How does it work?
Calcort tablets contain the active ingredient deflazacort, which is a type of medicine known as a corticosteroid. Corticosteroids are hormones that are produced naturally by the adrenal glands. They have many important functions in the body, including control of inflammatory responses. Corticosteroid medicines are man-made derivatives of the natural hormones. They are often simply called steroids, but it should be noted that they are very different from another group of steroids, called anabolic steroids, which have gained notoriety because of their abuse by some athletes and body builders.

Deflazacort is a synthetic steroid that has an anti-inflammatory effect. It is used to decrease inflammation in various different diseases and conditions.

Deflazacort works by acting within cells to prevent the release of certain chemicals that are important in the immune system. These chemicals are normally involved in producing immune and allergic responses, resulting in inflammation. By decreasing the release of these chemicals in a particular area, inflammation is reduced. This can help control a wide number of disease states characterised by excessive inflammation. These include severe allergic reactions, inflammation of the lungs in asthma and inflammation of the joints in arthritis.

Deflazacort also decreases the numbers of white blood cells circulating in the blood. This, along with the decrease in inflammatory chemicals, can prevent the rejection of organ transplants, as it prevents the body from attacking foreign tissue. It is useful for the treatment of certain types of leukaemia, where there is an abnormally large production of certain white blood cells, and for treating certain diseases that are caused by the immune system attacking tissues in the body (autoimmune diseases).

What is it used for?

Severe allergic reactions, eg anaphylaxis.
Asthma.
Rheumatoid arthritis, juvenile chronic arthritis, polymyalgia rheumatica.
Inflammatory bowel disease such as Crohn's disease and ulcerative colitis.
Inflammatory disorders of the kidney, such as nephrotic syndrome and interstitial nephritis.
Inflammatory eye disorders, eg uveitis, optic neuritis.
Inflammatory skin disorders, including pemphigus vulgaris, bullous pemphigoid and pyoderma gangrenosum.
Inflammatory disease of the skin and muscles (dermatomyositis).
Inflammatory disease called systemic lupus erythematosus, which can affect many organs throughout the body and is caused by the immune system attacking connective tissue in the body.
Mixed connective tissue disease.
Rare condition involving inflammation in the walls of arteries (polyarteritis nodosa).
Sarcoidosis.
Rheumatic carditis.
Cancer of the bone marrow (multiple myeloma).
Acute and lymphatic leukaemia.
Cancer of the lymph nodes (lymphoma).
Idiopathic thrombocytopenia purpura.
Anaemia caused by the immune system attacking red blood cells (autoimmune haemolytic anaemia).
Helping to prevent the immune system attacking a transplanted organ, eg heart, liver, kidney etc.

Warning!

Use with caution in

Not to be used in

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the developing baby. When administered for long periods or repeatedly during pregnancy, corticosteroids may increase the risk of slowed growth in the developing baby. They may also cause the baby to make less of its own steroid hormones after birth, though this usually resolves on its own and rarely causes any problems. Seek further medical advice from your doctor.
If you think you could have fallen pregnant while you are taking this medicine you should consult your doctor for advice. It is important that you do not suddenly stop taking the medicine unless your doctor tells you to - see the warnings above.
This medicine passes into breast milk. It should be used with caution in mothers who are breastfeeding and only if the benefits to the mother outweigh any risks to the nursing infant. Doses of up to 50mg deflazacort daily taken by the mother are unlikely to significantly affect the baby, but if the mother is taking higher doses for long periods of time, the medicine could cause the baby's adrenal glands to make less of their own steroid hormones. Seek medical advice from your doctor.

Label warnings

Side effects

Raised blood sugar level.
Increased appetite and weight gain.
Increased susceptibility to infections and increased severity of infections (see warnings above).
Effects on the gut, such as indigestion or abdominal bloating, nausea, ulceration in the stomach or intestine, inflammation of the pancreas (pancreatitis).
Ulceration or thrush infection in the throat.
Muscle weakness or wasting.
Thinning of the bones (osteoporosis) and increased risk of breaking a bone.
Effects on the skin, such as skin thinning, impaired healing, acne, bruising, stretch marks, increased sweating, change in pigmentation, increased hair growth (hirsutism).
Psychiatric reactions, such as mood changes (including irritability, depression and suicidal thoughts), psychotic reactions (including mania, delusions and hallucinations), anxiety, confusion, memory loss, sleep disturbances (see warning above).
Cushing's syndrome, characterised by a moon-shaped face.
Menstrual disturbances.
Sodium and water retention.
Increase in blood pressure (hypertension).
Decrease in the level of potassium in the blood.
Decrease in the production of natural steroids by the adrenal glands (adrenal suppression - see warning above).
Effects on the eyes, such as raised pressure inside the eye (glaucoma), cataracts.
Slowed growth in children and adolescents.
Hiccups.
Blood clots in the blood vessels (thromboembolism).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

Deflazacort can cause fluid and salt retention and so may oppose the effects of the following medicines:

antihypertensive medicines used to treat high blood pressure
diuretics, eg furosemide.

There may be an increased chance of the level of potassium in the blood falling too low (hypokalaemia) if deflazacort is used in combination with any of the following medicines, which can also lower the amount of potassium in the blood:

acetazolamide
amphotericin
beta agonists, eg salbutamol, salmeterol, terbutaline
carbenoxolone
potassium-losing diuretics, eg furosemide, bendroflumethiazide
theophylline.

Deflazacort may increase blood sugar levels and so may oppose the blood sugar lowering effects of antidiabetic medicines. People with diabetes may need an increase in their dose of insulin or antidiabetic tablets.

Deflazacort may enhance the anti-blood-clotting effect of anticoagulant medicines such as warfarin. People taking anticoagulant medicines in combination with deflazacort should have their blood clotting time (INR) regularly monitored, particularly after starting or stopping treatment with deflazacort and after any dose changes.

If deflazacort is used in combination with non-steroidal anti-inflammatory drugs (NSAIDs) eg ibuprofen, there may be an increased risk of side effects on the gut, such as stomach ulceration and bleeding.

Deflazacort may decrease the blood levels of salicylates such as aspirin. When deflazacort is stopped, this may result in excessive levels of the salicylate, unless the dose is readjusted.

You should not take antacids for indigestion or heartburn wthin two hours of taking this medicine, because they can decrease the absorption of deflazacort from the gut and may therefore make it less effective.

The following medicines may increase the removal of deflazacort from the body, thus reducing its effects. You may need a larger dose of deflazacort if you are also taking any of these medicines:

barbituates, eg amobarbital, phenobarbital
carbamazepine
phenytoin
primidone
rifabutin
rifampicin.

The effect of corticosteroids may be reduced in the three to four days following use of mifepristone.

The following medicines may reduce the removal of deflazacort from the body and so may increase its effects or side effects:

ciclosporin (deflazacort may also increase the blood level and risk of side effects of ciclosporin)
itraconazole
ketoconazole
macrolide-type antibiotics, eg erythromycin
protease inhibitors, eg ritonavir.

Deflazacort may decrease the body's immune response. This means that vaccines may be less effective if given during treatment, because the body does not produce sufficient antibodies. Live vaccines may cause serious infections. Live vaccines include: measles, mumps, rubella, MMR, BCG, chickenpox, oral polio, oral typhoid and yellow fever. These should not be given to people whose immune system is underactive due to treatment with this medicine.