IT IS RECOMMENDED TO INCREASE THE MAINTENANCE DOSE OF DEFLAZACORT IF DRUGS, WHICH ARE LIVER ENZYME INDUCERS, ARE CO-ADMINISTERED, E.G. RIFAMPICIN, RIFABUTIN, CARBAMAZEPINE, PHENOBARBITONE, PHENYTOIN, PRIMIDONE AND AMINOGLUTETHIMIDE. FOR DRUGS, WHICH INHIBIT LIVER ENZYMES, E.G. KETOCONAZOLE IT MAY BE POSSIBLE TO REDUCE THE MAINTENANCE DOSE OF DEFLAZACORT. IN PATIENTS TAKING ESTROGENS, CORTICOSTEROID REQUIREMENTS MAY BE REDUCED. THE DESIRED EFFECTS OF HYPOGLYCAEMIC AGENTS (INCLUDING INSULIN), ANTIHYPERTENSIVES AND DIURETICS ARE ANTAGONISED BY CORTICOSTEROIDS AND THE HYPOKALAEMIC EFFECTS OF ACETAZOLAMIDE, LOOP DIURETICS, THIAZIDE DIURETICS AND CARBENOXOLONE ARE ENHANCED. THE EFFICACY OF COUMARIN ANTICOAGULANTS MAY BE ENHANCED BY CONCURRENT CORTICOSTEROID THERAPY AND CLOSE MONITORING OF THE INR OR PROTHROMBIN TIME IS REQUIRED TO AVOID SPONTANEOUS BLEEDING.
IN PATIENTS TREATED WITH SYSTEMIC CORTICOSTEROIDS, USE OF NON-DEPOLARISING MUSCLE RELAXANTS CAN RESULT IN PROLONGED RELAXATION AND ACUTE MYOPATHY. RISK FACTORS FOR THIS INCLUDE PROLONGED AND HIGH DOSE CORTICOSTEROID TREATMENT, AND PROLONGED DURATION OF MUSCLE PARALYSIS. THE RENAL CLEARANCE OF SALICYLATES IS INCREASED BY CORTICOSTEROIDS AND STEROID WITHDRAWAL MAY RESULT IN SALICYLATE INTOXICATION. CONCURRENT USE OF GLUCOCORTICOIDS AND ORAL CONTRACEPTIVES SHOULD BE CLOSELY MONITORED AS PLASMA LEVELS OF GLUCOCORTICOIDS MAY BE INCREASED. ANTACIDS MAY REDUCE BIOAVAILABILITY; LEAVE AT LEAST 2 HOURS BETWEEN ADMINISTRATION OF DEFLAZACORT AND ANTACIDS. PATIENTS WITH RARE HEREDITARY PROBLEMS OF GALACTOSE INTOLERANCE, THE LAPP LACTOSE DEFICIENCY OR GLUCOSE GALACTOSE MALABSORPTION SHOULD NOT TAKE THIS MEDICINE.