Deflazacort
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| Trade names | Emflaza, Calcort, others |
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| Routes of administration |
By mouth |
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| Pharmacokinetic data | |
| Protein binding | 40% |
| Metabolism | By plasma esterases, to active metabolite |
| Biological half-life | 1.1–1.9 hours (metabolite) |
| Excretion | Renal (70%) and fecal (30%) |
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| ChEMBL | |
| ECHA InfoCard | 100.034.969 |
| Chemical and physical data | |
| Formula | C25H31NO6 |
| Molar mass | 441.517 g/mol |
| 3D model (Jmol) | |
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Deflazacort (trade name Emflaza or Calcort among others) is a glucocorticoid used as an anti-inflammatory and immunosuppressant.
The manufacturer lists the following uses for deflazacort:
In the United States, deflazacort is also FDA-approved for the treatment of Duchenne muscular dystrophy in people over the age of 5.
Deflazacort carries the risks common to all corticosteroids, including immune suppression, decreased bone density, and endocrine insufficiency. In clinical trials, the most common side effects (>10% above placebo) were Cushing's-like appearance, weight gain, and increased appetite.
Deflazacort is an inactive prodrug which is metabolized rapidly to the active drug 21-desacetyldeflazacort.
Deflazacort's potency is around 70–90% that of prednisone. A 2017 review found its activity of 7.5 mg of deflazacort is approximately equivalent to 25 mg cortisone, 20 mg hydrocortisone, 5 mg of prednisolone or prednisone, 4 mg of methylprednisolone or triamcinolone, or 0.75 mg of betamethasone or dexamethasone. The review noted that the drug has a high therapeutic index, being used at initial oral doses ranging from 6 to 90 mg, and probably requires a 50% higher dose to induce the same demineralizing effect as prednisolone. Thus it has "a smaller impact on calcium metabolism than any other synthetic corticosteroid, and therefore shows a lower risk of growth rate retardation in children and of osteoporosis" in the elderly, and comparatively small effects on carbohydrate metabolism, sodium retention, and hypokalemia.
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