HOW should this medicine be used?
Ciclesonide comes as an aerosol to inhale by mouth. Ciclesonide is usually inhaled twice a day. Try to use ciclesonide at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ciclesonide inhalation exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Talk to your doctor about how you should use your other oral and inhaled medications for asthma during your treatment with ciclesonide inhalation. If you are using any other inhaled medications, ask your doctor if you should inhale these medications a certain amount of time before and after you inhale ciclesonide inhalation. If you were taking an oral steroid such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), or prednisone (Deltasone), your doctor may want to gradually decrease your steroid dose starting at least one week after you begin to use ciclesonide inhalation. Special care will be needed in certain situations for several months as your body adjusts to the change in medication. Ask your doctor for more information.
Ciclesonide inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use ciclesonide inhalation during an asthma attack. Your doctor will prescribe a short-acting inhaler to use during asthma attacks.
Your doctor will probably start you on an average dose of ciclesonide inhalation. Your doctor may increase it if your symptoms have not improved after at least 4 weeks and later may decrease your dose when your symptoms are controlled.
Ciclesonide inhalation controls asthma but does not cure it. It may take 4 weeks or longer before you feel the full benefit of the medication. Continue to use ciclesonide inhalation even if you feel well. Do not stop using ciclesonide inhalation without talking to your doctor.
Tell your doctor if your asthma worsens during your treatment. Call your doctor if you have an asthma attack that does not stop when you use your fast-acting asthma medication, or if you need to use more of your fast-acting medication than usual.
The inhaler that comes with ciclesonide aerosol is designed for use only with a canister of ciclesonide. Never use it to inhale any other medication, and never use any other inhaler to inhale ciclesonide.
Each canister of ciclesonide aerosol is designed to provide 60 or 120 inhalations, depending on its size. After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication. Your inhaler comes with an attached counter that will change as every 10 sprays are used. When the number that shows on the counter is 020, you should call your doctor or pharmacist to refill your prescription. When the number that shows on the counter is 000, you should not use that canister anymore. You should also keep track of the number of inhalations you use each day to know the exact amount of sprays that remain in your inhaler. Throw away the canister after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed. If your inhaler is dropped, do not use the number on the counter to predict the number of sprays left in your inhaler.
Before you use your ciclesonide aerosol inhaler the first time, read the written instructions that come with it. Look at the diagrams carefully and be sure that you recognize all the parts of the inhaler. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it.
Do not use your ciclesonide inhaler while you are near an open flame or a heat source. The inhaler may explode if it is exposed to very high temperatures.
To use the aerosol, follow these steps:
- Be sure that the inhaler is at room temperature.
- Remove the cap from the mouthpiece.
- Be sure the canister is fully and firmly inserted in the actuator. You do not need to shake your inhaler before each use.
- If you are using the inhaler for the first time or if you have not used the inhaler in more than 10 days, prime it by releasing 3 test sprays into the air, away from your face. Be careful not to spray the medication into your eyes or face.
- Breathe out through your mouth.
- Hold the inhaler facing you with the mouthpiece on the bottom. Place your thumb under the mouthpiece and your index finger on the center of the dose indicator at the top of the canister. Place the mouthpiece in your mouth and close your lips around it, keeping your tongue below it.
- Breathe in deeply and slowly through your mouth. At the same time, press down firmly on the center of the dose indicator at the top of the canister with your index finger. Remove your index finger as soon as the spray is released.
- When you have breathed in fully, remove the inhaler from your mouth and close your mouth.
- Try to hold your breath for about 10 seconds, then breathe out gently.
- Put the cap back on the mouthpiece.
- Rinse your mouth with water and spit the water out. Do not swallow the water.
Clean your inhaler once a week. To clean your inhaler, use a clean, dry tissue or cloth. Do not wash or put any part of your inhaler in water.
What SIDE EFFECTS can this medicine cause?
Ciclesonide inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- stuffy or runny nose
- sore or irritated throat
- painful white patches in the mouth or throat
- joint pain
- back pain
- pain in arms, legs
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- new or increased acne (pimples)
- easy bruising
- enlarged face and neck
- growth of hair on the face
- extreme tiredness
- muscle weakness
- irregular menstruation (periods)
- pink or purple stretch marks on the skin
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- chest pain or tightness
- shortness of breath
Ciclesonide inhalation may cause children to grow more slowly. Your child's doctor will watch your child's growth carefully while your child is using ciclesonide inhalation. Talk to your child's doctor about the risks of giving this medication to your child.
In rare cases, people who used ciclesonide inhalation for a long time developed glaucoma or cataracts. Talk to your doctor about the risks of using ciclesonide inhalation and how often you should have your eyes examined during your treatment.
Ciclesonide inhalation may increase your risk of developing osteoporosis. Talk to your doctor about the risks of using this medication.
Ciclesonide inhalation may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at
] or by phone [1-800-332-1088].
What OTHER INFORMATION should I know?
Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: February 1, 2009.