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Inhaled Glucocorticoid·Respiratory - Asthma & COPD
Maintenance treatment of asthma in adults, adolescents, and children 6 years and older
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Max Dose
320 mcg/day
Half-life
0.5 h (Active)
Prodrug
LUNG ACTIVATED
Thrush
LOW RISK
Avoid / Cautions
Acute bronchospasm. Pregnancy Category B3 (Budesonide preferred due to more historical data).
Overview
A brilliant 'pro-drug' inhaled corticosteroid. It is completely inactive in the mouth/throat, and only becomes active once it hits enzymes deep in the lungs. Massively reduces oral thrush risk.
Clinical Focus
The safest ICS regarding systemic and oral side effects. Can be dosed once daily.
Bottom Line
Ciclesonide is a prodrug ICS activated in the lungs with minimal oropharyngeal deposition, but is more expensive and offers no clear efficacy advantage over budesonide/fluticasone.
Brand Names
Alvesco
Oral Routes
Metered Dose Inhaler (80, 160 mcg/actuation).
Prescribing & PBS
Authority Required (PBS).
Primary
Maintenance treatment of asthma in adults, adolescents, and children 6 years and older.
Clinical Place
The absolute best choice for patients who chronically suffer from oral thrush or hoarse voice on other steroid inhalers.
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