Dosing & Uses
Dosage Forms & Strengths
MDI
- 80mcg/inhalation
- 160mcg/inhalation
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
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (5)
- abametapir
abametapir will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.
- apalutamide
apalutamide will decrease the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.
- lonafarnib
lonafarnib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.
- saquinavir
saquinavir will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- tucatinib
tucatinib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
Monitor Closely (27)
- atazanavir
atazanavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- cenobamate
cenobamate will decrease the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.
- ceritinib
ceritinib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- clarithromycin
clarithromycin will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cobicistat
cobicistat will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- crizotinib
crizotinib increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- darunavir
darunavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
- fedratinib
fedratinib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
- fosamprenavir
fosamprenavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- idelalisib
idelalisib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- indinavir
indinavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- itraconazole
itraconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ketoconazole
ketoconazole increases levels of ciclesonide inhaled by decreasing metabolism. Use Caution/Monitor.
ketoconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - lenacapavir
lenacapavir will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
- levoketoconazole
levoketoconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
levoketoconazole increases levels of ciclesonide inhaled by decreasing metabolism. Use Caution/Monitor. - lopinavir
lopinavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- mifepristone
mifepristone will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nefazodone
nefazodone will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nelfinavir
nelfinavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- nirmatrelvir/ritonavir
nirmatrelvir/ritonavir will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration may increase certain systemic corticosteroid concentrations. Increased risk for Cushing syndrome and adrenal suppression. Consider alternant corticosteroids, including beclomethasone and prednisolone).
- posaconazole
posaconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ritonavir
ritonavir increases levels of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.
- rucaparib
rucaparib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
- stiripentol
stiripentol, ciclesonide inhaled. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
- tazemetostat
tazemetostat will decrease the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- voriconazole
voriconazole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
Minor (5)
- acetazolamide
acetazolamide will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- anastrozole
anastrozole will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cyclophosphamide
cyclophosphamide will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- larotrectinib
larotrectinib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ribociclib
ribociclib will increase the level or effect of ciclesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
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%)
Warnings
Contraindications
Documented hypersensitivity
Treatment of acute asthma or status asthmaticus
Cautions
Development of Kaposi's sarcoma associated with prolonged use of corticosteroids
Psychiatric disturbances reported with corticosteroid use
Mild to moderate oropharyngeal candidiasis reported; treat with appropriate local or systemic (eg, oral antifungal) therapy and discontinue therapy when symptoms occur; patients should rinse mouth after inhalation of medication
Not a bronchodilator and not indicated for rapid relief of bronchospasm or other acute episodes of asthma; patients should be instructed to contact their physician immediately if episodes of asthma not responsive to usual doses of bronchodilators occur during the course of treatment; during such episodes, patients may require therapy with oral corticosteroids
Glaucoma, increased intraocular pressure, and cataracts reported following administration of inhaled corticosteroids; close monitoring warranted in patients with a change in vision or with history of increased intraocular pressure, glaucoma, and/or cataracts
As with other inhaled asthma medications, bronchospasm, with an immediate increase in wheezing, may occur after dosing; if bronchospasm occurs following dosing, treat immediately with a fast-acting inhaled bronchodilator; treatment should be discontinued and alternative treatment should be instituted
Reduction in bone mineral density
- Decreases in bone mineral density (BMD) observed with long-term administration of products containing inhaled corticosteroids; the clinical significance of small changes in BMD with regard to long-term outcomes is unknown
- Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, or chronic use of drugs that can reduce bone mass (eg, anticonvulsants and oral corticosteroids) should be monitored and treated with established standards of care
Immune suppression and risk of infections
- Persons using drugs that suppress immune system are more susceptible to infections than healthy individuals; chickenpox and measles, can have a more serious or even fatal course in susceptible children or adults using corticosteroids; take particular care with patients who have not had these diseases or been properly immunized,
- How the dose, route, and duration of corticosteroid administration affect risk of developing a disseminated infection is not known; the safety and effectiveness of this medication have not been established in pediatric patients <12 years of age and this medication is not indicated for use in this population; the contribution of underlying disease and/or prior corticosteroid treatment to the risk is also not known
- If exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated; if exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated; if chickenpox develops, treatment with antiviral agents may be considered
- Inhaled corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculosis infection of respiratory tract; untreated systemic fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex
Transferring patients from systemic corticosteroid therapy
- Use caution in patients transferred from systemically active corticosteroids to this therapy because deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhaled corticosteroids
- After withdrawal from systemic corticosteroids, a number of months are required for recovery of hypothalamic-pituitary-adrenal (HPA) function
- Transfer of patients from systemic steroid therapy to this therapy may unmask allergic conditions previously suppressed by the systemic steroid therapy, eg, rhinitis, conjunctivitis, eczema, arthritis, and eosinophilic conditions
- During withdrawal from oral steroids, some patients may experience symptoms of systemically active steroid withdrawal, eg, joint and/or muscular pain, lassitude, and depression, despite maintenance or even improvement of respiratory function
Hypercorticism and adrenal suppression
- This medication will often help control asthma symptoms with less suppression of HPA function than therapeutically similar oral doses of prednisone; since individual sensitivity to effects on cortisol production exists, physicians should consider this information when prescribing therapy; take particular care in observing patients postoperatively or during periods of stress for evidence of inadequate adrenal response
- Hypercorticism and adrenal suppression may occur when corticosteroids, including this medication, are used at higher-than-recommended dosages or patients at risk for such effects
Effect on growth
- Orally inhaled corticosteroids, including this medication, may cause a reduction in growth velocity when administered to pediatric patients; the safety and effectiveness of this therapy have not been established in pediatric patients <12 years of age; this medication is not indicated for use in this population
- Monitor growth of pediatric patients receiving this medication routinely (eg, via stadiometry); to minimize systemic effects of orally inhaled corticosteroids, including this medication, titrate each patient’s dose to lowest dosage that effectively controls his/her symptoms
Pregnancy & Lactation
Pregnancy
There are no available data on use in pregnant women to assess drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; there is low systemic exposure following administration at recommended dose
In women with poorly or moderately controlled asthma, there is an increased risk of several perinatal outcomes such as pre-eclampsia in the mother and prematurity, low birth weight, and small for gestational age in the neonate; pregnant women with asthma should be closely monitored and medication adjusted as necessary to maintain optimal asthma control
Animal data
- In animal reproduction studies, drug administered by oral route to pregnant rats during period of organogenesis did not cause any evidence of fetal harm at doses up to 15 times maximum recommended human daily oral inhalation dose (MRHDOID)
- Teratogenicity, characteristic of corticosteroids, decreased body weight, and/or skeletal variations were observed in rabbit fetuses following administration of ciclesonide to pregnant rabbits by subcutaneous route during period of organogenesis at doses 0.15 times MRHDOID and higher on mcg/m2 basis; no evidence of fetal harm observed in rabbits at doses of 0.03 times MRHDOID
Lactation
There are no data on presence of the drug or its metabolite in human milk, effects on breastfed infant, or milk production; not known whether oral inhalation administration of this drug at recommended dose could result in sufficient systemic absorption to produce detectable quantities in human milk
The molecular weight of the prodrug ciclesonide (approximately 541 g/mol) is small enough to be excreted into breast milk; however, its high plasma protein binding affinity and very short half-life suggests that minimal amounts will be present within the milk
Conversely, the half-life of the active metabolite des-ciclesonide (approximately 471 g/mol) suggests that exposure to the nursing infant will be greater than that of the prodrug ciclesonide; although ciclesonide and des-ciclesonide have negligible oral bioavailability (both less than 1% for each) due to low gastrointestinal absorption and high first-pass metabolism, the relative anti-inflammatory activity of des-ciclesonide is 120 times greater than that of ciclesonide and 12 times greater than that of dexamethasone; the effects of this exposure on a nursing infant are unknown, however, like all corticosteroids, suppression of HPA function is a potential complication
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy, and any potential adverse effects on breastfed infant from therapy, or from underlying maternal condition
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.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%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Alvesco inhalation - | 160 mcg/actuation aerosol |  | |
| Alvesco inhalation - | 80 mcg/actuation aerosol |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
ciclesonide inhalation
CICLESONIDE HFA INHALER - ORAL INHALATION
(sye-KLES-oh-nide)
COMMON BRAND NAME(S): Alvesco
USES: Ciclesonide is used to prevent and reduce the symptoms (wheezing and shortness of breath) caused by asthma. Controlling asthma symptoms may decrease time lost from work or school. This medication belongs to a class of drugs known as corticosteroids. It works by reducing the swelling of the airways in the lungs to make breathing easier.This medication must be taken regularly to be effective. It does not work right away and should not be used to relieve sudden asthma attacks. If an asthma attack occurs, use your quick-relief inhaler as prescribed. Keep track of how often you need to use your quick-relief inhaler, and tell your doctor. If your quick-relief inhaler does not seem to work as well, if you need to use more than usual of your quick-relief inhaler for 2 or more days in a row, or if you need to use more than one full canister of your quick-relief inhaler over a 2-month period, get medical help right away.
HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using ciclesonide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Inhale this medication by mouth as directed by your doctor. No shaking of the inhaler is necessary before use. If the inhaler is new or has not been used for 1 week or more, prime the inhaler for use by spraying 3 puffs into the air. Remove the cover on the mouthpiece. Breathe out as much as you comfortably can. Place the mouthpiece into your mouth and close your lips tightly around it. While breathing in slowly and deeply, press down on the canister with your finger. After inhaling, try to hold your breath for at least 10 seconds to get this medication into your lungs and allow it to work properly.Dosage is based on your medical condition and response to treatment.A spacer device may be used with this medication if you find it difficult to use this inhaler. Ask your doctor or pharmacist for more information.If your prescribed dose is 2 puffs, wait at least one minute between them. If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication, and use this drug (the corticosteroid) last.To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. Do not swallow the rinse water.Clean the mouthpiece once a week with a dry tissue. Do not wet the mouthpiece to clean it.Use this medication regularly to get the most benefit from it. This medication works best when used at evenly spaced intervals. To help you remember, use it at the same time each day. Do not increase your dose, use this inhaler more frequently, or stop using it without first consulting your doctor.Learn which of your inhalers you should use every day (controller drugs) and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, worsening peak flow meter readings, waking up at night with trouble breathing, if you use your quick-relief inhaler more often (more than 2 days a week), or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.You may begin to feel this medication working within 24 hours, but it may take several weeks or longer before the full benefit of this drug takes effect. Tell your doctor if your symptoms do not improve or if they worsen.
SIDE EFFECTS: See also Precautions section.Dry/irritated throat, hoarseness, a bad taste in the mouth, or coughing may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: white patches in your mouth or on your tongue, headache that doesn't go away, vision changes, poor wound healing, puffy face, unexpected weight gain, muscle pain/weakness, mental/mood changes (such as depression, agitation), increased thirst/urination.Rarely, this medication may cause severe sudden worsening of breathing problems/asthma immediately after use. If you have sudden worsening of breathing, use your quick-relief inhaler and get medical help right away.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using ciclesonide, tell your doctor or pharmacist if you are allergic to it; or to other corticosteroids (such as beclomethasone, fluticasone); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: tuberculosis, untreated infections (such as those caused by fungus or bacteria), certain eye problems (glaucoma, cataracts, herpes infection of the eye), liver disease, adrenal gland problems (such as adrenal insufficiency), underactive thyroid (hypothyroidism), bone loss (osteoporosis).If you have switched from a corticosteroid taken by mouth (such as prednisone tablets) to this inhaler within the past 12 months, or if you have been using this product in higher-than-usual doses for a long time, it may be more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used a corticosteroid taken by mouth within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. Carry a warning card or medical ID bracelet that says you use (or have used) corticosteroid medications.This medication may mask signs of infection. It can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.When used for extended periods, medications similar to ciclesonide may affect bone strength, especially in people who smoke, have a family history of brittle bones (osteoporosis), or take other medications that may weaken bones (such as phenytoin). Bone density tests may help to determine whether you need medication to treat or prevent this problem. Consult your doctor for more information.This medication may temporarily slow down a child's growth if used for a long time. However, poorly controlled asthma can also slow down growth. See the doctor regularly so your child's height can be checked.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: aldesleukin, corticosteroids taken by mouth (such as prednisone, dexamethasone), mifepristone.Other medications can affect the removal of ciclesonide from your body, which may affect how ciclesonide works. Examples include some azole antifungals (such as ketoconazole), HIV protease inhibitors (such as nelfinavir), ritonavir, among others.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Learn to use a peak flow meter, use it daily, and promptly report worsening asthma (such as readings in the yellow/red range or increased use of quick-relief inhalers).Lab and/or medical tests (such as morning cortisol levels, eye exams, bone density tests) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.Avoid allergens (such as pollen), irritants, smoking/secondhand smoke, and other factors that make asthma worse.Most people with asthma or ongoing lung disease should receive a flu shot every year. Discuss this with your doctor.In adults, this medication can increase the risk of bone loss (osteoporosis) if used for a long time. Talk with your doctor about your risk, and about available treatments for osteoporosis. Lifestyle changes that reduce the risk of bone loss include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. To help prevent osteoporosis later in life, encourage children to exercise and eat a healthy diet (including calcium).
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised March 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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