Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes Alvesco (Ciclesonide-inh). If you are concerned about side effects, discuss the risks and benefits of Alvesco (Ciclesonide-inh) with your doctor.

The following side effects have been reported by at least 1% of people taking Alvesco (Ciclesonide-inh). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bad taste
• cough
• Dry Mouth or throat
• headache
• hoarseness or other voice changes
• increased blood pressure
• sore throat or tongue

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain
• decreased bone density (with high doses)
• eye pain
• pounding heartbeat
• rounded face (with high doses)
• vision changes
• signs of a fungal infection in the mouth (white patches in mouth and throat)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a Anaphylaxis (severe allergic reaction) (e.g., Hives; difficulty breathing; and swelling of the lips, face, eyelids, throat, or tongue)
• sudden wheezing and chest pain or tightness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Alvesco (Ciclesonide-inh).

50 µg
Each actuation of aerosol solution contains 50 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

100 µg
Each actuation of aerosol solution contains 100 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

200 µg
Each actuation of aerosol solution contains 200 µg of ciclesonide. Nonmedicinal ingredients: propellant HFA-134a (Norflurane) and ethanol.

Do not use ciclesonide if you:

• are allergic to ciclesonide or any ingredients of the medication
• are having an asthma attack or a sudden attack of breathlessness
• have an untreated fungal, bacterial, or Tuberculosis infection of the respiratory tract
• have moderate to severe Bronchiectasis (a lung problem where the bronchial tubes are damaged)

There may be an interaction between ciclesonide and any of the following:

• Aldesleukin
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• boceprevir
• Ceritinib
• clarithromycin
• conivaptan
• Deferasirox
• delavirdine
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• hyaluronidase
• loop diuretics (e.g., bumetanide, Furosemide)
• Loxapine
• nefazodone
• nelfinavir
• nicardipine
• telaprevir
• telithromycin
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Alvesco (Ciclesonide-inh). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Alvesco (Ciclesonide-inh).

Asthma control: Alvesco (Ciclesonide-inh) is not for use as a "reliever" medication. If you start developing an asthma attack, be sure to use your "reliever" medication for rapid relief of your asthma symptoms. Contact your doctor immediately if you find you are using your "reliever" medications (e.g., salbutamol, terbutaline, formoterol) more often or if they are not working as well as they used to. This may mean your asthma is not controlled. Your doctor may want you to temporarily change the dose of ciclesonide or may start you on an oral corticosteroid.

Bone problems: When used for long periods of time, Alvesco (Ciclesonide-inh) may reduce bone density and increase the risk of developing Osteoporosis. Your doctor may monitor for this periodically.

Breathing problems: If you experience wheezing or difficulty breathing right after using Alvesco (Ciclesonide-inh), use your "reliever" medication (e.g., salbutamol, terbutaline, or formoterol) and stop using Alvesco (Ciclesonide-inh) and contact your doctor.

Eye problems: Alvesco (Ciclesonide-inh) may increase the risk of Cataracts, increased pressure in the eye, and Glaucoma when used for long periods of time. Your doctor will monitor you by checking your eyes periodically.

Infections: Infections such as Chickenpox and Measles can be more serious in people taking medications such as ciclesonide. If you are exposed to someone with chickenpox or measles, contact your doctor.

Liver function: Liver disease or reduced liver function may cause Alvesco (Ciclesonide-inh) to build up in the body, causing side effects. Although this is not usually a problem if you have mildly-to-moderately reduced liver function, the effect of Alvesco (Ciclesonide-inh) on people with severely reduced liver function has not been determined. If you have liver problems, discuss with your doctor how Alvesco (Ciclesonide-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Alvesco (Ciclesonide-inh), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Alvesco (Ciclesonide-inh).

Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using Alvesco (Ciclesonide-inh), helps reduce the chances of developing a yeast infection of the mouth or throat ( called "thrush"). Using a spacer device with the inhaler can also reduce how much medication stays in your mouth. If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.

Steroid medication use: If you have taken or are still taking oral steroid medication during the last several months, consult your doctor before using Alvesco (Ciclesonide-inh). In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again.

Stopping medication: Do not stop Alvesco (Ciclesonide-inh) abruptly, as this may cause the cough and difficulty breathing to return. When Alvesco (Ciclesonide-inh) is stopped, it should be stopped gradually, as directed by your doctor.

Pregnancy: Alvesco (Ciclesonide-inh) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Alvesco (Ciclesonide-inh), contact your doctor immediately.

Breast-feeding: It is not known if ciclesonide passes into breast milk. If you are a breast-feeding mother and are taking Alvesco (Ciclesonide-inh), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Alvesco (Ciclesonide-inh) have not been established for children less than 6 years of age.