Ciclesonide nasal spray is used for the treatment of symptoms associated with seasonal allergic rhinitis in patients aged 6 years and above, and for perennial allergic rhinitis in patients aged 12 years and older.

Ciclesonide nasal spray is a corticosteroid with anti-inflammatory properties. It is formulated as an aqueous suspension designed for topical application to the nasal mucosa using a metered-dose spray device. The spray pump should be primed before the first use or if it has not been used for 4 days or longer.

1 spray (50 micrograms/spray) in each nostril once a day. The maximum total daily dosage should not exceed 2 sprays in each nostril (200 micrograms/day).

Priming information: Gently shake the bottle and prime Ciclesonide nasal spray by actuating eight times before using for the first time or when not used for 4 consecutive days.

Administration

How to use the Nasal Spray-

• Shake the bottle gently and remove the dust cover.
• Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.
• Gently blow the nose to clear the nostrils.
• Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.
• Breathe out through your mouth.
• Repeat the above steps in the same/ other nostril for consecutive doses.

Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-

• Remove the dust cover.
• Gently pull off the nasal applicator.
• Wash the applicator and dust cover in warm water.
• Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.
• Gently push the applicator back on the top of the bottle and re-fix the dust cover.

Ciclesonide nasal spray has minimal systemic absorption, so adverse effects are generally limited. However, some patients may experience headache, dizziness, nosebleeds, nasal congestion, or ear discomfort.

Pregnancy Category C. Ciclesonide nasal spray should be used during pregnancy only if the expected benefit outweighs the potential risk to the fetus. It is not known whether ciclesonide is excreted in human breast milk. Since other corticosteroids are known to pass into breast milk, caution is advised when administered to breastfeeding mothers.

Ciclesonide nasal spray should be used cautiously in patients with active or latent tuberculosis of the respiratory tract, as well as in those with untreated fungal, bacterial, or systemic viral infections, or ocular herpes simplex. Rare cases of nasal septum perforation, cataract, and glaucoma have been reported with intranasal use. Localized infections of the nose and throat with Candida albicans have also been rarely observed. Although systemic effects are minimal at recommended doses, the risk may increase with higher doses; therefore, exceeding the recommended dosage should be avoided.

Respiratory corticosteroids

Store below 30°C. Do not refrigerate. Protect from light and moisture. Avoid contact with eyes. Keep out of reach of children. The bottle should be discarded after 120 sprays or 4 months after opening the pouch.