Ciclesonide (Nasal)

Ciclesonide is a glucocorticoid nasal spray used to treat inflammation of the nasal area.

Overview

Ciclesonide is usually prescribed to treat excessive sneezing, a runny or itchy nose, or other symptoms of an allergy that may be either perennial or seasonal hay fever, otherwise known as allergic rhinitis.

Ciclesonide is a steroid, much like cortisone. It is used to reduce inflammation in the tissues that occur during an allergic reaction.

Ciclesonide is only available with your doctor's prescription. It is available as a nasal spray or in an aerosol liquid and is administered through the nostrils.

Conditions Treated:

  • Rhinitis
  • Allergies
  • Perennial allergies
  • Seasonal allergies
  • Hay fever

Type of Medicine:

  • Aerosol liquid
  • Spray
  • Glucocorticoid

Side Effects

Mild Side Effects

While taking ciclesonide, some patients may experience unwanted symptoms or side effects in addition to the desired therapeutic effects of this medication. Some of these side effects are just a result of your body adjusting to the medication and are not necessarily a cause for concern. These side effects should subside or go away once your body has adjusted to the medication. If any of these side effects worsen over the course of treatment or become bothersome, let your doctor know. Your doctor or health care professional may be able to suggest some ways to deal with the side effects as they occur.

Patients taking ciclesonide may experience some mild ear pain. If this pain does not go away after application, persists, changes, or gets worse, contact your doctor as soon as possible.

Serious Side Effects

Some patients taking ciclesonide may experience unwanted side effects that can lead to serious health problems, or that may be symptoms of serious health problems triggered by the usage of ciclesonide. If you experience any of these side effects, check with your doctor as quickly as possible. Patients experiencing these side effects will need medical attention and may need to discontinue ciclesonide or seek other treatment for some side effects.

Some patients taking ciclesonide may experience respiratory side effects, such as:

  • Nasal discomfort
  • A sore throat or irritation in the throat
  • A stuffy nose or a runny nose
  • Bleeding or bloody nose
  • Unexplained nosebleeds or mucous that has blood in it
  • Troubled breathing or difficulty with breathing
  • Wheezing or shortness of breath
  • Tightness or constriction in the chest
  • Some patients taking ciclesonide may experience dermatological side effects or side effects related to the skin, such as:
  • Acne, pimples, or other skin blemishes
  • Hives or welts on the skin
  • Reddening or flushing of the skin, especially around the ears
  • An unusual rash on the skin
  • White patches inside the throat, nose, or other mucous membranes
  • Swelling of skin around the face, eyes, eyelids, or the inside of the nose
  • Swelling of the skin anywhere else on the body
  • Severe redness of the skin anywhere on the body
  • Soreness, itching, burning, or other pain on the skin
  • Skin that is unusually dry, scaly, crusting over, of flaking off
  • Blisters on the skin
  • Unusual darkening of the skin
  • Some patients taking ciclesonide may experience side effects in the eyes, such as:
  • Pain in the eyes
  • Unusual tearing up or tear gland activity
  • Any change in vision
  • Decreased vision
  • Blurred vision
  • Loss of vision
  • Blindness
  • Some patients taking ciclesonide may experience gastrointestinal side effects, such as:
  • A loss of appetite
  • Difficulty in swallowing
  • Nausea
  • Vomiting
  • Diarrhea
  • Some patients taking ciclesonide may experience other side effects, such as:
  • Unusual headaches
  • Muscle aches
  • A fever
  • Unusual tiredness or weakness
  • Mental depression
  • Dizziness
  • Fainting
  • Loss of consciousness
  • Changes in menstrual cycle, pattern, or other menstrual changes
  • Weight gain around the trunk or torso, face, and neck

If you experience or notice any of these side effects while taking ciclesonide, contact your doctor right away. These side effects may require medical attention or medical treatment.

Dosage

All dosages and information given are provided by the manufacturer as a standard dose. Your individual dosage may vary depending on your condition, your needs, and what your doctor has decided is right for your condition. When in doubt, follow your doctor's directions for use. Using more of this medication than your doctor has directed may increase your risk of side effects.

Ciclesonide must be used on a regular basis in order to work correctly. You may feel symptoms of relief during the first 48 hours of use. Up to two weeks may pass before this medication will take its full effect.

  • To successfully use ciclesonide for best effect:
  • Shake the canister of medication gently before each individual use.
  • Before you use the spray, be sure to blow your nose and clear your nasal passages.
  • When using a canister of ciclesonide or after it has not been used for 10 days, you will need to press down on the top of the canister until a fine spray of the medication comes out. This primes the spray and provides accurate dosage.
  • Tilt your head back just slightly.
  • Insert the tip of the canister's nose piece into your nostril.
  • Press your finger to the opposite nostril until it is closed.
  • Release one spray of the medication while breathing in gently through your open nostril. Hold the breath for a few seconds to ensure the spray has time to get into your system.
  • Breathe the remaining vapor slowly out through your mouth. Use the same procedure in the opposite nostril.
  • Do not blow your nose for 15 minutes after you use your ciclesonide spray. Wipe the tip of the nose piece with a dry, clean cloth or tissue. Do not wash the bottle or put it in water.

Your bottle should hold 60 doses of the ciclesonide spray. When the majority of ciclesonide is left in the bottle, a display window will show a green color. When your medication needs to be replaced, the display window will show yellow. When the spray canister is almost empty, the window will show red. The display window may not work correctly if the canister is dropped; make sure you keep accurate records of how many doses you have taken. Throw the medicine away when the dose indicator reads zero or when you have used 60 sprays.

Missed Dose

If you miss a dose of ciclesonide, take it as soon as possible. If it is nearly time for your next dose, do not double dose. Skip the missed dose and return to your regular dosing schedule.

Interactions

Drug interactions can cause drugs to work differently in your body and can raise your risk of side effects. Keep a complete list of any drugs, supplements, or medications you take regularly, whether they are prescribed to you by a doctor or are taken over the counter. Your doctor, pharmacist, or other healthcare professional can help you identify drug interactions that could harm you.

Ciclesonide has been shown to have no potential for interactions with metabolic drugs or protein binding-based drugs.

Co-administration of orally inhaled medications including ketoconazole and ciclesonide has been shown to increase the amount of ciclesonide in your body. Check with your doctor to see if it's safe to use ciclesonide and your ketoconazole medication together.

Warnings

Monitoring of Progress

Patients using ciclesonide will need to make regular appointments and check-ups with their doctor to ensure that the medication is working as needed. This will allow your doctor to check up on the progress of your symptoms and decide whether the medication should continue to be administered or whether you may need to change your dosage or seek other treatment.

Ciclesonide should be effective in treating or reducing your symptoms in the first few days of usage. If your symptoms do not improve within a few days, or if they become worse while you are using ciclesonide, check with your doctor.

Infections and Immunosuppression

While taking ciclesonide, your risk of contracting another infection may go up and you may get sick more easily. Ciclesonide can also prolong or exacerbate viral infections, making you sicker for longer than you otherwise would have been. You can take some precautions to prevent this. Avoid people who may be sick, especially people who have had chicken pox or measles. Tell your doctor immediately if you think you have been exposed to chicken pox, measles, or anyone with a sickness or infection.

Use of ciclesonide can sometimes mask the symptoms of acute infections, such as fungal infections. While you are taking ciclesonide, keep your doctor's appointments regularly. Your doctor may be able to detect symptoms of fungal infection or other infections that may be masked by the therapeutic effects of ciclesonide.

The immunosuppressant properties of ciclesonide can limit the response to vaccines. If you are taking ciclesonide, consult with your doctor before getting any vaccines or immunizations to see if it's safe for you.

Ciclesonide may cause oral candidiasis, or thrush, a fungal infection that usually attacks the mouth and throat. Symptoms of thrush include white spots or patches on the tongue or in the mouth, swelling or irritation of the throat, difficulty breathing, or difficulty swallowing. If you experience any of these symptoms, contact your doctor immediately.

Ciclesonide may not be safe to take if you have some infections, such as:

  • Ocular herpes simplex
  • Latent tuberculosis
  • Tuberculosis reactivity
  • Untreated fungal infections
  • Untreated viral infections
  • Untreated bacterial infections

If you contract or you suspect that you have been exposed to any of these infections while taking ciclesonide, contact your doctor immediately for treatment.

Impaired Wound Healing

Direct topical application of ciclesonide or other cortical steroids can impair or delay the healing of wounds. If you have recently had a nasal septal ulcer, nasal surgery, or any other kind of nasal trauma, avoid using ciclesonide until your injury has healed. Consult your doctor to see whether it is safe for you to use ciclesonide.

Nasal Effects

Ciclesonide may cause some unwanted medical conditions in the nasal area. Some patients may experience epistaxis or bleeding from the nostril, nasal cavity, or nasopharynx. Some patients may experience localized thrush or Candida albicans infections in the nose and pharynx, which is characterized by white spots or patches on the skin. Some patients may experience nasal ulceration, or perforation of the nasal septum. Check with your doctor if you have sores inside your nose, bloody mucus or nosebleeds, or a whistling sound when you breathe. Patients should be monitored for adverse effects on the nose and nasal passages.

Angioedema

Ciclesonide can cause a serious allergic reaction in some patients. The specific type of allergic reaction seen in most patients is angioedema. You may experience swelling of the face, throat, tongue, lips, and arms or legs, as well as trouble breathing or swallowing. If you experience any of these symptoms while taking ciclesonide, get medical assistance immediately. If you experience an allergic reaction to ciclesonide, your doctor may decide that it is necessary for you to discontinue ciclesonide.

Effects on Growth

Ciclesonide may interfere with the normal growth of children. While taking ciclesonide on a regular basis, your child's weight or height may not advance as it normally would during the course of childhood development. Consult with your doctor if you are concerned that your child is not gaining weight or getting taller as they should, or if you have any questions about your child's normal growth and development.

Adrenal Gland Malfunction

Ciclesonide is a steroid. Your adrenal gland is the organ that normally makes steroids for your body. Use of ciclesonide or other medications with steroids may cause your adrenal gland to slow down, especially if you are taking high doses or using the medication for a long time.

The most common symptoms of an underactive adrenal gland include dizziness or fainting, unusual weakness or tiredness, nausea or loss of appetite, vomiting, diarrhea, unusual darkening of the skin or a skin rash, and mental depression. Some rarer symptoms include changes in the menstrual cycle, eruptions of pimples or acne, and weight changes or fat deposits around the torso, neck, and face. If you experience any of these symptoms while taking ciclesonide, check with your doctor to see if you should adjust your dosage or taper down to cease taking ciclesonide.

Vision Problems and Ocular Disease

Ciclesonide can cause vision problems and ocular disease. Check with your doctor if you experience blurred vision, darkening vision, difficulty in reading, or any other change in your vision. Patients taking ciclesonide may experience side effects such as increased intraocular pressure or pressure inside the eye, cataracts, and open-angle glaucoma. Patients who have experienced these problems before should use with caution. If you experience or have had vision problems, your doctor may recommend routine opthamologist visits or eye exams.

Storage

Store your canister of ciclesonide at room temperature. Keep ciclesonide away from direct light and excessive heat. Do not keep your ciclesonide inside a car or any other environment in which it could be exposed to extreme temperatures. Even if the canister of ciclesonide is empty, do not throw the canister into a fire or poke holes in it.

Do not keep your medication if it is outdated or past the expiration date. Ask your pharmacist or other healthcare professional how to dispose of any unused medication.

Summary

Ciclesonide is a glucocorticoid nasal spray. It is a steroid used to reduce inflammation of the nasal area. It is prescribed to treat symptoms of hay fever such as sneezing and nasal irritation. Ciclesonide is a steroid. It is only available through a doctor's prescription. It is taken via the nostrils through a nasal spray.

Ciclesonide has some mild side effects, which are usually a result of your body adjusting to the medication. You may experience some mild ear pain. If this persists or gets worse, contact your doctor.

Ciclesonide may cause some more serious side effects that need medical attention. You may experience nasal discomfort, a sore throat, bloody mucus or nosebleeds. You may experience wheezing or difficulty breathing, or constriction in the chest. You may experience acne, hives, rashes, white patches in the mouth or throat, skin redness or swelling, darkening of the skin, flaky skin, blisters, or other skin irritation. You may experience eye pain or problems with vision. You may experience nausea, a loss of appetite, vomiting, or diarrhea. You may experience muscle aches, headaches, fever, weakness or tiredness, depression, dizziness, or fainting. You may experience changes in your menstrual cycle or weight gain in unusual areas. If you experience any of these side effects, contact your doctor immediately.

Patients using ciclesonide will need to keep a regular check-up schedule with their doctor to ensure that the medication is working as directed. Your symptoms should reduce by two days and be treated as effectively as possible within two weeks. If your symptoms do not subside within this time, contact your doctor.

Ciclesonide can suppress your immune system, leaving you at a higher risk of contracting infections. Avoid sick people and tell your doctor if you are around anyone who has chicken pox or measles. Check with your doctor before getting an immunization or vaccine. Ciclesonide can cause thrush. It may not be safe to take if you have infections such as ocular herpes, tuberculosis, or any other untreated infections.

  • Ciclesonide can cause impaired wound healing in the nose. Check with your doctor if you have had any wounds or perforations in the nose before you take ciclesonide.
  • Ciclesonide can cause allergic angioedema in some patients. Seek medical attention if you experience swelling of the face, throat, arms, or legs.
  • Ciclesonide can cause growth problems in children and adrenal gland malfunction in many patients. It can also cause vision problems or ocular disease.