Ciclesonide Nasal Spray

Conditions Treated
Ciclesonide nasal spray is used to treat the symptoms of seasonal (occurs only at certain times of the year), and perennial (occurs all year round) allergic rhinitis. These symptoms include sneezing and stuffy, runny or itchy nose. Ciclesonide is in a class of medications called corticosteroids. It works by preventing and decreasing inflammation (swelling that can cause other symptoms) in the nose.

Possible Side Effects
What Side Effects Can This Cause?
Ciclesonide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- nosebleed
- burning or irritation in the nose
- earache
- painful white patches in nose or throat
- flu-like symptoms
- vision problems
- injury to nose
- new or increased acne (pimples)
- easy bruising
- enlarged face and neck
- extreme tiredness
- muscle weakness
- irregular menstruation (periods)
- hives
- rash
- itching
- swelling of the face, throat, lips, eyes, hands, feet, ankles or lower legs
- hoarseness
- difficulty breathing or swallowing
- wheezing

Usage Instructions
How Should This Medication Be Used
Ciclesonide comes as a solution (liquid) to spray in the nose. It is usually sprayed in each nostril once daily. Use ciclesonide at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ciclesonide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Ciclesonide nasal spray is only for use in the nose. Do not swallow the nasal spray and be careful not to spray it in your eyes or directly onto the nasal septum (the wall between the two nostrils). Ciclesonide controls the symptoms of rhinitis but does not cure it. Your symptoms probably will not begin to improve for at least 24-48 hours after your first dose and it may be longer before you feel the full benefit of ciclesonide. Continue to use ciclesonide even if you feel well. Do not stop taking ciclesonide without talking to your doctor. Each bottle of ciclesonide nasal spray is designed to provide 120 sprays after the bottle is primed initially. The bottle must be thrown away after 4 months of use. You should count 4 months from the date that the bottle is removed from the foil pouch and write it on the sticker that is provided in the carton. Place the sticker in the space provided on the bottle to remind you of this date. It is also important to keep track of the number of sprays you have used and throw away the bottle after you have used 120 sprays, even if the bottle still contains some liquid and it is before the 4 months have passed. To use the nasal spray, follow these steps:
What Dietary Instructions Should I Follow
Unless your doctor tells you otherwise, continue your normal diet.
Are There Any Special Instructions
Before using ciclesonide nasal spray, Tell your doctor and pharmacist if you are allergic to ciclesonide; any other nasal corticosteroid such as beclomethasone (Beconase AQ), budesonide (Rhinocort Aqua), fluticasone (Flonase), momentasone (Flonase), triamcinolone (Nasacort AQ); or any other medications. Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or have recently taken. Be sure to mention ketoconazole (Nizoral) or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol) and prednisone (Deltasone). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Tell your doctor if you have or have ever had tuberculosis (TB), cataracts (clouding of the lens in your eye), or glaucoma (an eye disease), and if you now have sores in your nose, any type of untreated infection, or a herpes infection of your eye (a type of infection that causes a sore on the eyelid or surface of your eye). Also tell your doctor if you have recently had surgery on your nose or injured your nose in any way. If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ciclesonide. If you have been taking oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), prednisolone (Pediapred, Prelone) or prednisone (Deltasone) your doctor may want to gradually decrease your steroid dose after you begin using ciclesonide. Special caution is needed for several months as your body adjusts to the change in medication. If you have any other medical conditions, such as asthma, arthritis, or eczema (a skin disease), they may worsen when your oral steroid dose is decreased. Tell your doctor if this happens or if you experience any of the following symptoms during this time: extreme tiredness, muscle weakness or pain; sudden pain in stomach, lower body or legs; loss of appetite; weight loss; upset stomach; vomiting; diarrhea; dizziness; fainting; depression; irritability; and darkening of skin. Your body may be less able to cope with stress such as surgery, illness, severe asthma attack, or injury during this time. Call your doctor right away if you get sick and be sure that all health care providers who treat you know that you recently replaced your oral steroid with ciclesonide inhalation. Carry a card or wear a medical identification bracelet to let emergency personnel know that you may need to be treated with steroids in an emergency. You should know that ciclesonide may decrease your ability to fight infection. Stay away from people who are sick and wash your hands often. Be especially careful to stay away from people who have chicken pox or measles. Tell your doctor right away if you find out that you have been around someone who has one of these viruses.

Brand Names
Common Brand Names for This Medication
- Omnaris®

Overdose
What To Do In The Case of Emergency
If someone swallows ciclesonide, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Using too much ciclesonide on a regular basis over a long period of time may cause the following symptoms:
- enlarged face and neck
- new or worsening acne
- easy bruising
- extreme tiredness
- muscle weakness
- irregular menstrual periods

Forgotten Doses
What Should I Do If I Forget A Dose?
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Additional Information
What Are the Storage Conditions for this Medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What Other Information Should I Know?
Keep all appointments with your doctor. If your applicator becomes clogged, remove the dust cap and gently pull upwards to free the nasal applicator. Wash the dust cap and applicator with warm water. Dry and replace the applicator and press down and release the pump one time or until you see a fine spray. Replace the dust cap. Do not use pins or other sharp objects in the tiny spray hole on the nasal applicator to remove the blockage. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

