed. For patients requiring long-term therapy, alternate-day administration may be considered to reduce the risk of hypothalamic-pituitary-adrenal (HPA) axis suppression. Dosage reduction should be gradual when discontinuing treatment after prolonged therapy.
Precautions
Patients requiring Calcort therapy require careful monitoring throughout treatment. Regular assessment of blood pressure, body weight, and serum electrolyte levels is recommended. Monitoring for hyperglycemia is essential, particularly in patients with diabetes or risk factors for glucose intolerance. Bone density monitoring should be considered for patients on long-term therapy. Patients should be monitored for signs of infection, as corticosteroids may mask symptoms and enhance susceptibility to infections. Ophthalmic examinations are recommended with prolonged use to monitor for cataract formation and glaucoma. Special caution is required in patients with emotional instability or psychotic tendencies, as corticosteroids may exacerbate these conditions. Growth monitoring is essential in pediatric patients.
Contraindications
Calcort is contraindicated in patients with known hypersensitivity to deflazacort or any component of the formulation. Systemic fungal infections represent an absolute contraindication. Live virus vaccinations are contraindicated in patients receiving immunosuppressive doses of corticosteroids. Administration during pregnancy requires careful risk-benefit assessment, particularly during the first trimester. Use is generally contraindicated in patients with active peptic ulcer disease, unless the benefits outweigh the risks and appropriate gastric protection is implemented. Severe hepatic impairment may require dosage adjustment or alternative therapy.
Possible side effect
Common adverse reactions may include gastrointestinal disturbances (dyspepsia, nausea), fluid retention, weight gain, and mood changes. Endocrine effects may include glucose intolerance, development of cushingoid state, and HPA axis suppression. Musculoskeletal effects can include osteoporosis, vertebral compression fractures, and muscle weakness. Dermatological reactions may include impaired wound healing, skin atrophy, and ecchymoses. Ophthalmic effects include increased intraocular pressure and posterior subcapsular cataracts. Cardiovascular effects may include hypertension and congestive heart failure in susceptible patients. Rare but serious adverse effects include pancreatitis, psychic disturbances, and avascular necrosis.
Drug interaction
Calcort may interact with several medication classes. Concurrent use with nonsteroidal anti-inflammatory drugs may increase the risk of gastrointestinal ulceration. Anticoagulant effects may be altered, requiring more frequent monitoring of coagulation parameters. Concomitant use with potassium-depleting diuretics may enhance hypokalemia. The hypoglycemic effect of antidiabetic agents may be antagonized. CYP3A4 inducers (phenytoin, rifampin) may enhance corticosteroid metabolism, while inhibitors may reduce it. Live vaccines may have reduced efficacy and increased risk of complications. Concurrent use with other immunosuppressants may increase infection risk.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed administration. For patients on alternate-day therapy, if a dose is missed, the schedule should be adjusted to maintain the alternate-day pattern. Healthcare providers should be consulted if multiple doses are missed, particularly during tapering regimens.
Overdose
Acute overdose with Calcort is unlikely to produce acute life-threatening symptoms, but may exacerbate corticosteroid-related adverse effects. Management is primarily supportive and symptomatic. Gastric lavage or activated charcoal may be considered if ingestion occurred recently. Electrolyte imbalance, particularly hypokalemia, should be corrected. Monitoring of vital signs and blood glucose levels is recommended. There is no specific antidote for corticosteroid overdose. Chronic excessive administration will produce cushingoid symptoms requiring gradual dose reduction under medical supervision.
Storage
Calcort tablets should be stored at room temperature (15-30°C) in their original container, protected from light and moisture. Keep the medication out of reach of children and pets. Do not store in bathrooms or other areas with high humidity. Properly discard any expired or unused medication according to local regulations. Do not flush medications down the toilet unless specifically instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. The prescribing physician remains the ultimate authority regarding appropriate use, dosage, and monitoring of Calcort therapy. Patients should not initiate, modify, or discontinue medication without consulting their healthcare provider. The complete prescribing information should be consulted before administration. Individual patient responses may vary, and therapeutic decisions should be based on clinical judgment and patient-specific factors.
Reviews
Clinical studies have demonstrated Calcort’s efficacy in managing inflammatory conditions with a generally favorable tolerability profile. Many rheumatologists report satisfactory inflammatory control with potentially reduced metabolic effects compared to prednisone. Dermatologists note effective management of severe inflammatory skin conditions with appropriate dosing. Some studies suggest potentially less impact on bone metabolism compared to equivalent anti-inflammatory doses of prednisone. Patient-reported outcomes generally indicate effective symptom control, though individual experiences with side effects vary. Long-term registry data continue to inform optimal use in chronic inflammatory conditions.