Ciclesonidum

Description
Inhaled glucocorticoid.
Indications
Long-term treatment of asthma in adults and children from 12 years of age.
Contraindications
Hypersensitivity to the active substance or to any of the excipients.
Dosage
For adults. Inh. 160 mcg once a day, some patients may be adequately controlled on 80 mcg once a day. Preferably taken in the evening. For inhalation technique, see Patient Counseling Section.
Elderly. No dose adjustment necessary. For children from 12 years of age. No dose adjustment necessary.
Renal impairment. No dose adjustment necessary.
Hepatic impairment. No dose adjustment necessary.
Undesirable effects
Uncommon: nausea, vomiting, altered taste; local reactions, dryness of the throat; oral candidiasis; headache; wheezing, cough after inhalation, paradoxical bronchospasm; rash, eczema.
Rare: palpitations; abdominal pain, dyspepsia; angioedema, hypersensitivity reactions; hypertension. Frequency unknown: psychomotor hyperactivity, sleep disturbances, anxiety, depression, aggression, altered behavior (most commonly in children), systemic effects: Cushing’s syndrome, delayed growth in children and adolescents.
Pregnancy
Can be used if benefit outweighs risk. If the mother has taken corticosteroids during pregnancy, the infant’s adrenal function should be monitored.
Breastfeeding
Can be used if benefit outweighs risk.
Warnings
Not recommended to be used concomitantly with drugs that strongly inhibit CYP3A4. Not suitable for acute asthma attacks. When switching from oral corticosteroids to inhaled ciclesonide, caution is needed due to potential adrenal insufficiency. Use with caution in active or latent pulmonary tuberculosis, fungal, viral, or bacterial infections, or severe hepatic impairment. Regularly monitor the height of children on long-term treatment (if growth is slowed, reevaluate treatment). In cases of severe asthma, regularly assess the patient’s condition. In situations of potential stress, consider the possibility of adrenal insufficiency. If paradoxical bronchospasm occurs, the patient should be evaluated and the benefit-risk ratio reassessed. It is essential to regularly check if the patient is inhaling correctly.

Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė