Deltacortril

Deltacortril is a prednisolone tablet produced by Phoenix Labs. Prednisolone is a synthetic glucocorticoid that mimics cortisol, the hormone your adrenal glands produce. At therapeutic doses it damps down inflammation and holds back immune activity, so one medicine serves many conditions. Each tablet has a gastro-resistant (enteric) coat that resists stomach acid and releases the drug lower down, in the bowel. It is easy to confuse with methylprednisolone, but that is a different steroid with its own tablet strengths.

Indications in the SmPC are arranged organ system by organ system. Among them are serious allergic reactions and drug hypersensitivity, asthma, systemic lupus erythematosus and related connective tissue disorders, rheumatoid arthritis, polymyalgia rheumatica, ulcerative colitis, autoimmune hepatitis, sarcoidosis and pemphigus. Eye and kidney inflammation, autoimmune haemolytic anaemia, certain blood and lymph cancers, adrenal insufficiency and the prevention of transplant rejection also feature. The SmPC describes the treatment as palliative; it controls the disease process; it does not cure what lies beneath.

This page lists Deltacortril at 5, 10, 20 and 40 mg, with 30, 60, 90, 120, 180, 270 or 360 tablets per pack. UK Deltacortril exists as 1 mg, 2.5 mg and 5 mg gastro-resistant tablets, which means only the 5 mg strength matches a UK product. The 10, 20 and 40 mg strengths are not UK-authorised Deltacortril strengths. Whatever the strength, tablets of this kind can only be supplied on prescription (POM) in Britain.

The SmPC gives an adult range of 5 to 60 mg per day, taken in one dose or split. As a rough guide, allergic and skin disorders need 5 to 15 mg, rheumatoid arthritis 10 to 15 mg, collagen diseases 20 to 30 mg, and blood disorders or lymphoma 15 to 60 mg. In long courses the dose is lowered gradually, in steps of 5 to 7.5 mg at most. A morning dose on alternate days, if the condition permits, reduces suppression of the adrenal glands. Children receive the lowest effective dose, ideally on alternate days, with their growth measured.

Anyone who has taken more than about 7.5 mg daily for over three weeks must not stop suddenly; once the daily dose is down to 7.5 mg, the steps get smaller. The adrenal glands can take months to recover, so extra cover may be needed around surgery, injury or serious illness. A steroid treatment card is advised so that other clinicians know about the treatment.

Deltacortril should be avoided with hypersensitivity to prednisolone or the other ingredients, with an untreated body-wide infection, or with herpes simplex infection of the eye. Lactose is an ingredient, so it is unsuitable in hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. The SmPC urges care in diabetes, hypertension, heart failure, osteoporosis, epilepsy, peptic ulcer, a history of tuberculosis, and personal or close family history of serious mood disorders. Steroids can hide the signs of infection. Contact with chickenpox or measles needs prompt advice if you are not immune, and live vaccines are postponed after high doses.

Rifampicin, carbamazepine, phenytoin and phenobarbital weaken the effect of prednisolone, whereas ketoconazole, ritonavir, ciclosporin and oestrogen-containing contraceptives strengthen it. NSAIDs taken alongside raise the risk of gastric bleeding or ulcers, and warfarin may call for more frequent INR tests. The SmPC also records relapses of Crohn's disease in people given enteric-coated prednisolone.

Higher doses and longer courses make side effects more likely. Mood swings and sleep problems are common, and low mood, mania or thoughts of self-harm should be reported straight away. Other effects in the SmPC include greater appetite and weight gain, a moon-shaped face, fluid retention, raised blood sugar, indigestion, thin skin that bruises, muscle weakness, thinning of the bones, cataracts, glaucoma and irregular periods. Your prescriber decides whether Deltacortril is the right choice and how long you should take it.