Ciclesonide - Revision history

ClaireLewis: /* References */

2019-09-20T17:29:41Z

References

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Fletc151: /* References */

2019-06-13T13:41:07Z

References

← Older revision		Revision as of 13:41, 13 June 2019
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	==References==		==References==
			*Lexicomp
			*ACOG Committee on Practice Bulletins-Obstetrics, "ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 90, February 2008: Asthma in Pregnancy," Obstet Gynecol, 2008, 111(2 Pt 1):457-64. [PubMed 18238988]
			*Alvesco (ciclesonide) [prescribing information]. Marlborough, MA: Sunovion Pharmaceuticals; March 2018.
			*Alvesco (ciclesonide) [product monograph]. Mississauga, Ontario, Canada: AstraZeneca Canada; January 2017.
			*Bakhireva LN, Jones KL, Schatz M, et al, “Asthma Medication Use in Pregnancy and Fetal Growth,” J Allergy Clin Immunol, 2005, 116(3):503-9. [PubMed 16159616]
			*Bateman E, Karpel J, Casale T, et al, “Ciclesonide Reduces the Need for Oral Steroid Use in Adult Patients With Severe, Persistent Asthma,” Chest, 2006, 129(5):1176-87. [PubMed 16685007]
			*Chmielewska M, Akst LM. Dysphonia associated with the use of inhaled corticosteroids. Curr Opin Otolaryngol Head Neck Surg. 2015; 23(3):255-259. [PubMed 25887975]
			*Derendorf H, “Pharmacokinetic and Pharmacodynamic Properties of Inhaled Ciclesonide,” J Clin Pharmacol, 2007, 47(6):782-9 [PubMed 17412829]

	<references/>		<references/>
	[[Category:Pharmacology]]		[[Category:Pharmacology]]

Jonwarren: Creation of page

2016-11-17T06:43:39Z

Creation of page

New page

==Administration==
*Type: [[Inhaled corticosteroid]]
*Dosage Forms: 80, 160 mcg/spray MDI
*Routes of Administration: Inhalation
*Common Trade Names: Alvesco

==Adult Dosing==
*Prior bronchodilator alone
**1 puff (80 mcg per spray) BID
***Start: 1 puff inhaled BID
***Max: 320 mcg/day
***Taper to lowest effective dose
*Prior inhaled steroid
**1-2 puffs (80 mcg per spray) BID
***Start: 1 puff inhaled BID
***Max: 640 mcg/day
***Taper to lowest effective dose
*Prior oral steroid
**2 puffs (160 mcg per spray) BID
***Max: 640 mcg/day
***Taper to lowest effective dose. Taper oral steroids gradually after >1 week

==Pediatric Dosing==
*12+ yo, Prior bronchodilator alone
**1 puff (80 mcg per spray) BID
***Start: 1 puff inhaled BID
***Max: 320 mcg/day
***Taper to lowest effective dose
*12+ yo, Prior inhaled steroid
**1-2 puffs (80 mcg per spray) BID
***Start: 1 puff inhaled BID
***Max: 640 mcg/day
***Taper to lowest effective dose
*12+ yo, Prior oral steroid
**2 puffs (160 mcg per spray) BID
***Max: 640 mcg/day
***Taper to lowest effective dose. Taper oral steroids gradually after >1 week

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C; Risk of teratogenicity low based on animal data at 10x MRHD
*[[Lactation risk categories|Lactation risk]]: L3; Safety unknown

===Renal Dosing===
*Adult: Not defined
*Pediatric: Not defined

===Hepatic Dosing===
*Adult: No adjustment
*Pediatric: No adjustment

==Contraindications==
*Allergy to class/drug
*[[Asthma]], acute
*Bronchospasm
*Avoid abrupt withdrawal

==Adverse Reactions==
===Serious===
*Bronchospasm
*[[Hypersensitivity reaction]]
*[[Angioedema]]
*Adrenal suppression
*Hypercorticism
*Growth suppression (peds pts)
*[[Glaucoma]]
*IOP increase
*Cataracts

===Common===
*[[Headache]]
*Nasopharyngitis
*[[URI]]
*[[Sinusitis]]
*Nasal congestion
*Pharyngolaryngeal pain
*[[Arthralgia]]
*Extremity pain
*[[Back pain]]
*Hoarseness
*[[Candidiasis]], oral
*[[Influenza]]
*[[Pneumonia]]
*Musculoskeletal chest pain
*[[Urticaria]]
*[[Dizziness]]
*[[Gastroenteritis]]
*Facial edema
*[[Fatigue]]
*[[Conjunctivitis]]

==Pharmacology==
*Half-life: 0.71 hr (parent); 6-7 hr (active metabolite)
*Metabolism: Liver; CYP450: 2D6, 3A4 (primary) substrate
*Excretion: Bile/feces 66%, urine <20%

==Mechanism of Action==
Exact mechanism of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines and produces multiple glucocorticoid and mineral corticoid effects

==Comments==

==See Also==

==References==
<references/>
[[Category:Pharmacology]]