ciclesonide

Last reviewed 01/2018

• ciclesonide is a once daily, inhaled corticosteroid delivered via a hydrofluoroalkane (non-CFC) metered-dose inhaler, licensed for the prophylactic treatment of persistent asthma in adults
• is converted to the active metabolite in the lungs and has low systemic bioavailability, therefore it has a lower potential for systemic adverse effects
• in short term studies ciclesonide caused less suppression of cortisol release compared with budesonide or fluticasone, but there is no evidence that this translates into fewer long-term (>52 weeks) adverse effects
• evidence indicates that it is of equivalent efficacy to existing inhaled steroids (budesonide and fluticasone) in the management of mild-to-moderate asthma, but long-term data on clinical outcomes such as exacerbations, hospitalisations and quality of life are unavailable
• promoted for its relative lack of local adverse effects, and convenience to the patient (once-daily administration). It may help patients who do not comply with regular inhaled corticosteroid therapy
• not licensed to use in children under the age of 12 years (2)

Reference:

• (1) UK Medicines Information Service (June 2005);05/08: 1-5.
• (2) National Prescribing Centre (NPC). Inhaled corticosteroids: children are at risk from high doses. MeReC Extra 2007;27