Ciclesonide

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Ciclesonide Brand Names

Alvesco | Omnaris | Zetonna

What is Ciclesonide

Ciclesonide is a non-halogenated glucocorticoid which is beneficial in treating inflammatory conditions such as allergic rhinitis and asthma.

Data from controlled trials suggest it may also be beneficial in the treatment of COPD.

Ciclesonide is used off-label for prevention of of exercise-induced bronchoconstriction (EIB); it may be a first-line choice for a controller agent to be added to an inhaled short-acting beta-2 agonist (SABA) to control EIB symptoms in patients who cannot be controlled by an inhaled SABA alone.

The drug has a low systemic bioavailability following intranasal or oral inhalational administration, which aids in limiting systemic effects such as cortisol suppression.

Ciclesonide is a prodrug with an active metabolite which is 100—120 times more potent than the parent compound, and a similar relative potency to beclomethasone and budesonide.

In October 2006, ciclesonide nasal spray (Omnaris) received FDA approval for the treatment of nasal symptoms associated with seasonal and perennial allergic rhinitis.

In January 2008, ciclesonide oral inhalation (Alvesco) was approved by the FDA for the maintenance treatment of asthma as prophylactic therapy.

In January 2012, a ciclesonide nasal aerosol (Zetonna) FDA approved for the treatment of symptoms associated with seasonal and perennial allergic rhinitis.

All dosage forms are approved in adult and pediatric patients 12 years of age and older.

Indications

  • allergic rhinitis
  • asthma
  • exercise-induced bronchospasm prophylaxis
  • perennial allergies
  • seasonal allergies

For the management of symptoms of perennial allergies and seasonal allergies, including allergic rhinitis

Side Effects

  1. abdominal pain
  2. angioedema
  3. arthralgia
  4. back pain
  5. bronchospasm
  6. candidiasis
  7. cataracts
  8. contact dermatitis
  9. cough
  10. dysphonia
  11. epistaxis
  12. growth inhibition
  13. headache
  14. hypothalamic-pituitary-adrenal (HPA) suppression
  15. infection
  16. influenza
  17. nasal congestion
  18. nasal irritation
  19. nasal septum perforation
  20. nausea
  21. osteopenia
  22. otalgia
  23. pharyngitis
  24. rhinitis
  25. sinusitis
  26. xerostomia

Monitoring Parameters

  • pulmonary function tests (PFTs)

Contraindications

  • acute bronchospasm
  • adrenal insufficiency
  • breast-feeding
  • cataracts
  • children
  • corticosteroid hypersensitivity
  • Cushing’s syndrome
  • fungal infection
  • geriatric
  • glaucoma
  • growth inhibition
  • herpes infection
  • hypothalamic-pituitary-adrenal (HPA) suppression
  • increased intracranial pressure
  • increased intraocular pressure
  • infants
  • infection
  • measles
  • nasal septal perforation
  • nasal surgery
  • nasal trauma
  • neonates
  • osteoporosis
  • pregnancy
  • status asthmaticus
  • tuberculosis
  • vaccination
  • varicella
  • viral infection

Interactions

  • Abatacept
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetazolamide
  • Acetohexamide
  • Adalimumab
  • Albiglutide
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alogliptin; Metformin
  • Alpha-glucosidase Inhibitors
  • Altretamine
  • Ambenonium Chloride
  • Amifampridine
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminolevulinic Acid
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Antithymocyte Globulin
  • Antitumor antibiotics
  • Argatroban
  • Arsenic Trioxide
  • Asparaginase Erwinia chrysanthemi
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  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol; Chlorthalidone
  • Atracurium
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Azathioprine
  • Azilsartan; Chlorthalidone
  • Basiliximab
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bepridil
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  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bivalirudin
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  • Brompheniramine; Carbetapentane; Phenylephrine
  • Bupropion
  • Bupropion; Naltrexone
  • Canagliflozin
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  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Phenylephrine
  • Carmustine, BCNU
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  • Chlorambucil
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  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Choline Salicylate; Magnesium Salicylate
  • Cimetidine
  • Cisatracurium
  • Citalopram
  • Clindamycin
  • Clofarabine
  • Cobicistat
  • Codeine; Phenylephrine; Promethazine
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Denileukin Diftitox
  • Denosumab
  • Desmopressin
  • Dextran
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Digoxin
  • Dipeptidyl Peptidase-4 Inhibitors
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Dofetilide
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  • Droperidol
  • Dulaglutide
  • Echinacea
  • Econazole
  • Efalizumab
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Ephedrine
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Ertugliflozin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Estramustine
  • Estrogens
  • Exenatide
  • Fluconazole
  • Fluoxymesterone
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Gallium Ga 68 Dotatate
  • Gemcitabine
  • Gentamicin
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycerol Phenylbutyrate
  • Guaifenesin; Phenylephrine
  • Halofantrine
  • Haloperidol
  • Hemin
  • Heparin
  • Hetastarch
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Phenylephrine
  • Hydroxyurea
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
  • Incretin Mimetics
  • Indapamide
  • Inebilizumab
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Isoproterenol
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  • Ketoconazole
  • L-Asparaginase Escherichia coli
  • Levetiracetam
  • Levomethadyl
  • Linagliptin; Metformin
  • Liraglutide
  • Lixisenatide
  • Lomustine, CCNU
  • Loop diuretics
  • Lopinavir; Ritonavir
  • Macimorelin
  • Magnesium Salicylate
  • Mannitol
  • Mecasermin rinfabate
  • Mecasermin, Recombinant, rh-IGF-1
  • Meglitinides
  • Melphalan
  • Mepenzolate
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methacholine
  • Methazolamide
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methoxsalen
  • Methyclothiazide
  • Metolazone
  • Micafungin
  • Mifepristone
  • Mitoxantrone
  • Mivacurium
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  • Muromonab-CD3
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  • Neostigmine
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  • Ondansetron
  • Oxymetholone
  • Pancuronium
  • Pegaspargase
  • Penicillamine
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Photosensitizing agents (topical)
  • Physostigmine
  • Pimozide
  • Potassium
  • Potassium Chloride
  • Potassium Phosphate; Sodium Phosphate
  • Potassium-sparing diuretics
  • Pramlintide
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Propranolol
  • Purine analogs
  • Pyridostigmine
  • Quetiapine
  • Rapacuronium
  • Regular Insulin
  • Repaglinide
  • Ritodrine
  • Ritonavir
  • Rituximab
  • Rituximab; Hyaluronidase
  • Rocuronium
  • Salicylates
  • Salsalate
  • Saquinavir
  • Sargramostim, GM-CSF
  • Semaglutide
  • SGLT2 Inhibitors
  • Sodium Benzoate; Sodium Phenylacetate
  • Sodium Chloride
  • Sodium Phenylbutyrate
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Somatropin, rh-GH
  • Succinylcholine
  • Sulfonylureas
  • Telbivudine
  • Testosterone
  • Thiazide diuretics
  • Thiazolidinediones
  • Thyroid hormones
  • Tobramycin
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  • Tolbutamide
  • Tositumomab
  • Tranexamic Acid
  • Tretinoin, ATRA
  • Tuberculin Purified Protein Derivative, PPD
  • Tubocurarine
  • Vancomycin
  • Vecuronium
  • Vigabatrin
  • Vinblastine
  • Vincristine Liposomal
  • Vorinostat
  • Warfarin
  • Zafirlukast
  • Zileuton

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