Alvesco Inhaler

Alvesco is a clear, colorless spray to be inhaled through the mouth to the lungs. It is a preventive medicine (corticosteroid) that must be taken daily and is only active when inhaled into the lungs.

Ciclesonide has a low affinity for the glucocorticoid receptor. Once inhaled through the mouth, ciclesonide is enzymatically converted into the lungs into a major metabolite (C21-des-methylpropionyl-ciclesonide) that has high anti-inflammatory activity and is therefore considered the active metabolite.

In four clinical trials, ciclesonide was observed to reduce airway hypersensitivity to adenosine monophosphate in hyperreactive patients, with the maximum effect observed at the 640 microgram dose. In another trial, a 7-day ciclesonide pretreatment significantly attenuated late and early phase reactions after exposure to inhaled allergen. Treatment with inhaled ciclesonide was also shown to decrease the increase in the number of inflammatory cells (total number of eosinophils) and of inflammatory mediators in induced sputum.

This medication is prescribed to control persistent asthma in adults and adolescents 12 years of age and older.

Alvesco Inhaler’s uses include helping the individual breathe easier, reducing asthma symptoms, and the likelihood of having an asthma attack. The effect of the medicine is potentiated with time and, for this reason, it must be taken daily, even when you feel well.

Always take this COPD medication exactly as your doctor has told you. Ask your doctor or pharmacist if you have doubts.

How much Alvesco should I use daily?

Your doctor will have informed you of the amount of medication you need to use daily. This amount will be established based on your needs.

The recommended dose of Alvesco is 160 micrograms daily in a single dose. This dose relieves asthma in most patients.

In some patients, a dose reduction to 80 micrograms daily in a single dose may be adequate to maintain effective asthma control.

In some patients with severe worsening of asthma symptoms, the Alvesco dose may need to be increased for a short period of time. This dose can be up to 640 micrograms daily, divided into two doses of 320 micrograms each, although there are no data to confirm the additional therapeutic effect after three months of treatment with this dose.

If necessary, your doctor may prescribe corticosteroid tablets or, in the event of an infection, an antibiotic.

Your doctor will adjust your dose to the minimum necessary to control asthma.

You should begin to notice an improvement in symptoms (wheezing, chest tightness, and cough) within 24 hours.

When should I use my Alvesco inhaler?

In most cases, in the morning or in the afternoon, in one or two inhalations once a day. Follow your doctor's instructions very carefully. It is important that you use Alvesco regularly every day, even when you feel better.

If you notice that you must use your rescue inhaler more than two or three times a week, you should see your doctor to review your treatment.

Follow these instructions carefully to guide you.

1. Remove the mouthpiece cap and check the mouthpiece, inside and out, to make sure it is clean and dry.
2. Hold the inhaler upside down (cartridge base up) with your index finger on the cartridge base and your thumb under the mouthpiece.
3. Expel the air from your lungs as much as possible. Do not breathe out into the inhaler.
4. Place the mouthpiece in your mouth and close your lips tightly around it.
5. Immediately after starting to breathe through your mouth, press your index finger on the top of the inhaler to make a discharge while continuing to breathe in slowly and deeply. Take care that the discharge does not leak medicine from the top or sides of the mouth.
6. Hold your breath, remove the inhaler from your mouth, and the index finger from the top of the inhaler. Continue to hold your breath for about 10 seconds or until you start to feel uncomfortable holding your breath. Exhale slowly through your mouth, but do not breathe out into the inhaler. It is advisable not to rush in steps 3 to 6
7. If you have been instructed to perform another download, wait approximately half a minute and repeat steps 3 through 6.
8. After use, always put on the mouthpiece cap to prevent dust from entering. When you cover it well, you will hear a click, indicating that it has closed properly.
9. For hygiene reasons. Clean the mouthpiece weekly with a dry cloth inside and out. Use a folded, dry tissue and wipe the front of the small hole where the medicine comes out. Do not use water or other liquids.

A good technique will ensure that the amount of medicine reaching your lungs is adequate each time you use the inhaler. Your doctor will check that you use a proper inhalation technique to make sure that the treatment can have its greatest effect.

Like all medicines, Alvesco can cause side effects, although not everyone gets it.

• severe allergic reactions such as swelling of the lips, tongue, and throat (may affect 1 in 1,000 patients treated)
• allergic reactions: skin rash, redness, itching or hives like hives (may affect up to 1 to 1000 patients treated 1 in 100 patients)
• Coughing or wheezing may worsen after inhalation (may affect 1 in 100 patients treated)

The other side effects observed with Alvesco are usually mild. In most cases, treatment can be continued. The adverse effects it may have are:

Uncommon Alvesco inhaler side effects (may affect up to 1 in 100 patients treated):

• hoarseness
• burning, inflammation, irritation of the mouth or throat
• canker sores (fungal infections of the oral cavity)
• headache
• bad mouth taste
• dry mouth or throat
• nausea or vomiting

Rare Alvesco inhaler side effects (may affect up to 1 in 10,000 treated patients):

• A feeling of heartbeat (palpitations)
• discomfort or pain in the abdomen.
• high blood pressure

Alvesco inhaler interactions.

In a study of drug interactions with ciclesonide and ketoconazole as a potent CYP3A4 inhibitor, exposure to the active metabolite M1 increased approximately 3.5-fold, while exposure to ciclesonide was unaffected. Therefore, concomitant administration with strong CYP 3A4 inhibitors should be avoided (eg ketoconazole, itraconazole, and ritonavir or nelfinavir), unless the benefits outweigh the increased risk of systemic corticosteroid adverse reactions.

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