Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Substrate of
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Alvesco; Czech Republic: Alvesco; Estonia: Alvesco; Finland: Alvesco; Germany: Alvesco; Greece: Alvesco; Hungary: Alvesco; Ireland: Alvesco; Latvia: Alvesco; Lithuania: Alvesco; Netherlands: Alvesco; Poland: Alvesco; Portugal: Alvesco; Slovakia: Alvesco; Slovenia: Alvesco; Sweden: Alvesco; UK: Alvesco.

North America

Canada: Alvesco, Omnaris; USA: Alvesco, Omnaris.

Latin America

Argentina: Alvesco, Cicletex, Omnaris; Brazil: Alvesco; Mexico: Alvesco.


Japan: Alvesco.

Drug combinations


Ciclesonide: C~32~H~44~O~7~. Mw: 540.69. (1) Pregna-1,4-diene-3,20-dione, 16,17-[[(R)-cyclohexylmethylene] bis(oxy)]-11-hydroxy-21-(2-methyl-1-oxopropoxy)-, (11β,16α); (2) 2H-Naphth [2′,1′:4,5] indeno [1,2-d] [1,3] dioxole, pregna-1,4-diene-3,20-dione deriv. CAS-126544-47-6; CAS-141845-82-1 (2004).

Pharmacologic Category

Hormones and Synthetic Substitutes; Adrenals. EENT Preparations; Anti-inflammatory Agents; Corticosteroids. (ATC-Code: R03BA08).

Mechanism of action

Nonhalogenated, glucocorticoid prodrug which is hydrolyzed to the pharmacologically active metabolite des-ciclesonide. Des-ciclesonide has a high affinity for the glucocorticoid receptor and exhibits anti-inflammatory activity. As other corticosteroids, it has anti-inflammatory, immunosuppressive, and antiproliferative activities.

Therapeutic use

Seasonal and perennial allergic rhinitis. Prophylactic management of bronchial asthma.

Pregnancy and lactiation implications

Teratogenic effects reported in some animal studies. There are no adequate studies in pregnant women. The extent of intranasal absorption of ciclesonide is systemically low but variable (use with caution during pregnancy). Hypoadrenalism may occur in infants born to mothers receiving corticosteroids during pregnancy. Excretion in breast milk unknown (use caution).

Unlabeled use


Hypersensitivity to ciclesonide or any component of the formulation. Primary treatment of acute asthma or status asthmaticus. Moderate-to-severe bronchiectasis. Untreated fungal, bacterial, or tuberculosis infections of the respiratory tract.

Warnings and precautions

May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal axis, particularly in younger children or in patients receiving high doses for prolonged periods (risk of adrenal crisis). Withdrawal and discontinuation of a corticosteroid should be done slowly and carefully. Bronchospasm may occur with wheezing after inhalation. Not to be used in status asthmaticus or for the relief of acute bronchospasm. Avoid nasal corticosteroid use in nasal wounds until healing. Prolonged use of corticosteroids may increase the incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines. Exposure to chickenpox and measles should be avoided. Use caution in active or quiescent tuberculosis infections or in ocular herpes. Prolonged treatment with corticosteroids has been associated with the development of Kaposi’s sarcoma. Candida albicans infections (mostly mild to moderate) of the mouth and pharynx may occur with orally-inhaled corticosteroid use. Rare cases of vasculitis (Churg-Strauss syndrome) or other eosinophilic conditions (e.g. vasculitic rash, decreased pulmonary function, cardiac complications) can occur. Use with caution in cataracts and/or glaucoma (increased intraocular pressure, open-angle glaucoma, and cataracts have occurred with prolonged use). Use with caution in osteoporosis (risk of increased bone loss and osteoporotic fractures). Use with caution in history of seizure disorder. Metabolic clearance of corticosteroids increases in hyperthyroidism and decreases in hypothyroidism. May cause reduction in growth velocity in pediatric patients.



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