Ciclesonide belongs to the class of medications called inhaled corticosteroids. It is used to treat asthma in adults and children 6 years and older. It helps to control symptoms and prevent asthma attacks by decreasing inflammation in the lungs, thereby opening the airways and improving breathing. Ciclesonide usually starts to work within 24 hours, but it may take 1 to 2 weeks to see the full benefit.

It is important to remember that ciclesonide will not provide immediate relief for an asthma attack that has already started. This medication is intended for long-term relief. Inhalers that contain "reliever" medications with fast action (e.g., salbutamol, terbutaline) will still be needed while using this medication on a regular basis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

For adults and adolescents 12 years of age and older, the recommended starting dose of ciclesonide is 400 µg daily. The recommended daily dose is 100 µg to 800 µg. For most people, the dose can be taken as 1 to 2 puffs once daily either in the morning or evening. Some people with more severe asthma may need 800 µg daily, taken as 400 µg twice daily.

For children 6 to 11 years of age, the recommended dose of ciclesonide is 100 µg to 200 µg once daily given as 1 to 2 puffs either in the morning or evening.

Your doctor will help you determine the dose that is most appropriate for you. The regular daily dose of ciclesonide should be the lowest dose required to control asthma symptoms.

Inhaled ciclesonide is used to prevent asthma attacks. It is not used to relieve an attack that has already started. Use your "reliever" medication (e.g., salbutamol, terbutaline, formoterol) to relieve an asthma attack that has already started. If you do not have another medication to use for an attack or if you have any questions about this, speak with your doctor.

In order to get the most medication into the lungs from the inhaled dose, ask your doctor or pharmacist about proper techniques for taking this medication and about whether a spacer device might be right for you.

Rinsing your mouth and gargling with water after each inhalation can help prevent hoarseness, throat irritation, and an infection in the mouth called candidiasis (a type of yeast infection of the mouth, also known as "thrush").

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. It should be used daily, even when you are not experiencing any symptoms of asthma. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If the inhaler is new or it has not been used for 1 week or more, 3 puffs should be released into the air. It is not necessary to shake the inhaler before using it. Clean the mouthpiece with a tissue or dry cloth once a week. Do not wash or put any part of the inhaler in water.

Store this medication at room temperature between 15°C and 30°C. Do no pierce or burn the canister, or allow it to freeze. Keep this medication out of the reach of children.

100 µg
Each actuation of aerosol solution contains 100 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

200 µg
Each actuation of aerosol solution contains 200 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

Do not use ciclesonide if you:

• are allergic to ciclesonide or any ingredients of the medication
• are having an asthma attack or a sudden attack of breathlessness
• have an untreated fungal, bacterial, or tuberculosis infection of the respiratory tract
• have moderate to severe bronchiectasis (a lung problem where the bronchial tubes are damaged)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bad taste
• cough
• dry mouth or throat
• eczema
• headache
• hoarseness or other voice changes
• increased blood pressure
• nausea
• skin rash
• sore throat or tongue
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain
• decreased bone density (with high doses)
• eye pain
• pounding heartbeat
• rounded face (with high doses)
• vision changes
• signs of a fungal infection in the mouth (white patches in mouth and throat)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a severe allergic reaction (e.g., hives; difficulty breathing; and swelling of the lips, face, eyelids, throat, or tongue)
• sudden wheezing and chest pain or tightness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Asthma control: This medication is not for use as a "reliever" medication. If you start developing an asthma attack, be sure to use your "reliever" medication for rapid relief of your asthma symptoms. Contact your doctor immediately if you find you are using your "reliever" medications (e.g., salbutamol, terbutaline, formoterol) more often or if they are not working as well as they used to. This may mean your asthma is not controlled. Your doctor may want you to temporarily change the dose of ciclesonide or may start you on an oral corticosteroid.

Bone problems: When used for long periods of time, this medication may reduce bone density and increase the risk of developing osteoporosis. Your doctor may monitor for this periodically.

Breathing problems: If you experience wheezing or difficulty breathing right after using this medication, use your "reliever" medication (e.g., salbutamol, terbutaline, or formoterol) and stop using this medication and contact your doctor.

Eye problems: This medication may increase the risk of cataracts, increased pressure in the eye, and glaucoma when used for long periods of time. Your doctor will monitor you by checking your eyes periodically.

Infections: Infections such as chickenpox and measles can be more serious in people taking medications such as ciclesonide. If you are exposed to someone with chickenpox or measles, contact your doctor.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. Although this is not usually a problem if you have mildly-to-moderately reduced liver function, the effect of this medication on people with severely reduced liver function has not been determined. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using this medication, helps reduce the chances of developing a yeast infection of the mouth or throat ( called "thrush"). Using a spacer device with the inhaler can also reduce how much medication stays in your mouth. If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.

Steroid medication use: If you have taken or are still taking oral steroid medication during the last several months, consult your doctor before using this medication. In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again.

Stopping medication: Do not stop this medication abruptly, as this may cause the cough and difficulty breathing to return. When this medication is stopped, it should be stopped gradually, as directed by your doctor.

Thyroid problems: People with decreased thyroid function (hypothyroid) may experience an increased effect from corticosteroids. If you have a history of thyroid problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if ciclesonide passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.

There may be an interaction between ciclesonide and any of the following:

• aldesleukin
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• ceritinib
• clarithromycin
• cobicistat
• desmopressin
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• idelalisib
• loxapine
• mifepristone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.