Maintenance therapy with either azathioprine or methotrexate is initiated if remission has occurred after three to six months of induction therapy. Steroid dosage is tapered during this phase. Patients may need to continue maintenance treatment for up to 24 months. 24 Maintenance treatment for up to five years is recommended in patients with Wegener granulomatosis and patients who remain ANCA-positive. 19 Some patients may require treatment indefinitely. Disease relapse may occur anytime after the remission. Serial measurements of ANCA are not closely associated with disease activity; therefore, treatment should not be solely guided on the basis of an increase in ANCA. 25 Relapsing disease can be managed with an increase in steroid dose, optimization of the current immunosuppressant, or combination of an immunosuppressant with an increased dose of steroid.
Animals In all species examined, prochloraz is rapidly metabolised initially by cleavage of the imidazole ring and quantitatively eliminated from the body, following oral administration. Whilst absorption following dermal exposure is low, residues in plasma and tissues are again rapidly eliminated from the body. Plants The primary plant metabolite, N-formyl-N'-1-propyl-N-(2-(2,4,6-trichlorophenoxy)ethyl)urea, is formed from cleavage of the imidazole ring. This is degraded to N-propyl-N-(2-(2,4,6-trichlorophenoxy)ethyl)urea, which occurs in both free and conjugated forms. Other metabolites include 2-(2,4,6-trichlorophenoxy)ethanol, 2-(2,4,6-trichlorophenoxy)acetic acid, traces of 2,4,6-trichlorophenol and conjugates of the above. Little unchanged prochloraz is present. Soil/Environment Degrades in the soil to a range of mainly volatile metabolites (degradation is not pH-dependent). Prochloraz is well adsorbed onto soil particles, and is not readily leached; Kd 152 (sandy loam), 256 (silty clay loam). In a further study, mean Koc 1463. Possesses low toxicity to a wide range of soil microflora and microfauna, but has inhibitory effects on soil fungi. DT50 under field conditions is 5-37 d.