Formulary
Ciclesonide: Indications, Dosing, Side Effects and Interactions
Ciclesonide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Ciclesonide: Indications, Dosing, Side Effects and Interactions
Ciclesonide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Prophylaxis of asthma**
- **Child** (By Inhalation Of Aerosol): 12-17 years 160 micrograms once daily, increased if necessary up to 320 micrograms twice daily, dose increased in severe asthma; reduced to 80 micrograms once daily, dose reduced only if control is maintained.
- **Adult** (By Inhalation Of Aerosol): 160 micrograms once daily, increased if necessary up to 320 micrograms twice daily, dose increased in severe asthma; reduced to 80 micrograms once daily, dose reduced only if control is maintained.
**Prophylaxis of asthma for ciclesonide**
- **Child 12-17 years** (By inhalation of aerosol): 160 micrograms once daily, increased if necessary up to 320 micrograms twice daily, dose increased in severe asthma; reduced to 80 micrograms once daily, dose reduced only if control is maintained.
Side effects
For all corticosteroids (inhaled) Common or very common Headache; oral candidiasis; pneumonia (in patients with COPD); taste altered; voice alteration Uncommon Bronchospasm paradoxical; cataract; vision blurred Rare or very rare Adrenal suppression; anxiety; behaviour abnormal; glaucoma; growth retardation (in children); sleep disorder Side-effects, further information Systemic absorption may follow inhaled administration particularly if high doses are used or if treatment is prolonged. Therefore also consider the side-effects of systemic corticosteroids. Candidiasis The risk of oral candidiasis can be reduced by using a spacer device with the corticosteroid inhaler; rinsing the mouth with water after inhalation of a dose may also be helpful. An anti-fungal oral suspension or oral gel can be used to treat oral candidiasis without discontinuing corticosteroid therapy. Paradoxical bronchospasm The potential for paradoxical bronchospasm (calling for discontinuation and alternative therapy) should be borne in mind. Mild bronchospasm may be prevented by inhalation of a short-acting beta2 agonist beforehand (or by transfer from an aerosol inhalation to a dry powder inhalation). Side-effects For ciclesonide Frequency not known Cushing's syndrome
Interactions
**Other interactions (3):**
- In vitro data indicate that CYP3A4 is the major enzyme involved in the metabolism of the active metabolite of ciclesonide M1 in man.
- In a drug-drug interaction study at steady state with ciclesonide and ketoconazole as a potent CYP3A4 inhibitor, the exposure to the active metabolite M1 increased approximately 3.5-fold, whereas...
- Therefore the concomitant administration of potent inhibitors of CYP 3A4 (e.g.
Pregnancy
For all corticosteroids (inhaled) Inhaled drugs for asthma can be taken as normal during pregnancy.
Breast feeding
For all corticosteroids (inhaled) Inhaled corticosteroids for asthma can be taken as normal during breast-feeding.
Hepatic impairment
Manufacturer advises caution in severe impairment (risk of increased exposure, no information available).
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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