Precautions and Warnings With the Ciclesonide Inhaler

Because the ciclesonide inhaler is used to prevent (not treat) asthma attacks, everyone who takes it should also have a "rescue medication" available at all times. This product may not the best asthma drug for everyone, so before starting treatment, it's a good idea to talk to your healthcare provider about the ciclesonide inhaler warnings and precautions that apply to you.

What Should I Tell My Healthcare Provider?

Prior to using the ciclesonide inhaler (Alvesco®), tell your healthcare provider if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Warnings and Precautions With the Ciclesonide Inhaler

Warnings and precautions to be aware of prior to using this asthma medicine include the following:
 
  • If you are switching from an oral steroid to the ciclesonide inhaler (which is an inhaled steroid), your healthcare provider should slowly decrease your dose of the oral steroid. Stopping an oral steroid too quickly can be dangerous.
     
  • The ciclesonide inhaler is not a fast-acting asthma medication and cannot replace fast-acting rescue inhalers. Do not use this inhaler to treat an asthma attack. Everyone using the ciclesonide inhaler should also have a "rescue" asthma medication available at all times. Let your healthcare provider know if you need to use your rescue inhaler more frequently than usual, as this may be a sign of worsening asthma.
     
  • The ciclesonide inhaler can cause an immediate worsening of asthma symptoms. If this happens, use your rescue inhaler (such as albuterol) as needed and contact your healthcare provider for further instruction.
     
  • This medication is a steroid and may suppress the immune system. Although this is more likely to occur with oral steroids, it is still possible with inhaled steroids such as the ciclesonide inhaler. You may be at higher risk for infections as a result.
 
  • Certain infections (such as chickenpox or the measles) may be more dangerous if you are using the ciclesonide inhaler. Let your healthcare provider know right away if you are exposed to chickenpox or the measles if you have not had these infections before and have not been vaccinated against them.
 
  • Like other steroids, the ciclesonide inhaler may slow the growth of children and teenagers. Usually, this slowing of growth is small, with children growing about a centimeter less per year. Contact your child's healthcare provider if you are concerned about slow growth in your child.
     
  • Inhaled steroids may cause decreased bone mineral density. This means that over time, it is possible that a weakening of the bones could occur.
     
  • The ciclesonide inhaler can cause thrush (a yeast infection of the mouth or throat). In order to help prevent this, rinse your mouth with water (without swallowing) after each dose.
     
  • Taking steroids can decrease the body's ability to make its own natural steroids (this is known as "adrenal suppression"). Usually, inhaled steroids like the ciclesonide inhaler are less likely to cause such problems, compared to oral steroids. Still, this could occur, especially during times of physical stress, such as illness or recovery from a surgery.
     
  • Inhaled steroids can cause glaucoma or cataracts (conditions affecting the eyes).
     
  • Before starting the ciclesonide inhaler, tell your healthcare provider if you currently have any type of infection. Also, let your healthcare provider know if you have ever had tuberculosis or a herpes infection of the eye, as this medication may weaken the immune system, allowing these infections to worsen.
     
  • The ciclesonide inhaler can react with other medications (see Drug Interactions With the Ciclesonide inhaler).
     
  • The ciclesonide inhaler is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using this medication when pregnant (see Alvesco and Pregnancy for more information).
     
  • It is not known if the ciclesonide inhaler passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider before beginning treatment (see Alvesco and Breastfeeding for more information).
     
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