Presentation

Deltacort tablet: Each tablet contains 5 mg Prednisolone BP.

Indication

A wide variety of diseases may sometimes require corticosteroid (Deltacort) therapy. Some of the principal indications are bronchial asthma, severe allergic disturbances, acute and lymphatic leukemia, rheumatoid arthritis, collagen diseases and various inflammatory skin diseases. Other indications are the minimum change nephrotic syndrome, ulcerative colitis, regional ileitis (Crohn's disease), pemphigus, sarcoidosis (especially with hypercalcemia), rheumatoid carditis, and various blood dyscrasias, including selected cases of hemolytic anemia and idiopathic thrombocytopenic purpura.

Dosage & administration

Adults: The dose used will depend upon the disease, its severity and the clinical response obtained. The following regimens are for guidance only. Divided dosage is usually employed.

Short term treatment: 20 to 30 mg daily for the first few days, subsequently reducing the daily dosage by 2.5 or 5 mg every two to five days, depending upon the response.

Rheumatoid arthritis: 7.5 to 10 mg daily. For maintenance therapy the lowest effective dosage is used. Most other conditions: 10 to 100 mg daily for one to three weeks, then reducing to the minimum effective dosage.

Children: Fractions of the adult dosage may be used (e.g.75% at 12 years, 50% at 7 years and 25% at 1 year), but clinical factors must be given due weight or as directed by the physician.

Contraindication

Until life is threatened corticosteroids should not be used in the following conditions: Peptic ulcer, osteoporosis, infections, diabetes mellitus, and psychological disturbances.

Side effects

Prolonged treatment with corticosteroids in high dosage is occasionally associated with subcapsular cataract, skin thinning, osteoporosis and glaucoma. In addition, any of the features of hypercorticism, such as suppression of HPA axis may occur. Peptic ulceration may develop or be aggravated. In children prolonged therapy may retard growth. In patients on long term therapy fluid and electrolyte balance may be altered. Other rare side effects which have been reported include benign intracranial hypertension and psychic instability.

Precaution

Care should be taken in congestive heart failure, adrenal suppression, infection, childhood, adolescence, history of tuberculosis. Corticosteroids may worsen diabetes mellitus, osteoporosis, glaucoma and epilepsy.

Drug interaction

Steroids may reduce the effects of anticholinesterases in myasthenia gravis, cholecystographic X-ray media and nonsteroidal anti- inflammatory agents. It should also be remembered that the effects of steroids may be reduced by phenytoin, phenobarbitone, ephedrine and rifampicin.

Overdosage

Acute overdosage is unlikely to occur. However in the case of chronic overdosage or misuse the features of hypercorticism may appear and in this situation the product should be discontinued slowly.

Pharmaceutical precaution

Store in cool and dry place, protect from light. Keep out of reach of children.

Packing

Deltacort Tablet: Box containing 50 x 10 tablets in blister pack.