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Ciclesonide

    Brands

    DEA Class; Rx

    Common Brand Names; Alvesco, Omnaris, Zetonna

    • Corticosteroids, Inhalants

    Non-halogenated glucocorticoid; similar potency as beclomethasone and budesonide; low systemic absorption
    Nasal spray used for seasonal/perennial allergic rhinitis in adults and children 12 years and older
    Oral inhalation used for asthma in adults and children 12 years and older

    Indicated for asthma maintenance treatment.

    For the management of symptoms of perennial allergies and seasonal allergies, including allergic rhinitis.
    For transient increase in bronchospasm (e.g., episodic wheezing) as asthma reliever therapy.
    For exercise-induced bronchospasm prophylaxis.

    Documented hypersensitivity

    Treatment of acute asthma or status asthmaticus

    • Headache (11%)
    • Nasopharyngitis (11%)
    • 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%)

    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

    Pregnancy Category: C

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

    Adults

    200 mcg intranasally (2 sprays in each nostril) daily (Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.

    Geriatric

    200 mcg intranasally (2 sprays in each nostril) daily(Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.

    Adolescents

    200 mcg intranasally (2 sprays in each nostril) daily (Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.

    Children

    >= 12: 200 mcg intranasally (2 sprays in each nostril) daily (Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.
    6—11 years: 200 mcg intranasally (2 sprays in each nostril) daily (Omnaris). Safe and effective use has not been established for nasal aerosol (Zetonna) or oral inhalation; however, doses up to 160 mcg/day via oral inhalation have been used off-label for asthma.
    4—5 years: Safety and efficacy have not been established; however, doses up to 160 mcg/day via oral inhalation have been used off-label for asthma.
    < 4 years: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Ciclesonide 

    MDI

    • 80mcg/inhalation
    • 160mcg/inhalation

    intranasal spray

    • 50mcg/actuation (Omnaris)
    • 37mcg/actuation (Zetonna)