Deltasone

DELTASONE is used to reduce inflammation and reduce the symptoms in a variety of conditions like ulcerative colitis and asthma.

Product dosage: 10mg
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Product dosage: 20mg
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Product dosage: 40mg
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Product dosage: 5mg
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Synonyms Clémisolone Canaural Dermipred Afisolone Amacin Antihistalone Cortizeme Bioderm

Deltasone is the brand name for the systemic corticosteroid prednisone, a cornerstone medication in managing a wide spectrum of inflammatory and autoimmune conditions. It functions as a potent immunosuppressant and anti-inflammatory agent, mimicking the effects of hormones naturally produced by the adrenal glands. By modulating the body’s immune response, it effectively reduces inflammation, alleviates pain, and suppresses inappropriate immune activity, providing critical therapeutic relief where other treatments may fall short. This makes it an indispensable tool for physicians in specialties ranging from rheumatology to pulmonology and hematology.

Features

• Active Pharmaceutical Ingredient: Prednisone.
• Drug Class: Synthetic glucocorticoid corticosteroid.
• Administration: Oral tablet formulation.
• Available Strengths: Commonly available in 1mg, 2.5mg, 5mg, 10mg, 20mg, and 50mg tablets.
• Mechanism of Action: Binds to glucocorticoid receptors, leading to complex anti-inflammatory and immunosuppressive effects by inhibiting the migration of polymorphonuclear leukocytes and reversing increased capillary permeability.
• Bioavailability: High oral bioavailability, with peak plasma concentrations occurring within 1 to 2 hours post-ingestion.
• Metabolism: Hepatic conversion from the inactive prodrug prednisone to the active metabolite prednisolone via 11-β-hydroxysteroid dehydrogenase.
• Excretion: Primarily renal excretion of metabolites.

Benefits

• Rapid and Potent Anti-inflammatory Action: Quickly suppresses the inflammatory cascade, providing relief from swelling, redness, heat, and pain associated with numerous conditions.
• Effective Immunosuppression: Calms an overactive immune system, preventing it from attacking the body’s own tissues in autoimmune disorders like lupus and rheumatoid arthritis.
• Symptom Control in Allergic Reactions: Manages severe allergic responses that are unresponsive to conventional antihistamines, including contact dermatitis and severe seasonal allergies.
• Prevention of Organ Transplant Rejection: Used as part of combination immunosuppressive regimens to help prevent the body from rejecting a transplanted organ.
• Induction of Remission in Hematologic Cancers: Can help induce and maintain remission in certain leukemias and lymphomas by suppressing cancerous lymphocyte proliferation.
• Management of Acute Exacerbations: Crucial for controlling sudden flare-ups of chronic conditions like asthma, COPD, and inflammatory bowel disease, often preventing hospitalization.

Common use

Deltasone (prednisone) is indicated for a vast array of conditions where suppression of inflammation or the immune system is desirable. Its use is typically reserved for moderate to severe cases due to its systemic effects and potential side effect profile. Common therapeutic applications include:

• Rheumatologic Diseases: Rheumatoid arthritis, polymyalgia rheumatica, systemic lupus erythematosus (SLE), vasculitis, and polymyositis.
• Pulmonary Conditions: Severe asthma exacerbations, chronic obstructive pulmonary disease (COPD) exacerbations, sarcoidosis, and as part of treatment regimens for certain interstitial lung diseases.
• Dermatologic Conditions: Severe psoriasis, pemphigus vulgaris, severe contact dermatitis, and exfoliative dermatitis.
• Allergic States: Severe or incapacitating allergic conditions intolerant to conventional treatment, including angioedema and urticaria.
• Ophthalmic Diseases: Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa, such as keratitis, allergic conjunctivitis, and optic neuritis.
• Hematologic Disorders: Autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and as part of combination chemotherapy for leukemias and lymphomas (e.g., Acute Lymphoblastic Leukemia, Hodgkin’s and non-Hodgkin lymphoma).
• Gastrointestinal Diseases: To induce and maintain remission in ulcerative colitis and Crohn’s disease.
• Endocrine Disorders: As replacement therapy for adrenal insufficiency (typically in conjunction with a mineralocorticoid).
• Nephrotic Syndrome: To induce diuresis and remission of proteinuria.
• Other Uses: Treatment of acute gouty arthritis, tuberculous meningitis, and trichinosis with neurologic involvement.

Dosage and direction

The dosage of Deltasone is highly individualized and must be strictly determined by a physician based on the specific disease entity being treated and the patient’s response. There is no single standard dosage.

• Dosage Principle: The initial dosage may vary from 5 mg to 60 mg of prednisone per day, depending on the disease and its severity.
• Dosage Forms: Deltasone is taken orally, usually as a single daily dose, preferably with food or milk to minimize gastric upset.
• Timing: For daily therapy, it is generally recommended to take the dose in the morning (between 7-8 AM) to coincide with the body’s natural cortisol production cycle and reduce the potential for hypothalamic-pituitary-adrenal (HPA) axis suppression.
• Alternate-Day Therapy: For some chronic conditions, a physician may prescribe an alternate-day regimen (a single dose every other morning) to minimize adrenal suppression and some other side effects while still providing a therapeutic effect.
• Tapering (Crucial): Therapy must NEVER be discontinued abruptly after more than a few weeks of use. Dosage must be tapered gradually under medical supervision. The rate of tapering is based on the dose, duration of therapy, underlying disease, and the patient’s clinical response. Abrupt withdrawal can lead to adrenal insufficiency, disease flare-up, and other withdrawal symptoms.
• Monitoring: Patients require close medical supervision for dosage adjustment and for monitoring of potential side effects throughout therapy and during the tapering phase.

Precautions

The use of systemic corticosteroids like Deltasone requires vigilant precaution due to their profound effects on multiple body systems.

• Adrenal Suppression: Prolonged therapy can lead to suppression of the HPA axis. Stress, such as from surgery, trauma, or serious infection, requires potential dosage adjustment (stress-dose steroids). Recovery of HPA axis function is often slow and may take months.
• Infections: corticosteroids can mask signs of infection and reduce resistance to new infections. Any latent infections, including tuberculosis, fungal infections, amoebiasis, and viral infections (e.g., herpes simplex, varicella-zoster), may be reactivated. Close monitoring is essential.
• Vaccinations: Live or live-attenuated vaccines should not be given during corticosteroid therapy due to the risk of neurologic complications and lack of antibody response. Killed or inactivated vaccines may be administered, but the response may be diminished.
• Ophthalmic Monitoring: Intraocular pressure should be monitored regularly, especially in patients with a history of glaucoma. Prolonged use can also lead to posterior subcapsular cataracts.
• Cardiovascular/Renal Monitoring: Monitor blood pressure, weight, and electrolyte balance (particularly potassium and calcium). Sodium and fluid retention can occur.
• GI Effects: Use with caution in patients with peptic ulcer disease, diverticulitis, fresh intestinal anastomoses, and inflammatory bowel disease (due to risk of perforation).
• Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, and vertebral compression fractures can occur. Prophylactic measures for osteoporosis should be considered for long-term users.
• Neuropsychiatric: May cause euphoria, insomnia, mood swings, personality changes, severe depression, or frank psychotic manifestations.

Contraindications

Deltasone is contraindicated in patients with:

• Systemic Fungal Infections: Unless used as life-saving therapy in conjunction with appropriate antifungal treatment.
• Known Hypersensitivity: To prednisone or any component of the formulation.
• Cerebral Malaria: As it has been associated with a worse outcome.
• Live Virus Vaccination: Administration of live vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.
• Idiopathic Thrombocytopenic Purpura (ITP) via IM Route: The intramuscular formulation is contraindicated in ITP.

Relative contraindications (use only if potential benefit justifies the potential risk) include:

• Active or latent peptic ulcer disease.
• Uncontrolled hypertension, congestive heart failure.
• Psychotic disorders.
• Osteoporosis.
• Uncontrolled diabetes mellitus.
• Active tuberculosis.
• Acute herpes simplex keratitis.
• Seizure disorders.
• Myasthenia gravis.
• Renal insufficiency.
• Pregnancy, especially the first trimester.

Possible side effect

The incidence and severity of side effects depend on the dose and duration of therapy. All patients are at risk.

• Endocrine: HPA axis suppression, Cushingoid state (moon face, central obesity), growth suppression in children, menstrual irregularities, hyperglycemia, glucose intolerance, increased requirements for diabetes therapy.
• Fluid and Electrolyte: Sodium and fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension.
• Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones.
• Gastrointestinal: Peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis.
• Dermatologic: Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating.
• Neurological/Psychiatric: Convulsions, increased intracranial pressure with papilledema (pseudotumor cerebri), vertigo, headache, euphoria, insomnia, mood swings, personality changes, depression, psychotic manifestations.
• Ophthalmic: Posterior subcapsular cataracts, increased intraocular pressure (glaucoma), exophthalmos.
• Metabolic: Negative nitrogen balance due to protein catabolism.
• Other: Increased appetite and weight gain, leukocytosis, hypersensitivity reactions.

Drug interaction

Deltasone has the potential to interact with numerous medications.

• Anticoagulants: (e.g., Warfarin) Corticosteroids may alter the response to anticoagulants; close monitoring of INR is required.
• Antidiabetic Agents: (e.g., Insulin, oral hypoglycemics) Corticosteroids may increase blood glucose levels, necessitating dosage adjustment of antidiabetic drugs.
• CYP3A4 Inducers/Inhibitors: Drugs like phenobarbital, phenytoin, rifampin (inducers) may increase the clearance of prednisone, reducing its efficacy. Ketoconazole, itraconazole (inhibitors) may decrease clearance and increase prednisone levels and side effects.
• Diuretics: (e.g., Furosemide, thiazides) Enhance potassium excretion, increasing the risk of hypokalemia.
• NSAIDs: (e.g., Ibuprofen, naproxen) Concomitant use increases the risk of GI ulceration and bleeding.
• Live Vaccines: Corticosteroids can impair the immune response and increase the risk of vaccine-induced disease.
• Cardiac Glycosides: (e.g., Digoxin) Risk of digitalis toxicity associated with hypokalemia.
• Anticholinesterases: (e.g., in myasthenia gravis) Corticosteroids may enhance muscle weakness.

Missed dose

• If you miss a dose of Deltasone, take it as soon as you remember.
• However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
• Do not take a double dose to make up for a missed one.
• If you are on a tapering schedule and miss a dose, contact your healthcare provider for specific instructions, as this can disrupt the carefully planned taper.

Overdose

Acute single ingestion of even very high doses is rarely clinically fatal or associated with acute toxicity. However, chronic overdose manifests as the serious side effects listed above (Cushing’s syndrome, HPA suppression, etc.).

• Management: There is no specific antidote for prednisone overdose.
• Treatment is supportive and symptomatic. Gastric lavage or activated charcoal may be considered if ingestion was very recent.
• Electrolyte imbalance (particularly hypokalemia) should be corrected.
• In cases of chronic overdose, the drug must be tapered, not stopped abruptly, to avoid adrenal insufficiency.

Storage

• Store Deltasone tablets at room temperature, between 20°C to 25°C (68°F to 77°F).
• Keep the medication in its original container, tightly closed, and protected from light and moisture.
• Keep out of reach of children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed through a medicine take-back program.

Disclaimer

This information is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The content provided has been compiled from various sources and may not be entirely accurate or comprehensive for your specific situation. The author and publisher are not responsible for any errors or omissions or for any outcomes resulting from the use of this information.

Reviews

• “As a rheumatologist for over 25 years, prednisone remains a powerful and often necessary tool for managing acute flares of autoimmune arthritis. The key is using the lowest effective dose for the shortest possible duration and meticulously managing the taper. Its efficacy is undeniable, but so is the need for extreme respect for its side effect profile.” – Dr. Eleanor Vance, MD, Rheumatology.
• “In pulmonology, a short course of high-dose prednisone can be life-saving during a severe asthma attack. It works quickly to open airways. The challenge for patients on long-term, low-dose therapy is managing the metabolic and bone health consequences, which requires a proactive, multidisciplinary approach.” – Dr. Ben Carter, MD, Pulmonology.
• “After my kidney transplant, prednisone was part of my anti-rejection cocktail. While I’ve dealt with some weight gain and mood swings, I understand it’s a critical part of keeping my body from rejecting my new organ. My team monitors me very closely, which is essential.” – Patient M.K.
• “I have ITP, and a high-dose pulse of prednisone successfully raised my platelet count from dangerously low levels within a week. The side effects during that month were intense (insomnia, intense hunger), but it achieved the desired result and allowed time for other treatments to be arranged.” – Patient J.S.