Ciclesonide (Systemic, Oral Inhalation)

Class: Adrenals
ATC Class: R03BA08
Chemical Name: 2-[(1S,2S,4R,8S,9S,11S,12S,13R)-6-cyclohexyl-11-hydroxy-9,13-dimethyl-16-oxo-5,7-dioxapentacycloicosa-14, 17-dien-8-yl]- 2-oxoethyl 2-methylpropanoate
Molecular Formula: C₃₂H₄₄O₇
CAS Number: 141845-82-1
Brands: Alvesco

Medically reviewed by Drugs.com on Jul 2, 2021. Written by ASHP.

Introduction

Synthetic, non-halogenated glucocorticoid.

Uses for Ciclesonide (Systemic, Oral Inhalation)

Asthma

Long-term prevention of bronchospasm in patients with asthma.

In corticosteroid-dependent patients, may permit a reduction in dosage or discontinuance of systemic corticosteroids.

Not indicated for management of acute bronchospasm.

Ciclesonide (Systemic, Oral Inhalation) Dosage and Administration

General

• Adjust dosage carefully according to individual requirements and response.

• Base initial and maximum dosages in adults and children ≥12 years of age on previous asthma therapy.

• After a satisfactory response is obtained, decrease dosage gradually to the lowest dosage that maintains an adequate clinical response. Achieve the lowest effective dosage, particularly in children, since inhaled corticosteroids have the potential to affect growth. (See Pediatric Use under Cautions.)

Conversion to Orally Inhaled Therapy in Patients Receiving Systemic Corticosteroids

• When switching from systemic corticosteroids to orally inhaled ciclesonide, asthma should be reasonably stable before initiating treatment with oral inhalation.

• Initially, administer oral inhalation concurrently with the maintenance dosage of the systemic corticosteroid. After at least 1 week, gradually withdraw the systemic corticosteroid.

• Decrements usually should not exceed 2.5 mg daily of prednisone (or its equivalent) each week in patients receiving the oral inhalation. Once oral corticosteroids are discontinued and symptoms of asthma have been controlled, titrate the dosage to the lowest effective level.

• Death has occurred in some individuals in whom systemic corticosteroids were withdrawn too rapidly. (See Withdrawal of Systemic Corticosteroid Therapy under Cautions.)

Administration

Oral Inhalation

Administer by oral inhalation using an oral aerosol inhaler.

Test-spray aerosol (3 times) before first use or when the inhaler is unused for >10 days.

Oral inhalation aerosol is formulated as a solution, which does not require shaking.

Exhale completely and place the mouthpiece of the inhaler well into the mouth with the lips closed firmly around it; keep the tongue below the mouthpiece. Inhale slowly and deeply through the mouth while pressing the canister down with forefinger. Hold the breath for about 10 seconds, or as long as comfortable, then withdraw the mouthpiece and exhale gently.

Patients receiving oral inhalation of ciclesonide should rinse their mouth with water after each dose to remove residual medication in the oropharyngeal area and to ...