Deflazacort vs. Prednisone: 5 Differences Between These Muscular Dystrophy Treatments

Muscular dystrophy refers to a group of genetic disorders that cause progressive muscle breakdown and weakness over time. There are over 30 different types of muscular dystrophy, each affecting muscles in their own unique way.

If you or your child have muscular dystrophy, your healthcare provider may prescribe corticosteroids to help slow down the progression of muscle weakness. They aim to keep your muscles stronger for longer. Two of the most commonly used corticosteroids for muscular dystrophy are deflazacort (Emflaza) and prednisone (Rayos).

Deflazacort and prednisone offer similar benefits, but they aren’t one in the same. Here, we’ll look at the top five differences between deflazacort and prednisone.

1. Deflazacort is FDA approved to treat Duchenne muscular dystrophy

Deflazacort is FDA approved to treat a specific type of muscular dystrophy — Duchenne muscular dystrophy (DMD). DMD is a serious type of childhood muscular dystrophy that mostly affects boys. Symptoms often begin in the toddler years, once they start walking.

Deflazacort is the only corticosteroid that’s officially approved to treat DMD. But that doesn’t mean deflazacort is the only corticosteroid that can treat DMD in practice. Prednisone is regularly taken off label for DMD management, too. Most people take one or the other; you usually wouldn’t take both at the same time.

There are other FDA-approved medications for DMD, too. Medications such as Exondys 51 (eteplirsen) and Vyondys 53 (golodirsen) can treat specific gene mutations related to DMD. And a gene therapy medication called Elevidys (delandistrogene moxeparvovec-rokl) can address the root cause of DMD in certain kids younger than 6 years old.

Good to know: Prednisone is also prescribed off label for Becker’s muscular dystrophy. Becker’s muscular dystrophy mostly affects boys and has similar symptoms as DMD.

2. Deflazacort and prednisone have different side effect profiles

As with all medications, side effects are possible with corticosteroids like deflazacort and prednisone.

Common corticosteroid side effects include trouble sleeping, mood changes, and stomach upset. Taking corticosteroids for longer periods of time can also increase the risk of other side effects, including:

• A weakened immune system

• Weight gain

• Fatty deposits in the upper back

• Abnormal behavior, including aggression and irritability

• Weaker bones

• Higher blood glucose (sugar)

• Higher blood pressure

• Cataracts and glaucoma

• Stunted growth and delayed puberty (in children)

Specific side effect differences

Deflazacort and prednisone’s side effects have some overlap. But studies show that certain side effects are more likely with one over the other.

Regardless of which corticosteroid you take, it may be possible to take them only a few days out of the week instead of taking them daily. One study found non-daily use to be just as effective as daily use, and another study found that it may come with fewer side effects.

Always take your medication as prescribed by your healthcare provider, and never stop taking it without speaking with them first.

3. Some studies suggest deflazacort is more effective

Deflazacort and prednisone are both helpful options for managing DMD. But some studies suggest that deflazacort delays the progression of muscle weakness more than prednisone. Preserving muscle strength and function can significantly improve quality of life.

In one meta analysis, boys who took deflazacort had a slower progression of muscle weakness compared to boys who took prednisone over 48 weeks (11 months). And a 10-year study found that deflazacort helped keep study participants mobile and active for longer than prednisone.

This doesn’t mean that deflazacort is better than prednisone for everyone. Other factors — like your overall health, how severe your symptoms are, and your response to treatment — also play important roles in deciding the best medication for you. Medication affordability is another big factor.

4. Deflazacort and prednisone have different dosages

Delazacort and prednisone are both available as oral tablets and an oral liquid. But the specific amount of medication you’ll need varies for each one. Your body weight will also play a role in your dose.

A typical deflazacort dosage for DMD is 0.9 mg per kilogram of body weight per day. For a child weighing 73 lbs (33 kg), this would translate to 30 mg of deflazacort per day. Your healthcare provider may want them to take one 30 mg tablet per day (or an equivalent amount of the oral liquid).

By comparison, a typical prednisone dosage for DMD is 0.75 mg per kilogram of body weight per day. For a different child weighing 73 kg (33 kg), this would be 25 mg per day.

For both medications, the recommended dosage may go up or down depending on how you respond to the medication. Drug interactions may also prompt your provider to adjust your dose.

Good to know: In general, deflazacort is prescribed in higher dosages than prednisone. But that doesn’t mean it’s stronger or weaker than prednisone. It just means your provider will need to prescribe a different dosage for each one.

5. In general, prednisone is more affordable

Prednisone is generally more affordable than deflazacort. Prednisone is available as a lower-cost generic, while deflazacort is only available as a brand-name medication.

That being said, the exact price you’ll pay will depend on the pharmacy you choose and your insurance coverage status. If you have health insurance and it covers your prescription, your out-of-pocket cost will depend on your specific plan’s details.

How to save on prednisone and deflazacort

There are ways to save on deflazacort and prednisone. GoodRx can help you navigate ways to save on your prescription.

• Save with GoodRx. GoodRx can help you save over 70% off the average retail price of the generic version of prednisone. Prednisone’s price at certain pharmacies is as low as $7.20 with a free GoodRx discount. The specific price will vary depending on how much medication you need and where you fill your prescription.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for deflazacort’s patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, you can save on deflazacort using a savings card from the manufacturer. 

Can you switch from prednisone to deflazacort?

Yes, it’s possible to switch between prednisone and deflazacort (and vice versa). 

You and your healthcare provider may decide to switch medications if you’re experiencing bothersome side effects. Or you may decide to switch if your provider thinks you may get more benefit from a different medication.

But you shouldn’t do this on your own. It’s a good idea to make this decision with your provider. If you end up switching from prednisone to deflazacort, you’ll likely start on a lower dosage of the new medication and gradually increase the dosage. This is also true if you’re switching from deflazacort to prednisone.

Suddenly stopping or reducing the dosage of any corticosteroid can increase your risk for adrenal insufficiency. Adrenal insufficiency happens when your body doesn't produce enough of the hormones cortisol or aldosterone. Symptoms include fatigue, muscle weakness, and weight loss — which can be especially burdensome with muscular dystrophy.

Your provider can walk you through how to safely adjust your medication regimen, when needed.

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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