Ciclesonide

Indications
 Inhalation
Asthma
Adult: Usual dose 160 mcg once daily, preferably in the evening from a metered-dose inhaler; reduced to 80 mcg once daily for maintenance.
Child: ≥12 yr: Usual dose 160 mcg once daily, preferably in the evening from a metered-dose inhaler; reduced to 80 mcg once daily for maintenance.
Contraindications
 Not for status asthmaticus or severe acute asthma where intensive measures are needed.
Warnings / Precautions
 Active or quiescent pulmonary TB, fungal, viral or bacterial infections, unless adequately treated. Severe hepatic impairment. Monitor height of children and adolescents on long term treatment with inhaled corticosteroids; reduce dose if growth is slow. Pregnancy, lactation.
Adverse Reactions
 Bad taste, hoarse voice, paradoxical bronchospasm, rash and eczema. Dryness, burning, inflammation and irritation at application site. Cough after inhalation. Systemic effects after prolonged use e.g. Cushing's syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, bone mineral density decrease, cataract, glaucoma.
Drug Interactions
 Increased ciclesonide concentrations with concomitant ketoconazole, itraconazole, ritonavir, nelfinavir or other potent CYP3A4 inhibitors.
See Below for More ciclesonide Drug Interactions
Mechanism of Actions
 Ciclesonide, an inhaled corticosteriod, is converted by esterases in the lungs to the active metabolite, desisobutyryl-ciclesonide, which has anti-inflammatory activity.
Absorption: Oral bioavailability: <1%. Systemic bioavailability of active metabolite when given as inhaler: >50%.
Distribution: Protein binding: Extensive (ciclesonide and active metabolite).
Metabolism: Hydrolysed to its active metabolite by esterases in the lung. Further metabolised to inactive metabolites via cytochrome P450 isoenzyme CYP3A4.
Excretion: Excreted via faeces (67%).
Storage Conditions
 Inhalation: Do not expose to temperatures > 50°C.
ATC Classification
 R03BA08 - ciclesonide ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.
Storage
 Inhalation: Do not expose to temperatures > 50°C.
Available As
  • Ciclesonide 200 mcg
  • Ciclesonide 50 mcg

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