Drug interactions
Deflazacort + Nefazodone
Severity: Major
Deflazacort and Nefazodone: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nefazodone is a strong CYP3A4 inhibitor and can raise exposure to 21-desacetyl deflazacort, the active metabolite of deflazacort. Higher glucocorticoid exposure increases the risk of steroid adverse effects such as infection, hyperglycemia, fluid retention and adrenal suppression.
What this interaction means in plain words
Deflazacort and Nefazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Inhibition of CYP3A4-mediated metabolism of the active deflazacort metabolite, with a possible additional contribution from P-glycoprotein inhibition.
What to do
Reduce the deflazacort dose to about one-third of the usual dose while nefazodone is taken, as per labeling. Monitor for corticosteroid adverse effects and consider an alternative antidepressant.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Deflazacort
- Adenovirus types 4 and 7 live + Deflazacort Contraindicated
- Bcg vaccine live + Deflazacort Contraindicated
- Deflazacort + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Deflazacort + Measles mumps and rubella vaccine Contraindicated
- Deflazacort + Measles mumps and rubella vaccine live Contraindicated
- Deflazacort + Measles mumps rubella and varicella vaccine live Contraindicated
Frequently asked questions
Can I take Deflazacort with Nefazodone?
MediHelp rates the interaction as major. Deflazacort and Nefazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nefazodone is a strong CYP3A4 inhibitor and can raise exposure to 21-desacetyl deflazacort, the active metabolite of deflazacort. Higher glucocorticoid exposure increases the risk of steroid adverse effects such as infection, hyperglycemia, fluid retention and adrenal suppression.
How serious is the interaction between Deflazacort and Nefazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the deflazacort dose to about one-third of the usual dose while nefazodone is taken, as per labeling. Monitor for corticosteroid adverse effects and consider an alternative antidepressant.
What other medicines interact with Deflazacort?
MediHelp also lists interactions of Deflazacort with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Deflazacort page.
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