Alvesco

For adults and adolescents 12 years of age and older, the recommended starting dose of ciclesonide is 400 µg daily. The recommended daily dose is 100 µg to 800 µg. For most people, the dose can be taken as 1 to 2 puffs once daily either in the morning or evening. Some people with more severe asthma may need 800 µg daily, taken as 400 µg twice daily.

For children 6 to 11 years of age, the recommended dose of ciclesonide is 100 µg to 200 µg once daily given as 1 to 2 puffs either in the morning or evening.

Your doctor will help you determine the dose that is most appropriate for you. The regular daily dose of ciclesonide should be the lowest dose required to control asthma symptoms.

Inhaled ciclesonide is used to prevent asthma attacks. It is not used to relieve an attack that has already started. Use your "reliever" medication (e.g., salbutamol, terbutaline, formoterol) to relieve an asthma attack that has already started. If you do not have another medication to use for an attack or if you have any questions about this, speak with your doctor.

In order to get the most medication into the lungs from the inhaled dose, ask your doctor or pharmacist about proper techniques for taking this medication and about whether a spacer device might be right for you.

Rinsing your mouth and gargling with water after each inhalation can help prevent hoarseness, throat irritation, and an infection in the mouth called Candidiasis (a type of yeast infection of the mouth, also known as "thrush").

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use Alvesco (Ciclesonide-inh) exactly as prescribed by your doctor. It should be used daily, even when you are not experiencing any symptoms of asthma. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If the inhaler is new or it has not been used for 1 week or more, 3 puffs should be released into the air. It is not necessary to shake the inhaler before using it. Clean the mouthpiece with a tissue or dry cloth once a week. Do not wash or put any part of the inhaler in water.

Store Alvesco (Ciclesonide-inh) at room temperature between 15°C and 30°C. Do no pierce or burn the canister, or allow it to freeze. Keep Alvesco (Ciclesonide-inh) out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause an infection of the mouth or throat, known as thrush; it may cause headaches; it may cause hoarseness. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

50 µg
Each actuation of aerosol solution contains 50 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

100 µg
Each actuation of aerosol solution contains 100 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

200 µg
Each actuation of aerosol solution contains 200 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

Do not use ciclesonide if you:

• are allergic to ciclesonide or any ingredients of the medication
• are having an asthma attack or a sudden attack of breathlessness
• have an untreated fungal, bacterial, or Tuberculosis infection of the respiratory tract
• have moderate to severe Bronchiectasis (a lung problem where the bronchial tubes are damaged)

There may be an interaction between ciclesonide and any of the following:

• Aldesleukin
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• boceprevir
• Ceritinib
• clarithromycin
• conivaptan
• Deferasirox
• delavirdine
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• hyaluronidase
• loop diuretics (e.g., bumetanide, Furosemide)
• Loxapine
• nefazodone
• nelfinavir
• nicardipine
• telaprevir
• telithromycin
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Alvesco (Ciclesonide-inh). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Alvesco (Ciclesonide-inh).

Asthma control: Alvesco (Ciclesonide-inh) is not for use as a "reliever" medication. If you start developing an asthma attack, be sure to use your "reliever" medication for rapid relief of your asthma symptoms. Contact your doctor immediately if you find you are using your "reliever" medications (e.g., salbutamol, terbutaline, formoterol) more often or if they are not working as well as they used to. This may mean your asthma is not controlled. Your doctor may want you to temporarily change the dose of ciclesonide or may start you on an oral corticosteroid.

Bone problems: When used for long periods of time, Alvesco (Ciclesonide-inh) may reduce bone density and increase the risk of developing Osteoporosis. Your doctor may monitor for this periodically.

Breathing problems: If you experience wheezing or difficulty breathing right after using Alvesco (Ciclesonide-inh), use your "reliever" medication (e.g., salbutamol, terbutaline, or formoterol) and stop using Alvesco (Ciclesonide-inh) and contact your doctor.

Eye problems: Alvesco (Ciclesonide-inh) may increase the risk of Cataracts, increased pressure in the eye, and Glaucoma when used for long periods of time. Your doctor will monitor you by checking your eyes periodically.

Infections: Infections such as Chickenpox and Measles can be more serious in people taking medications such as ciclesonide. If you are exposed to someone with chickenpox or measles, contact your doctor.

Liver function: Liver disease or reduced liver function may cause Alvesco (Ciclesonide-inh) to build up in the body, causing side effects. Although this is not usually a problem if you have mildly-to-moderately reduced liver function, the effect of Alvesco (Ciclesonide-inh) on people with severely reduced liver function has not been determined. If you have liver problems, discuss with your doctor how Alvesco (Ciclesonide-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Alvesco (Ciclesonide-inh), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Alvesco (Ciclesonide-inh).

Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using Alvesco (Ciclesonide-inh), helps reduce the chances of developing a yeast infection of the mouth or throat ( called "thrush"). Using a spacer device with the inhaler can also reduce how much medication stays in your mouth. If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.

Steroid medication use: If you have taken or are still taking oral steroid medication during the last several months, consult your doctor before using Alvesco (Ciclesonide-inh). In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again.

Stopping medication: Do not stop Alvesco (Ciclesonide-inh) abruptly, as this may cause the cough and difficulty breathing to return. When Alvesco (Ciclesonide-inh) is stopped, it should be stopped gradually, as directed by your doctor.

Pregnancy: Alvesco (Ciclesonide-inh) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Alvesco (Ciclesonide-inh), contact your doctor immediately.

Breast-feeding: It is not known if ciclesonide passes into breast milk. If you are a breast-feeding mother and are taking Alvesco (Ciclesonide-inh), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Alvesco (Ciclesonide-inh) have not been established for children less than 6 years of age.

This product must be inhaled by mouth. Carefully follow the package's instructions. If needed, ask your pharmacist for additional information or for a demonstration. This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. Using this product may cause throat irritation and coughing. You can avoid these problems by thoroughly rinsing your mouth and gargling after each dose. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up.