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ciclesonide inhaled (Rx)Brand and Other Names:Alvesco

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

MDI

  • 80mcg/inhalation
  • 160mcg/inhalation
more...

Asthma, Prophylaxis

Receiving Bronchodilators or Inhaled Corticosteroids: 80 mcg inhaled PO twice daily initially; may increase to 160 mcg twice daily

Receiving Oral Corticosteroids: 80 mcg inhaled PO twice daily initially; may increase to 320 mcg twice daily

Dosage Forms & Strengths

MDI

  • 80mcg/inhalation
  • 160mcg/inhalation
more...

Asthma Prophylaxis

<12 years

  • Safety and efficacy not established

>12 years

  • Receiving bronchodilators or inhaled corticosteroids: 80 mcg inhaled PO twice daily initially; may increase to 160 mcg twice daily
  • Receiving Oral Corticosteroids: 80 mcg inhaled twice daily initially; may increase to 320 mcg twice daily
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Interactions

Interaction Checker

ciclesonide inhaled and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Headache (11%)

            Nasopharyngitis (11%)

            1-10%

            Epistaxis (4.9%)

            Ear pain (2.2%)

            Facial edema (3%)

            Urticaria (3%)

            Oral candidiasis (3%)

            Back pain (3%)

            Extremety pain (3%)

            Conjunctivitis (3%)

            Upper respiratory infection (9%)

            Gastroenteritis (3%)

            Sinusitis (3%)

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            Warnings

            Contraindications

            Documented hypersensitivity

            Treatment of acute asthma or status asthmaticus

            Cautions

            Caution in active serious infections

            Secondary infections may occur as a result of prolonged use of corticosteroids

            Avoid exposure to chickenpox or measles

            Not for acute asthma treatment

            When switching from oral corticosteroids

            Bronchospasm may occur following inhalation (treat with fast acting bronchodilator)

            High doses may cause suppression of hypothalamic-pituitary-adrenal axis, which can result in adrenal crisis

            Long-term use may result in: reduced BMD; glaucoma or cataracts; increased IOP

            Development of Kaposi's sarcoma associated with prolonged use of corticosteroids

            Psychiatric disturbances reported with corticosteroid use

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Not known if excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Glucocorticoid prodrug, converted to active ingredient des-ciclesonide; has immunosuppressive properties, anti-inflammatory activity, and anti-inflammatory effects.

            Distribution

            Bioavailability: 63% (active metabolite)

            Absorption: 52%

            Protein Bound: 99% (IV)

            Vd: 2.9 L/kg (ciclesonide); 12.1 L/kg (des-ciclesonide) following IV administration

            Metabolism

            Metabolized to active des-ciclesonide by esterases, then further metabolized by liver CYP3A4 and to a lesser extent, CYP2D6

            Eliminiation

            Following IV administration

            • Half-life: 0.71 hr (ciclesonide); 6-7 hr (des-ciclesonide)
            • Clearance: 152 L/L/hr (ciclesonide); 228 L/L/hr (des-ciclesonide)
            • Excretion: Feces (66%); urine (20%)
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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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