Introduction
Cesonide 80 HFA is used to prevent the symptoms of asthma (wheezing and shortness of breath). It is a corticosteroid and is known as a "preventer". You need to have a fast-acting “reliever” as well because this medicine will not stop an asthma attack that has already started.
Your doctor will tell you how often you need to use your inhaler. It is important that you take the lowest dose needed to effectively control your asthma. The effect of this medicine may be noticeable after a few days but will only reach its maximum after a few weeks. This medicine must be used regularly to be effective, so go on taking it even if you do not have any symptoms. That means it is doing its job. If you stop taking it your asthma may get worse. It should not be used to relieve sudden asthma attacks. If an asthma attack occurs, use your quick-relief inhaler (reliever). To get the benefit from this medicine you need to make sure you get your inhaler technique right, otherwise it will not work as well.
The most common side effects are hoarseness of voice, sore throat and oral infections in the mouth or throat. If you get these, do not stop taking it but do talk to your doctor. You can help prevent these symptoms by rinsing your mouth and throat with water or brushing your teeth after using your inhaler. There are other, rarer side effects which can be serious. Talk to your doctor if you are worried about them. In general, you should be trying to avoid situations which make your asthma worse (your triggers) and try not to smoke.
Before taking Cesonide 80 HFA, you should tell your doctor if you have tuberculosis, any infections in your mouth or lungs, or liver disease. While taking it you may be more at risk of getting infections so stay away from people with colds and flu. If you use Cesonide 80 HFA for a long time it may cause weak bones (osteoporosis) and damage to your eyes (glaucoma or cataracts). You might need tests for bone density and eye pressure. Ask your doctor whether it is safe to take this medicine if you are pregnant or breastfeeding.
Side effects of Cesonide 80 HFA
Common
- Hoarseness of voice
- Sore throat
- Oral infections
How to use Cesonide 80 HFA
Rotacaps must not be swallowed. Check the label for directions before use. Place the capsule at the base of rotahaler, not in the mouthpiece. Twist the mouthpiece completely until your hear a click and breathe in deeply through the mouthpiece. Hold your breath for up to 10 seconds. If some powder remains in the rotahaler repeat the process.
How Cesonide 80 HFA works
Cesonide 80 HFA is a steroid. It prevents the cells in the lungs and breathing passages from releasing chemical messengers that cause inflammation (swelling) of the airways. This widens the airways and makes breathing easier.
Indication
Asthma, seasonal allergic rhinitis, perennial allergic rhinitis
Administration
Gently shake and prime nasal spray by actuating 3 times before using for the first time or when not in use for 4 consecutive days
Adult Dose
Inhalation
Asthma
Adult: Usual dose 160 mcg once daily, preferably in the evening from a metered-dose inhaler; reduced to 80 mcg once daily for maintenance.
May increase to 160 mcg twice daily
Nasal Spray:
1 spray (50 micrograms/spray) in each nostril once a day. The maximum total daily dosage should not exceed 2 sprays in each nostril (200 micrograms/day).
Child Dose
Inhalation
Asthma
Child: >12 yr: Usual dose 160 mcg once daily, preferably in the evening from a metered-dose inhaler; reduced to 80 mcg once daily for maintenance.
May increase to 160 mcg twice daily
Nasal Spray:
1 spray (50 micrograms/spray) in each nostril once a day. The maximum total daily dosage should not exceed 2 sprays in each nostril (200 micrograms/day).
Contraindication
Not for status asthmaticus or severe acute asthma where intensive measures are needed. Ciclesonide nasal spray is contraindicated in patients with a hypersensitivity to any of its ingredients.
Mode of Action
Ciclesonide, an inhaled corticosteriod, is converted by esterases in the lungs to the active metabolite, desisobutyryl-ciclesonide, which has anti-inflammatory activity.
Precaution
Active or quiescent pulmonary TB, fungal, viral or bacterial infections, unless adequately treated. Severe hepatic impairment. Monitor height of children and adolescents on long term treatment with inhaled corticosteroids; reduce dose if growth is slow. Pregnancy, lactation.
Ciclesonide nasal spray should be used with caution in patients with active or quiescent tuberculosis infection of the respiratory tract or in patients with untreated fungal, bacterial or systemic viral infections or ocular herpes simplex. Rare instances of nasal septal perforation, cataract, and glaucoma have been reported following intranasal application. Development of localized infections of the nose and pharynx with Candida albcans has rarely occurred. Although systemic effects have been minimal with recommended doses of Ciclesonide nasal spray, potential risk increases with larger doses. Therefore, larger than recommended doses of Ciclesonide nasal spray should be avoided.
Lactation: Not known if excreted in breast milk, use caution
Side Effect
Inhalation
>10%
Headache (11%),Nasopharyngitis (11%)
1-10%
Epistaxis (4.9%),Ear pain (2.2%),Facial edema (3%),Urticaria (3%),Oral candidiasis (3%),Back pain (3%),Extremety pain (3%),Conjunctivitis (3%),Upper respiratory infection (9%),Gastroenteritis (3%),Sinusitis (3%)
Nasal spray
1-10%
Headache (3.1-6.6%),Epistaxis (2.9-6%),Nasopharyngitis (3.7%),Nasal discomfort (3.2%),Ear pain (2.2%)
Pregnancy Category Note
Pregnancy Category: C
Lactation: Not known if excreted in breast milk, use caution
Interaction
Increased ciclesonide concentrations with concomitant ketoconazole, itraconazole, ritonavir, nelfinavir or other potent CYP3A4 inhibitors.