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Ciclesonide
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Important Resources for Ciclesonide:
Ciclesonide is a prescription nasal spray used for the treatment of allergic rhinitis ("runny nose" or "hay fever"). It belongs to a family of drugs called glucocorticoids and is marketed as Omnaris by Sepracor. The drug was approved in October 2006.
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Uses
Ciclesonide is specifically indicated for the treatment of nasal symptoms associated with:
- Seasonal allergic rhinitis in adults and children six years of age and older.
- Perennial (non-seasonal) allergic rhinitis in adults and adolescents twelve years of age and older.
It has also been reported that ciclesonide may be an appropriate drug for management of asthma.[1] The drug is marketed as Alvesco for use in asthma.
How Ciclesonide is Taken
Ciclesonide is available in an amber glass bottle with a nasal spray applicator. The recommended (and maximum) dose is two sprays in each nostril once daily. Each spray delivers 50 micrograms of active ingredient.
How Ciclesonide Works
Ciclesonide is enzymatically broken down into its active metabolite, des-ciclesonide, in the lining of the nose. The precise mechanism through which des-ciclesonide reduces allergic rhinitis symptoms is not known. However, corticosteroids like des-ciclesonide have been shown to have a wide range of effects on multiple cell types involved in allergic inflammation.
How the Body Affects Ciclesonide
Intranasal ciclesonide is broken down to a biologically active metabolite, des-ciclesonide, by enzymes called esterases in the nasal lining. The metabolite des-ciclesonide undergoes further metabolism in the liver by the enzyme CYP3A4 and to a lesser extent by CYP2D6.
Side Effects
The most common side effects (>1% of patients) attributable to ciclesonide use include:
- Epistaxis (nose bleed)
- Nasal discomfort
- Headache
Risks and Precautions
Patients who are on immunosuppressive doses of corticosteroids while taking ciclesonide need to avoid exposure to persons with chickenpox or measles.
Drug Interactions
Ketoconazole needs to be taken with caution in patients taking ciclesonide.
Effectiveness
The effectiveness of ciclesonide has been studied in two groups:[2]
- Adults and adolescents aged twelve years and older
- Children aged six to eleven years of age
In adults and adolescents aged twelve years and older
The effectiveness of ciclesonide was evaluated in four clinical trials conducted in adolescents and adults with allergic rhinitis. The results of these trials showed that patients treated with ciclesonide 200 mcg (two sprays once daily) exhibited significantly greater decreases in total nasal symptom scores than placebo treated patients.[3]
In children aged six to eleven years of age
The effectiveness of ciclesonide was evaluated in two clinical trials involving patients 6 to 11 years of age with allergic rhinitis. Ciclesonide 200 mcg (two sprays once daily) dose significantly improved nasal symptoms as compared to placebo.
References
- ↑ Dahl R. Ciclesonide for the treatment of asthma. Ther Clin Risk Manag. 2006 Mar;2(1):25-38. Abstract | Full Text | PDF
- ↑ http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6940
- ↑ Chervinsky P, Kunjibettu S, Miller DL, et al. Long-term safety and efficacy of intranasal ciclesonide in adult and adolescent patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2007 Jul;99(1):69-76. Abstract
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The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional.
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