Ciclesonide nasal spray belongs to the class of medications called corticosteroids. It is used to treat seasonal and perennial (year-round) allergic rhinitis in adults and adolescents 12 years of age and older.

Ciclesonide nasal spray works by reducing inflammation in the nose that may cause itching, nasal congestion (blocked nose), runny nose and sneezing, symptoms that occur with seasonal allergies (e.g., hay fever), and other year-round allergies. It may start to work in about 1 hour, but it may take a few days for you to notice the full effects of this medication.

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 usual recommended dose is 2 sprays in each nostril once daily. The maximum total daily dosage should not exceed 2 sprays in each nostril (200 µg per day). For the best results, ciclesonide nasal spray should be used regularly each day. Shake the medication gently before using it and gently blow your nose to clear your nostrils before each use.

If you are using this medication for the first time, you will need to prime the pump by spraying the pump in the air, away from you, about 8 times. If you have not used the nasal spray for 4 or more days in a row you will need to prime the pump again with one spray or until a fine mist appears.

Wipe the applicator tip with a clean tissue following each use, and clean it once a week with warm water then prime the pump with one spray or until a fine mist appears.

You should dispose of the bottle of medication after using 120 sprays, or 4 months after you first used the medication.

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 take this medication exactly as prescribed by your doctor. If you miss a dose of this medication by several hours, skip the missed dose and continue with your regular dosing schedule. Do not double a 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.

Store this medication at room temperature in an upright position, keep it from freezing, and keep it out of the reach of children.

Each spray of unscented aqueous suspension delivers 50 µg of ciclesonide. Nonmedicinal ingredients: disodium edetate, hydroxypropyl methylcellulose, microcrystalline cellulose, carboxymethylcellulose sodium, potassium sorbate, and purified water. Hydrochloric acid may be added to adjust the pH to a target 4.5.

Ciclesonide nasal spray should not be used by anyone who:

• is allergic to ciclesonide or to any of the ingredients of the medication
• has an active (or history of) tuberculosis lung infection

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.

• changed sense of taste
• dry mouth
• headache
• nausea
• nosebleeds
• nose burning, irritation, or discomfort
• sores or ulcers on the inside of the nose
• sore throat

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

• symptoms of an allergic reaction (e.g., difficulty breathing, hives, itchy skin rash, or swelling of the mouth and throat)

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.

Growth in adolescents: Corticosteroids such as ciclesonide nasal spray may impair the growth of adolescents. Your doctor will monitor for this. Talk to your doctor if you have any concerns.

Infections: Corticosteroids such as ciclesonide nasal spray may worsen existing infections, mask the signs of infection, and cause new infections. If you use this medication for several months or longer, your doctor will monitor you periodically for signs of infection. People using this medication who have not had chickenpox or measles or have not been vaccinated against these infections should take special care to avoid exposure to them. People with herpes simplex infection of the eye should talk to their doctor before using this medication.

Other steroid medications: People who have been taking steroid medications by mouth or by inhalation should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vision problems: Rarely, corticosteroids such as ciclesonide nasal spray causes glaucoma or cataracts. Report any vision changes to your doctor immediately.

Wound healing: Corticosteroids such as ciclesonide nasal spray can impair the ability of wounds to heal. This medication should not be used if you have ulcers in your nose, have had nasal surgery, or have had nasal trauma, until wounds have completely healed.

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

Breast-feeding: It is not known if ciclesonide nasal spray passes into breast milk. If you are a breast-feeding mother and are using 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 under 12 years of age.

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

• esketamine (nasal)

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 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.