Indications: Zodet (Deflazacort) is indicated in:

Anaphylaxis, asthma, severe hypersensitivity reactions
Rheumatoid arthritis, juvenile chronic arthritis, polymyalgia rheumatica
Systemic lupus erythematosus, dermatomyositis, mixed connective tissue disease (except systemic sclerosis), polyarteritis nodosa, sarcoidosis
Pemphigus, bullous pemphigoid, pyoderma gangrenosum
Minimal change nephrotic syndrome, acute interstitial nephritis
Rheumatic carditis
Ulcerative colitis, Crohn’s disease
Uveitis, optic neuritis
Autoimmune haemolytic anaemia, idiopathic thrombocytopenic purpura
Acute and lymphatic leukemia, malignant lymphoma, multiple myeloma
Immune suppression in transplantation

Pharmacology: Deflazacort provides anti‑inflammatory action by inhibiting Phospholipase A2, reducing prostaglandin synthesis. It also decreases the release of immune system chemicals, providing immunosuppressive effects.

Dosage & Administration:

Adults:
- Acute disorders: Up to 120 mg/day initially; maintenance 3–18 mg/day.
- Rheumatoid arthritis: 3–18 mg/day, smallest effective dose.
- Bronchial asthma: Acute attack 48–72 mg/day, tapered after control; chronic asthma titrated to lowest effective dose.
- Other conditions: Dose based on clinical need; 5 mg prednisone ≈ 6 mg deflazacort.
Children:
- Juvenile chronic arthritis: 0.25–1.0 mg/kg/day.
- Nephrotic syndrome: 1.5 mg/kg/day initially, then tapered.
- Bronchial asthma: 0.25–1.0 mg/kg on alternate days.
- General range: 0.25–1.5 mg/kg/day.
Withdrawal: Gradual tapering required if >9 mg/day for >3 weeks.

Interactions:

Liver enzyme inducers (rifampicin, carbamazepine, phenytoin, phenobarbitone, etc.) may require increased dose.
Liver enzyme inhibitors (ketoconazole) may require reduced dose.

Contraindications:

Hypersensitivity to ingredients
Patients receiving live virus immunization

Side Effects:

GI disturbances, musculoskeletal issues, endocrine and neuropsychiatric effects
Ophthalmic problems, fluid/electrolyte imbalance
Increased infection risk, impaired healing, hypersensitivity, skin atrophy, striae, acne
Rare: myocardial rupture post‑MI, thromboembolism

Pregnancy & Lactation:

Pregnancy: Crosses placenta; prolonged use may cause intrauterine growth retardation. Use only if benefits outweigh risks.
Lactation: Excreted in breast milk. Doses ≤50 mg/day unlikely to cause systemic effects in infants; higher doses may cause adrenal suppression.

Precautions & Warnings:

Caution in cardiac disease, hypertension, thromboembolic disorders.
GI conditions (gastritis, ulcer, colitis, diverticulitis).
Diabetes, osteoporosis, myasthenia gravis, renal insufficiency.
Emotional instability, epilepsy, prior steroid‑induced myopathy.
Liver failure, hypothyroidism, cirrhosis.
Ocular herpes simplex (risk of corneal perforation).

Use in Special Populations:

Hepatic impairment: Increased blood levels; monitor and adjust dose.
Renal impairment: Usual precautions for glucocorticoid therapy.
Elderly: Adverse effects may have more serious consequences.

Therapeutic Class: Glucocorticoids