ciclesonide Inhl

See also Precautions section.
Dry/irritated throat, hoarseness, a bad taste in the mouth, or coughing may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: white patches in your mouth or on your tongue.
Tell your doctor immediately if any of these rare but very serious side effects occur: vision changes, unusual/persistent headache, poor wound healing, puffy face, unexpected weight gain, muscle pain/weakness, mental/mood changes (e.g., depression, agitation), increased thirst/urination.
Infrequently, this medication may cause severe sudden worsening of breathing problems/asthma immediately after use. If you have sudden worsening of breathing, use your quick-relief inhaler and seek immediate medical attention.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using ciclesonide, tell your doctor or pharmacist if you are allergic to it; or to other corticosteroids (e.g., beclomethasone, fluticasone); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: tuberculosis, untreated infections (e.g., fungus, bacteria), certain eye problems (glaucoma, cataracts, herpes infection of the eye), liver disease, adrenal gland problems (e.g., adrenal insufficiency), underactive thyroid (hypothyroidism), bone loss (osteoporosis).
If you have switched from a corticosteroid taken by mouth (such as prednisone tablets) to this inhaler within the past 12 months, or if you have been using this product in higher-than-usual doses for a long time, it may be more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used a corticosteroid taken by mouth within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. Carry a warning card or medical ID bracelet that says you use (or have used) corticosteroid medications.
Avoid exposure to chickenpox or measles infection while taking this medication unless you have previously had these infections (e.g., in childhood). If you are exposed to one of these infections and you have not previously had it, seek immediate medical attention.
This medication may mask signs of infection or put you at greater risk of developing an infection. Report any signs of infection (e.g., persistent sore throat, fever, cough, changes in sputum color) that occur during treatment.
When used for extended periods, medications similar to ciclesonide may affect bone strength, especially in people who smoke, have a family history of brittle bones (osteoporosis), or take other medications that may weaken bones (e.g., phenytoin). Bone density tests may help to determine whether you need medication to treat or prevent this problem. Consult your doctor for more information.
This medication may slow down a child\'s growth if used for a long time, but poorly controlled asthma can also slow down growth. The effect on final adult height is unknown. See the doctor regularly so your child\'s height can be checked.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended time may have low levels of corticosteroid hormone. Tell the doctor immediately if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn.
It is not known whether this drug passes into breast milk. Therefore, consult your doctor before breast-feeding.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medication because very serious interactions may occur: natalizumab.
If you are currently using the medication listed above, tell your doctor or pharmacist before starting ciclesonide.
Before using ciclesonide, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: aldesleukin, bupropion, corticosteroids taken by mouth (e.g., prednisone, dexamethasone), mifepristone, quinolone antibiotics (e.g., ciprofloxacin, levofloxacin), drugs affecting the removal of ciclesonide from your system (potent CYP 3A4 inhibitors such as ketoconazole, itraconazole, nelfinavir, ritonavir).
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES:
Do not share this medication with others.
Learn to use a peak flow meter, use it daily, and promptly report worsening asthma (such as readings in the yellow/red range or increased use of quick-relief inhalers).
Tell all your doctors that you use, or have used, this medication.
Keep all medical appointments. Laboratory and/or medical tests (e.g., morning cortisol levels, eye exams, bone density tests) may be performed to monitor your progress and check for side effects.
Avoid allergens (e.g., pollen), irritants, smoking/secondhand smoke, and other factors that make asthma worse.
Most people with asthma or ongoing lung disease should receive a flu shot every year. Discuss this with your doctor.
In adults, this medication can increase the risk of bone loss (osteoporosis) if used for a long time. Talk with your doctor about your risk, and about available treatments for osteoporosis. Lifestyle changes that reduce the risk of bone loss include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. To help prevent osteoporosis later in life, encourage children to exercise and eat a healthy diet (including calcium).

MISSED DOSE:
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE:
Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not freeze. Do not store in the bathroom. Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
Information last revised February 2011. Copyright(c) 2011 First Databank, Inc.