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Alvesco (Ciclesonide) is an inhaled corticosteroid (ICS) used for the maintenance treatment of asthma in adults and children aged 12 and older. It is a preventive medication — meaning it is taken daily to control and prevent asthma symptoms, not as a rescue inhaler for sudden breathing difficulties. Alvesco is manufactured by Covis Pharma, which acquired the drug from AstraZeneca in 2018.
Ciclesonide is unique among inhaled corticosteroids because it is a prodrug — it only becomes fully active once it reaches the lungs, which may reduce side effects in the mouth and throat compared to other ICS medications.
Alvesco contains Ciclesonide, a prodrug that is enzymatically converted to its active form, des-Ciclesonide, directly in the lungs. Des-Ciclesonide binds to glucocorticoid receptors in the airway tissues, reducing inflammation, swelling, and mucus production. By calming the inflammatory response in the airways, Alvesco helps prevent asthma symptoms like wheezing, shortness of breath, and coughing.
Because Ciclesonide is activated locally in the lungs rather than systemically, it may have a more favorable side-effect profile compared to some other inhaled corticosteroids. The inhaler should be primed before first use (3 actuations) and after not using it for more than 10 days. Always rinse your mouth with water after use to reduce the risk of oral thrush.
Typical dosing ranges from 80 mcg to 320 mcg twice daily, depending on asthma severity and prior therapy. Your doctor will determine the appropriate strength based on your treatment history.
Alvesco scores a 60 out of 100 on our findability scale, meaning it can be moderately difficult to locate in stock. As a brand-only inhaled corticosteroid manufactured solely by Covis Pharma, Alvesco has no generic equivalent — the earliest possible generic launch is 2028. While it is not currently listed on the FDA Drug Shortage Database, patients frequently report stock-outs at individual pharmacies due to its niche status and single-manufacturer supply chain. If your local pharmacy is out of stock, try calling specialty pharmacies, using the Medfinder tool, or asking your pharmacist to order it directly from their wholesaler.
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Alvesco can be prescribed by a variety of healthcare providers, including:
Telehealth providers can also prescribe Alvesco, making it convenient for patients who have difficulty visiting a doctor in person.
No. Alvesco (Ciclesonide) is not a controlled substance and has no DEA scheduling. It is a standard prescription medication that does not carry restrictions related to controlled substance regulations. You do not need special documentation or monitoring to receive an Alvesco prescription, though your insurance may require prior authorization.
Serious but less common side effects include oropharyngeal candidiasis (oral thrush), adrenal suppression, increased risk of infections, paradoxical bronchospasm, reduced bone mineral density with long-term use, growth suppression in children, and glaucoma or cataracts. Always rinse your mouth after use and report any unusual symptoms to your doctor.
If Alvesco is unavailable or not covered by your insurance, your doctor may consider these alternatives:
Talk to your doctor before switching medications, as each ICS has different dosing, delivery mechanisms, and insurance coverage.
Alvesco (Ciclesonide) is metabolized by the CYP3A4 enzyme, so medications that inhibit this enzyme can significantly increase Ciclesonide levels in your body:
Always inform your doctor and pharmacist about all medications you take, including over-the-counter drugs and supplements.
Alvesco is an effective inhaled corticosteroid for asthma maintenance with the unique advantage of being a prodrug that activates directly in the lungs. However, as a brand-only medication with no generic alternative, it can be expensive at $275–$411 per inhaler without insurance, and stock-outs at individual pharmacies are not uncommon.
The good news: commercially insured patients can pay as little as $0 with the Alvesco Savings Card, and cash-paying patients can access the Alvesco Transition Pharmacy Program for $60 per prescription with home delivery. If you're having trouble finding Alvesco in stock, try using Medfinder to locate pharmacies near you that have it available. If cost is a barrier, ask your doctor about switching to generic Fluticasone Propionate HFA or generic Budesonide, which offer similar benefits at a fraction of the price.
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