Ciclex - Nasal Spray Ciclesonide - 50mcg/Spray 1 120metered Spray(s) / 120metered Spray Opsonin Pharma Limited Introduction: Ciclex 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... Uses of Ciclex: Asthma Side effects of Ciclex: Hoarseness of voiceSore throatOral infections How to use Ciclex: 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 Ciclex works: Ciclex 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... 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.