Understanding Ciclesonide Side Effects

Ciclesonide — available as Alvesco (inhaler for asthma) and Omnaris (nasal spray for allergies) — is an inhaled corticosteroid used for long-term maintenance treatment. Like all medications, it can cause side effects. The good news is that Ciclesonide is a prodrug, meaning it becomes active only after it reaches your lungs or nasal passages. This design helps reduce side effects compared to some other corticosteroids.

This guide covers the most common side effects, the rare but serious ones to watch for, and clear guidance on when you should contact your doctor.

Common Side Effects of Ciclesonide

Most people who take Ciclesonide tolerate it well. The most frequently reported side effects are mild and often improve as your body adjusts to the medication:

For Alvesco (Inhaler)

• Headache — The most commonly reported side effect
• Nasopharyngitis — Sore throat or stuffy nose
• Upper respiratory tract infection — Cold-like symptoms
• Hoarseness — Caused by the medication contacting your throat
• Back pain and joint pain — Reported in some patients

For Omnaris (Nasal Spray)

• Headache
• Nosebleeds (epistaxis) — The most common nasal side effect
• Ear pain
• Unpleasant taste in mouth
• Dry mouth

These side effects usually don't require medical attention unless they become severe or don't go away after a few weeks of use.

How to Reduce Common Side Effects

There are simple steps you can take to minimize side effects:

• Rinse your mouth after using Alvesco — Swish water around your mouth and spit it out after each dose. This helps prevent oral thrush (a yeast infection in the mouth) and reduces hoarseness.
• Use proper inhaler technique — Hold the inhaler correctly and breathe in slowly. Poor technique can increase throat irritation. Your pharmacist or doctor can show you the right way.
• Blow your nose gently before using Omnaris — Clearing your nasal passages helps the spray reach where it needs to go and can reduce nosebleeds.
• Stay hydrated — Drinking water throughout the day can help with dry mouth.
• Use a spacer with your inhaler — If hoarseness is a problem, ask your doctor about using a spacer device, which helps more medication reach your lungs instead of your throat.

Serious Side Effects to Watch For

Serious side effects from Ciclesonide are uncommon, but they can happen — especially with long-term or high-dose use. Contact your doctor right away if you experience any of the following:

Adrenal Suppression

Long-term use of any corticosteroid can suppress your body's natural cortisol production. Symptoms include:

• Extreme tiredness or weakness
• Dizziness or fainting
• Nausea, vomiting, or loss of appetite
• Darkening of the skin

This is more likely if you're switching from oral corticosteroids to Ciclesonide or if you've been on high doses for a long time. Never stop taking Ciclesonide suddenly without talking to your doctor.

Immune System Suppression

Inhaled corticosteroids can lower your immune response. Be especially cautious if you haven't had chickenpox or measles — exposure to these infections while on Ciclesonide can be serious. Tell your doctor right away if you're exposed.

Eye Problems

Prolonged corticosteroid use has been linked to:

• Glaucoma — Increased pressure in the eye
• Cataracts — Clouding of the eye lens

If you notice changes in your vision, see an eye doctor promptly.

Paradoxical Bronchospasm (Alvesco)

In rare cases, using an inhaler can cause sudden wheezing and difficulty breathing — the opposite of what it's supposed to do. If this happens, stop using Alvesco and use your rescue inhaler immediately. Call your doctor or go to the emergency room.

Allergic Reactions

Seek emergency help if you experience:

• Swelling of the face, lips, tongue, or throat
• Difficulty breathing or swallowing
• Severe rash or hives

Nasal Septal Perforation (Omnaris)

In very rare cases, long-term use of nasal corticosteroid sprays can cause a hole in the nasal septum (the wall between your nostrils). If you notice persistent whistling sounds when breathing through your nose, crusting, or pain, see your doctor.

Growth Effects in Children

Inhaled corticosteroids may slow growth in children. If your child is taking Ciclesonide, their doctor should monitor their height regularly. The benefit of controlling asthma or allergies usually outweighs this small risk.

Oral Thrush: A Special Note for Inhaler Users

Oral thrush (candidiasis) is a yeast infection that can develop in your mouth and throat from inhaled corticosteroids. Signs include:

• White patches on your tongue, inner cheeks, or throat
• Redness or soreness in your mouth
• Difficulty swallowing
• A cottony feeling in your mouth

Ciclesonide has a lower rate of oral thrush compared to some other inhaled corticosteroids because of its prodrug design. Still, rinsing your mouth after every use is the best prevention.

When to Call Your Doctor

Call your doctor if you experience:

• Side effects that don't improve after 1-2 weeks
• Worsening asthma symptoms despite regular use
• Signs of infection (fever, chills, persistent sore throat)
• Vision changes
• Unexplained fatigue or weakness
• Severe nosebleeds that don't stop

Call 911 or go to the ER if you have signs of a severe allergic reaction, sudden difficulty breathing, or paradoxical bronchospasm.

Ciclesonide vs. Other Inhaled Corticosteroids: Side Effect Comparison

One reason doctors sometimes choose Ciclesonide over other options is its favorable side effect profile. Because it's a prodrug that activates locally, it tends to cause less oral thrush and hoarseness than older inhaled corticosteroids like Fluticasone or Budesonide. If you've had side effects with other corticosteroids, talk to your doctor about whether Ciclesonide might be a better fit. You can also read about Ciclesonide alternatives to compare options.

Drug Interactions That Can Affect Side Effects

Certain medications can increase Ciclesonide levels in your body, which raises the risk of side effects. The biggest concern is strong CYP3A4 inhibitors like Ketoconazole, which can increase Ciclesonide exposure by about 3.6 times. Read our full guide on Ciclesonide drug interactions to learn what to avoid.

What Ciclesonide Does NOT Do

It's worth noting what Ciclesonide is not meant for:

• It is not a rescue inhaler — it won't help during an asthma attack. You still need a fast-acting bronchodilator (like Albuterol) for emergencies.
• It does not work immediately — it may take several days to weeks of regular use before you feel the full benefit.
• It does not carry a boxed warning — the FDA's most serious warning label. This is a positive safety signal.

For a full overview of what Ciclesonide is and how it works, see our guides on What Is Ciclesonide? and How Does Ciclesonide Work?.

Bottom Line

Ciclesonide is generally well tolerated, with headache, sore throat, and nosebleeds being the most common side effects. Serious side effects are rare but possible with long-term use. Rinse your mouth after using the inhaler, use proper technique, and keep up with regular doctor visits. If something feels off, don't hesitate to call your doctor.

If you're ready to fill your Ciclesonide prescription, MedFinder can help you find a pharmacy that has it in stock.