Ciscort

Indications

Ciclesonide is a corticosteroid (steroid) used in two forms. As a nasal spray, it treats the symptoms of seasonal and year-round allergic rhinitis, such as a blocked or runny nose, sneezing and itching. As an inhaler, it is used every day to prevent asthma symptoms and attacks. It is a preventer and does not give quick relief during an asthma attack.

How It Works

Ciclesonide is an inactive form (prodrug) that is changed into its active form inside the nose or lungs. There it reduces swelling and irritation of the lining by calming the immune cells and chemicals involved in allergy and asthma. Because it acts mainly where it is applied and little reaches the rest of the body, side effects elsewhere are uncommon. Full benefit may take several days to a few weeks.

Dosage and Administration

Nasal spray, adults and children 12 years and over: usually 2 sprays in each nostril once a day, or as prescribed. Shake gently, prime before first use, and point the nozzle slightly away from the middle of the nose. Inhaler for asthma: usually 80 to 160 micrograms once a day, adjusted by your doctor; use it every day even when you feel well. Children: as prescribed. Keep a reliever inhaler for sudden symptoms.

Interactions

Strong liver enzyme blockers such as Ketoconazole, Itraconazole, Ritonavir and Cobicistat can increase steroid levels in the body. Using other steroid medicines at the same time (tablets, creams, inhalers) adds to the total steroid dose. Tell your doctor about all medicines you take.

Contraindications

Do not use ciclesonide if you are allergic to it. The inhaler must not be used to treat a sudden asthma attack. The nasal spray should not be used soon after nose surgery or injury, or with an untreated nasal infection, until healed and on a doctor's advice.

Side Effects

Nasal spray: nosebleeds, nasal irritation or dryness, headache and sore throat. Inhaler: hoarse voice, sore throat, mouth irritation and, less often, oral thrush. Rarely, steroid effects such as slowed growth in children, raised eye pressure, cataracts or a hole in the nasal septum can occur with long use.

Get urgent medical help if your breathing suddenly gets worse or you wheeze right after using the inhaler, if your reliever does not help, if you notice changes in vision, or if you have signs of a serious allergic reaction such as swelling of the face, lips or throat.

Pregnancy and Lactation

There is little information on ciclesonide in pregnancy and breastfeeding. Well-controlled asthma and allergy are important in pregnancy, so your doctor will choose the best inhaled or nasal steroid. Use only on medical advice.

Precautions and Warnings

Use regularly for the best effect. Rinse your mouth with water after using the inhaler. Tell your doctor if you have tuberculosis, untreated infections, glaucoma or cataracts. Children on long-term steroids should have their height checked. If you are switching from steroid tablets, your doctor will reduce them slowly. Do not stop the inhaler suddenly without advice.

Overdose

A single large dose is unlikely to cause harm. Using much more than prescribed for a long time can cause steroid side effects such as adrenal suppression. Seek medical advice if this happens.

Therapeutic Class

Corticosteroid (inhaled and intranasal).

Storage

Store below 30°C, away from direct sunlight and out of the reach of children. Do not freeze. Do not puncture or burn inhaler canisters, even when empty. Keep the cap on the nasal spray.