部分中文Deflazacort处方资料（仅供参考）

药物名称： 地夫可特

英文名称： Deflazacort

药理：

　　本品具有抗炎、抗过敏作用，其效果相当于泼尼松龙10～20倍。

　　适应症：

　　用于肾上腺皮质机能减退、自身免疫性疾病、过敏性疾病及血液系统疾病等。

　　用法用量：

　　口服：成人每日6-90毫克，视病情而定

　　片剂：每片6毫克。30毫克

　　禁用慎用：

　　1、一般性的感染不应使用本药。对病毒性感染应慎用，以免因抑制机体免疫系统功能而导致病毒感染的扩散与加重。

　　2、孕妇应慎用或禁用。肝功能不良病人不宜用。

　　3、高血压、糖尿病、肾上腺皮质机能亢进症、活动性溃疡及新近胃肠吻合手术、心力衰竭、精神病、癫痫、动脉硬化、血栓性静脉炎、骨质疏松、耐药性感染及真菌感染等慎用或禁用。

　　给药说明：

　　1、应用本类药物时，必须严格掌握适应症，防止滥用，以减少不良反应和并发症。用药期间应测定肾功能。

　　2、治疗急性感染中毒，必须与足量的抗感染药物配合应用。

　　3、长期使用本品时，应给予促皮质素。医学教育网搜集整理

　　4、停药时应逐渐减量，不可骤停，以免复发或出现肾上腺皮质机能不足症状。

　　5、已经长期使用本品的病人，在手术时及术后的3-4天内，须适当增加用量，以防止皮质功能不足，一般外科病人尽量不用，以免影响伤口愈合。

　　6、密闭置干燥阴凉处保存。

　　不良反应：

　　1、本品在大剂量长期应用时，可引起肥胖、多毛、痤疮、血糖升高、高血压、眼内压升高、钠和水储留、水肿、血钾降低、精神兴奋、胃及十二指肠溃疡甚至出血穿孔、骨质疏松、脱钙、病理性骨折、伤口愈合不良、柯兴氏综合症等。

　　2、本品对病原微生物并无抑制作用，且由于能抑制炎症反应和免疫反应，降低机体的防御功能，反而有可能使潜在的感染病灶活动并扩散，应特别注意及时加以控制。特别是因缺乏具有确切疗效的抗病毒药物，病毒性感染病人用药可能会导致不能控制的病毒感染扩散与加重。

　　3、长期使用本品可能导致肾上腺皮质功能减退，可加用促皮质素。

　　4、妊娠期间特别是早期使用可能会影响胎儿的发育，甚至造成多发性畸形。

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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).

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What is it used for?
Calcort tablets can be used to treat a wide variety of diseases and conditions that require either reduction of inflammation or suppression of the immune system. These include those listed below.

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!
Calcort tablets should be taken in the morning to mimic the natural production of corticosteroids by the body. They should be taken after food to minimise irritation to the stomach.

You must not stop taking this medicine suddenly if you have been taking it for more than three weeks. This is because long-term use of corticosteroids can suppress the natural production of corticosteroids by the adrenal glands, which means that the body becomes temporarily reliant on the medicine. When it is time to stop treatment the dose should be tapered down gradually, to allow the adrenal glands to start producing adequate amounts of natural steroids again. Follow the instructions given by your doctor or pharmacist. Your doctor may also want you to stop treatment gradually if you have been taking high doses (more than 48mg deflazacort daily) even if only for three weeks or less; if you have been treated with corticosteroid tablets or injections in the last year; if you had problems with your adrenal glands before treatment was started; or if you have been repeatedly taking doses in the evening.

You will be given a steroid card with this medicine that you should carry with you at all times. Show it to anyone who treats you (eg doctor, nurse, pharmacist, dentist, anaesthetist). The card contains details of your prescriber, type of steroid, dose taken and the duration of treatment. It's purpose is to act as a reminder that your medicine should not be stopped suddenly, and to provide information of your treatment to other people treating you. This is important because the effects that corticosteroids have on the body may affect other medical treatment you may be given. If you have an accident the card contains information that could save your life. You should also show your steroid card to anyone who treats you for three months after you stop treatment with steroids.

During times of physical stress, for example illnesses, trauma or surgery, your adrenal glands would normally produce more steroid hormones to cope. However, during long-term treatment with this medicine the action of your adrenal glands will be suppressed, so this increase in hormones won't happen naturally. As a result your steroid dose will normally need to be increased temporarily during these kind of events. Discuss this with your doctor.

Corticosteroids decrease the body's natural immune and inflammatory responses. They may increase your susceptibility to infections and can also mask the symptoms of infections, making you think they are less serious than they are. For this reason, it is important to consult your doctor if you get any signs of infection during treatment.

If you have never had chickenpox you could be at risk of severe chickenpox while having treatment with this medicine and should avoid close personal contact with people who have chickenpox or shingles (herpes zoster). You should also avoid contact with people who have measles. If you are exposed to people with these diseases either during treatment, or in the three months after stopping treatment, you should consult your doctor urgently, as you will need an injection of immunoglobulin to help you stop getting the diseases. This is very important as these diseases can be life-threatening in people treated with long-term corticosteroids.

Corticosteroid treatment, especially with high doses, can alter mood and behaviour early in treatment. People may experience confusion, irritability, nightmares, difficulty sleeping, mood changes and depression, and suffer from delusions and suicidal thoughts. In a few cases these effects have also occured when corticosteroid treatment is being withdrawn. For this reason, it is important to let your doctor know if you notice any change in your mood or behaviour during treatment or when stopping treatment, particularly if you begin to feel depressed, or have any disturbing thoughts or feelings. Most of these problems go away if the dose is lowered or the medicine is stopped. However if problems do happen they might need treatment.

Children and adolescents having long-term treatment with this medicine should have their growth regularly monitored.

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Use with caution in

Children and adolescents.
Elderly people.
Decreased kidney function.
Decreased liver function or liver failure.
Liver cirrhosis.
Peptic ulcer.
Inflammation of the stomach lining (gastritis).
Inflammation of the food pipe (oesophagitis)
Inflammation of the bowel and back passage (ulcerative colitis).
Painful inflammation of small sacs or pouches in the wall of the gut (diverticulitis).
People who have recently had a surgical procedure called intestinal anastomosis, which involves the joining together of ends of the intestine after a section has been removed.
People with a history of blood clots in the blood vessels (thromboembolism).
Heart failure.
People who have recently had a heart attack.
High blood pressure (hypertension).
Diabetes, or a family history of diabetes.
Underactive thyroid gland (hypothyroidism).
Epilepsy.
Glaucoma, or a family history of glaucoma.
Current severe psychiatric illness, or a personal or family history of psychiatric illness, including depression, manic depression or schizophrenia.
History of psychiatric illness caused by the use of a corticosteroid.
Osteoporosis.
Women who have passed the menopause.
Abnormal muscle weakness (myasthenia gravis).
People who have previously experienced muscle disorders (myopathy) caused by steroids.
People with a history of tuberculosis (TB).
People with abscesses or other pus-producing infections.
Herpes simplex virus infection of the eye.
People with a low level of potassium in their blood (hypokalaemia).

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Not to be used in
People with widespread infection, unless this is being treated with specific anti-infectives.
Rare hereditary problems of galactose intolerance, the Lapp lactose deficiency or glucose-galactose malabsorption (Calcort tablets contain lactose).
Corticosteroids should not be used for the management of head injury or stroke because they are unlikely to be of benefit and may even be harmful.
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
Do not take indigestion remedies at the same time of day as this medication.
Follow the printed instructions you have been given with this medication.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

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.