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RESPIRATORY SYSTEM › NASAL PREPARATIONS › DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE › Corticosteroids
ciclesonide
R01AD13
Forms & Strengths
- Nasal spray 50 µg per spray (1 actuation)
- Nasal spray 100 µg per spray (2 actuations)
- Bottle sizes 10 mL, 15 mL
Adult Dosing
- 2 sprays (100 µg) per nostril once daily (total 200 µg)
- If needed, may increase to 2 sprays per nostril twice daily (max 400 µg)
Pediatric Dosing
- Ages 6‑11: 1 spray (50 µg) per nostril once daily (total 100 µg)
- Ages ≥12: same as adult dosing
Indications
- Allergic rhinitis (seasonal and perennial)
Mechanism of Action
- Prodrug converted by nasal esterases to active des‑ciclesonide
- Binds glucocorticoid receptor → ↓ cytokine, chemokine, eosinophil infiltration
- Reduces nasal mucosal edema and hypersecretion
Contraindications
- Hypersensitivity to ciclesonide or formulation excipients
- Acute viral, bacterial, or fungal infection of the nasal passages
Adverse Reactions
- Epistaxis
- Nasal irritation or burning
- Headache
- Pharyngitis
- Dysgeusia (taste alteration)
- Nasal candidiasis (rare)
- Transient growth suppression in children (high‑dose, long‑term)
Drug Interactions
- Strong CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) may raise systemic levels
- Concurrent intranasal or systemic corticosteroids increase risk of HPA‑axis suppression
- Systemic CYP3A inducers (rifampin, carbamazepine) may reduce exposure
Curated Content: Needs Vetting Before Put to Clinical Use