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Ciclesonide is an inhaled corticosteroid used to treat persistent asthma and allergic rhinitis. It is sold under three brand names: Alvesco (oral inhaler for asthma), Omnaris (nasal spray for allergic rhinitis), and Zetonna (nasal aerosol for seasonal allergic rhinitis).
Alvesco is approved for maintenance treatment of asthma in adults and children 12 years and older. Omnaris is approved for seasonal and perennial allergic rhinitis in patients 6 years and older. Zetonna is approved for seasonal allergic rhinitis in patients 12 and older.
Ciclesonide is a maintenance medication — it is taken daily to prevent symptoms and is not intended for acute asthma attacks or sudden allergy flare-ups.
Ciclesonide is a prodrug, meaning it becomes active only after reaching the lungs or nasal passages. Once inhaled, enzymes convert it into its active form called des-ciclesonide, which has 120 times greater affinity for the glucocorticoid receptor than the parent compound.
Des-ciclesonide works by suppressing inflammation — it reduces the release of inflammatory chemicals and inhibits immune cell activity in the airways and nasal tissues. This decreases swelling, mucus production, and irritation, helping to control asthma symptoms and relieve nasal congestion, sneezing, and runny nose from allergies.
Because Ciclesonide is activated locally rather than systemically, it may cause fewer systemic side effects compared to some other inhaled corticosteroids.
Your doctor will determine the appropriate dose based on your condition and prior corticosteroid use. Typical inhaler dosing ranges from 80–320 mcg twice daily for asthma.
Ciclesonide scores a 55 out of 100 on our findability scale, meaning it can be moderately difficult to locate. Because Ciclesonide is a single-source brand product with no generic competition, supply depends entirely on Covis Pharma's manufacturing capacity. While Ciclesonide is not currently on the FDA drug shortage list, periodic supply disruptions have been reported at individual pharmacies. If your usual pharmacy is out of stock, try checking specialty or mail-order pharmacies, or use Medfinder to locate it nearby.
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Several types of healthcare providers can prescribe Ciclesonide:
Telehealth prescribing is also available for Ciclesonide, making it accessible for patients who cannot visit a clinic in person.
No. Ciclesonide is not a controlled substance and does not have a DEA schedule. It is a prescription-only corticosteroid with no known abuse potential. You will still need a valid prescription from a licensed healthcare provider to purchase it.
Most side effects are mild and improve with continued use. With the inhaler formulation, rinse your mouth after each use to reduce the risk of oral thrush (candidiasis). Serious side effects are rare but may include adrenal suppression, immunosuppression, glaucoma, cataracts, and growth suppression in children with long-term use. Contact your doctor if you experience vision changes, signs of infection, or worsening breathing.
If you cannot find Ciclesonide in stock or your insurance prefers a different option, several alternatives are available:
Many of the nasal alternatives are available over the counter, which may be more convenient and affordable. Talk to your doctor before switching medications.
Ciclesonide is metabolized by the CYP3A4 enzyme, so drugs that inhibit this enzyme can significantly increase its levels in the body:
Grapefruit juice may also modestly increase Ciclesonide levels. Always inform your doctor of all medications you are taking.
Ciclesonide is an effective inhaled corticosteroid for managing persistent asthma and allergic rhinitis. Its unique prodrug design means it's activated locally, which may result in fewer systemic side effects. However, as a brand-only medication with no generic available, it can be expensive without insurance — ranging from $150 to $420 depending on the formulation.
If you have commercial insurance, the Alvesco Savings Card from Covis Pharma may reduce your out-of-pocket cost to as little as $0. Uninsured patients should check the Covis Patient Assistance Program at alvesco.us for eligibility.
If your pharmacy is out of stock, use Medfinder to search nearby pharmacies or consider asking your doctor about widely available alternatives like Fluticasone or Budesonide.
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