Ciclesonide

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Ciclesonide

Systematic (IUPAC) name
2-[(1S, 2S, 4R, 8S, 9S,11S, 12S, 13R)-6-cyclohexyl-11-hydroxy-9, 13-dimethyl-16-oxo-5, 7-dioxapentacyclo [10.8.0.02,9.04, 8.013,18] icosa-14, 17-dien-8-yl]- 2-oxoethyl 2-methylpropanoate
Clinical data
AHFS/Drugs.com	monograph
MedlinePlus	a607008
Pregnancy cat.	B3 (AU) C (US)
Legal status	Prescription Only (S4) (AU) POM (UK) ℞-only (US)
Identifiers
CAS number	141845-82-1 Y
ATC code	R03BA08
PubChem	CID 6918155
DrugBank	DB01410
ChemSpider	5293368 Y
UNII	S59502J185 Y
KEGG	D01703 Y
ChEMBL	CHEMBL1201164 N
Synonyms	(11β, 16α)-16, 17-[[(R)-cyclohexylmethylene]bis(oxy)]-11-hydroxy-21- (2-methyl-1-oxopropoxy)- pregna-1, 4-diene-3, 20-dione
Chemical data
Formula	C32H44O7
Mol. mass	540.688 g/mol
SMILES	eMolecules & PubChem
InChI InChI=1S/C32H44O7/c1-18(2)28(36)37-17-25(35)32-26(38-29(39-32)19-8-6-5-7-9-19)15-23-22-11-10-20-14-21(33)12-13-30(20,3)27(22)24(34)16-31(23,32)4/h12-14,18-19,22-24,26-27,29,34H,5-11,15-17H2,1-4H3/t22-,23-,24-,26+,27+,29+,30-,31-,32+/m0/s1 Y Key:LUKZNWIVRBCLON-GXOBDPJESA-N Y
N (what is this?)  (verify)

Ciclesonide is a glucocorticoid used to treat asthma and allergic rhinitis. It is marketed under the brand name Alvesco for asthma and Omnaris/Omniair for hay fever in the US and Canada. Phase 3 trials for the hay fever indication outside the US are ongoing.^[1]

Indications

Maintenance treatment in persistent asthma; hay fever.

Specific considerations

Pregnancy

No data as yet exist. Other inhaled glucocorticoids are considered ADEC category B3.

Breastfeeding

Should be safe to use. Consult your medical professional.^{[citation needed]}

Practice points

• Appears to be as effective as budesonide or fluticasone for maintenance treatment in persistent asthma although long term data on clinical outcomes are lacking.
• In short term studies ciclesonide had a minimal effect on markers of adrenal suppression but data with long term use is lacking. The US Food and Drug Administration (FDA) announced October 2006 the approval of ciclesonide nasal spray for the treatment of nasal symptoms associated with seasonal and perennial allergic rhinitis in adults and children 12 years of age and older.^[2]

The safety and efficacy of the nasal spray, manufactured by ALTANA Pharma US, Inc. of Florham Park, NJ, were studied in randomized placebo controlled clinical trials. The studies showed that patients treated with nasal spray had an 8-10 percent greater reduction in nasal symptoms compared to placebo, with difference between ciclesonide nasal spray and placebo significant, i.e. p<0.05.

The most common side effects were headache, nosebleeds, and inflammation of the nose and throat linings.^[3]

References

• Rossi S (Ed.) (2006). Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook. ISBN 0-9757919-2-3

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