Alvesco (Ciclesonide)
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Alvesco Ciclesonide
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What is Alvesco?

Alvesco (ciclesonide) is an inhaled corticosteroid (ICS) used to help manage asthma symptoms by reducing inflammation in the lungs. Alvesco, approved by the FDA in January 2010, is used by adults and children aged at least six to treat their asthma. Alvesco is a maintenance medication that helps control asthma symptoms and reduce inflammation in the lungs.

Once you begin taking it, Alvesco normally begins working within 24 hours, however, it may be up to 2 weeks before you begin to see its full effects. Alvesco is not a rescue inhaler. You should not take Alvesco expecting it to provide instant relief for an asthma attack that is already in progress. It should be used regularly as a long-term controller medication along with an inhaler that provides faster relief, such as salbutamol, formoterol, or terbutaline.

How Alvesco works

Glucocorticoid steroids are powerful anti-inflammatories. While Alvesco, part of the glucocorticoid family, is a man-made steroid, it is related to the natural steroid hormone, cortisol, or hydrocortisone, which is supplied by the adrenal glands. After inhalation, ciclesonide is converted in the lungs to its active form, des-ciclesonide, which exerts anti-inflammatory effects.

For asthmatics, Alvesco in its inhaler form targets the lungs and reduces inflammation in the airways. It helps to prevent muscle cells around the airways from spasming, cutting back on fluid and cells that can result in airways becoming narrow in the wake of inflammation. Narrowing airways means it can be difficult for the lungs to get air in and out.

At lower doses, the body does not absorb much Alvesco, however, more is absorbed when taking higher doses, potentially resulting in side effects.

Ingredients

50 µg

This form contains 50 µg of Alvesco per actuation. Its inactive ingredients include propellant HFA-134a (Norflurane) and ethanol.

100 µg

This form contains 100 µg of Alvesco per actuation. Its inactive ingredients include propellant HFA-134a (Norflurane) and ethanol.

200 µg

This form contains 200 µg of Alvesco per actuation. Its inactive ingredients include propellant HFA-134a (Norflurane) and ethanol.

Dosage

The usual starting dose for adults and adolescents over the age of 12 is 400 µg taken daily. Thereafter, the usual daily dose is between 100 µg and 800 µg.

Most asthma patients can take 1 or 2 puffs each morning or night. Those with more severe asthma may require 800 µg each day, taken as two 400 µg puffs.

Children aged between 6 and 11 are usually prescribed 100 µg to 200 µg once a day, either as 1 or 2 puffs in the morning or at night.

You should discuss the most suitable dose for you or your child with your doctor. Your daily dose of Alvesco should be the lowest dose you can use to keep your asthma symptoms under control.

Alvesco is for preventing asthma attacks. It should not be used to relieve the symptoms of an attack that has begun. For this, you should use your reliever medication. If you do not have medication to relieve the symptoms of asthma attacks, you should discuss it with your doctor.

You should also discuss with them whether you might benefit from a spacer. For Alvesco to be as effective as possible, you need to get as much of your inhaled dose to your lungs as possible. Your doctor or pharmacist will be able to advise you on the best techniques for taking Alvesco, this might include using a spacer.

You do not need to shake your inhaler before using it.

Overdose

Life-threatening symptoms are not expected from an overdose of Alvesco. But using high doses of steroids over long periods of time can result in symptoms, such as:

  • Thinning skin
  • Easy bruising
  • Displacement of body fat in the:
    • face
    • neck
    • back
    • waist
  • More acne or facial hair
  • Menstrual issues
  • Impotence
  • Reduced sexual appetite

If you believe you or someone else has overdosed on Alvesco, you should contact your doctor as soon as possible. If someone has collapsed or isn’t breathing after using Alvesco, you should contact the emergency services.

Side Effects

If you are concerned about experiencing side effects from taking Alvesco, you should talk it over with your doctor and weigh up the risks against the benefits. Many of these side effects may disappear over time or can be managed. Your pharmacist should be able to make recommendations for managing these side effects, however, you should contact your doctor if they become severe or significantly uncomfortable.

The side effects of Alvesco are not experienced by everyone who takes it, but at least 1% of people taking this medication have experienced those listed below.

  • bad taste
  • cough
  • dry mouth or throat
  • headache
  • hoarseness or other voice changes
  • increased blood pressure
  • sore throat or tongue

More serious side effects

These serious side effects are rare but can cause serious issues if they are not addressed. If you experience any of these, you should see your doctor as soon as possible.

  • abdominal pain
  • high doses leading to decreased bone density
  • eye pain
  • pounding heartbeat
  • high doses leading to a more rounded face
  • changes in vision
  • fungal infection symptoms in the mouth, such as white patches in the mouth and throat

Side effects requiring urgent medical attention

If you experience any of the following side effects, discontinue the treatment and immediately seek the attention of a medical professional.

  • signs of a severe allergic reaction, such as:
    • hives
    • difficulty breathing
    • swelling of:
      • lips
      • face
      • eyelids
      • throat
      • or tongue
    • sudden wheezing, chest pain, or chest tightness

Side effects other than those listed above are possible. If any symptoms develop that worry you whilst taking Alvesco, you should discuss them with your doctor.

Warnings & Precautions

Always check the ingredients of any medication you take for anything you may be allergic to. You should not take Alvesco if you are allergic to it or any of its ingredients.

Make sure your doctor is aware of any medical conditions or allergies you have as this may impact whether or not they recommend Alvesco for you.

You should not use Alvesco if:

  • you are experiencing an asthma attack or are suddenly breathless
  • your respiratory tract has an untreated fungal, bacterial, or tuberculosis infection
  • you have moderate to severe bronchiectasis

It’s possible to develop hoarseness, an irritated throat, and candidiasis, a yeast infection also known as thrush, when using Alvesco. To help prevent this, you can gargle with water after each use of your inhaler.

You should release 3 puffs into the air if your inhaler is new or has been left unused for at least a week.

Do not submerge your inhaler or any part of it in water. You should clean the mouthpiece once a week with a dry tissue.

Bones

Using Alvesco over a long period of time can lead to a decrease in bone density and a heightened risk of osteoporosis. Your doctor should monitor the situation.

Breathing

You should use your reliever medication if you begin wheezing or find it difficult to breathe immediately after using Alvesco. If this is the case, you should stop using it and let your doctor know.

Eyes

Using Alvesco can heighten the risk of cataracts, glaucoma, and increased pressure in the eye. Your doctor should check your eyes regularly.

Children

Alvesco has not yet been established as safe or effective for children under the age of 6.

Drug Interactions

Alvesco may interact with any of the following drugs, so you should let your doctor know or seek guidance from your pharmacist if you are taking any of them.

  • aldesleukin
  • “azole” antifungals, such as:
    • itraconazole
    • ketoconazole
    • voriconazole
  • boceprevir
  • ceritinib
  • clarithromycin
  • conivaptan
  • deferasirox
  • delavirdine
  • HIV protease inhibitors, such as:
    • atazanavir
    • darunavir
    • lopinavir
    • ritonavir
  • hyaluronidase
  • loop diuretics, such as:
    • bumetanide
    • furosemide
  • loxapine
  • nefazodone
  • nelfinavir
  • nicardipine
  • telaprevir
  • telithromycin
  • thiazide diuretics, water pills, such as:
    • hydrochlorothiazide
    • indapamide
    • metolazone

Frequently Asked Questions

Alvesco may be prescribed for conditions other than those mentioned above. If you do not know why your doctor has prescribed it for you, you should ask them. It is important not to stop taking Alvesco without discussing it with your doctor.

You mustn’t give your prescribed Alvesco to anyone else. Even if they have the same symptoms as you, it can be harmful to them if they have not been prescribed it.

Alvesco may be available with different brand names and in different forms. Specific brand names or forms of this medication and other conditions they may treat, may not have been discussed here.

Alvesco should not be disposed of in wastewater or thrown out in the rubbish. You should seek the recommendations of your pharmacist to determine how best to dispose of the medication in your area.

Alvesco should be kept at room temperature, between 59 F and 86 F, and out of the reach of children. Do not pierce the canister or allow it to become frozen. Also, do not allow it to come into contact with an open flame, or high temperatures, such as in a car on a very warm day. If it gets too hot, the canister may explode.

An interaction does not necessarily mean you need to stop taking one. You should speak with your doctor and they will be able to help you manage your medications.

It depends on the situation, but your doctor might suggest:
  • you stop taking the medication
  • you change to a different medication
  • change your dosage of Alvesco, the other medication, or both
  • leave things as they are.

Other medications may interact with Alvesco, you should inform your doctor of all prescription, over-the-counter and herbal medicines. They should be made aware of any supplements you’re taking. You should also tell your doctor if you smoke, use street drugs or consume caffeine products.

While it is unknown whether Alvesco can affect an unborn baby, the risk should not be ignored. You should let your doctor know if you are pregnant or planning to become pregnant whilst using Alvesco. As for breastfeeding, it is also unknown whether Alvesco can pass into breast milk or affect a nursing baby. You should let your doctor know if you are breastfeeding a baby, or planning to breastfeed.

Many things might affect the dose you are prescribed. Your weight, other medical factors, and other medications you are on can have an impact. Do not take anything other than the dose you have been given by your doctor.

It is vital that you take Alvesco exactly as your doctor has prescribed, so if you miss a dose you should seek guidance from your doctor. However, do not attempt to give yourself two doses to make up for the one you missed.

You should avoid getting too close to people who are sick or have infections. If you come into contact with anyone with chicken pox or measles, you should see your doctor for preventative measures. For people using steroid medication, chicken pox and measles can be serious and even life-threatening.

No, Alvesco is a brand-name medication and is unavailable in a generic form which is an exact copy of the brand-name drug, but usually less costly. Ciclesonide is the active drug in Alvesco.

Yes, you will need to see your doctor.

In clinical trials, weight gain wasn’t a reported side effect amongst those taking Alvesco. However, it is possible for patients taking corticosteroids orally to gain weight. Your doctor may prescribe oral steroids like these with Alvesco. You should discuss any unusual weight gain with your doctor, they may be able to help you to find the cause or manage your weight.

Disclaimer

Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.

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Kenneth Fill, PharmD, MBA Fill

Kenneth Fill, PharmD, MBA, is a clinical pharmacist specialist and medical writer with a strong background in ambulatory care, pharmacogenomics, and medical content development. Based in the state of Michigan, he provides expert guidance on chronic disease state management. Kenneth completed his PharmD and MBA at the University of Toledo and pursued post-graduate residency training in ambulatory care and community-based pharmacy. His diverse background also includes academic detailing, clinical education, and interdisciplinary collaboration to enhance patient outcomes.