Ciclesonide Orifarm
Inhaled corticosteroid inhalation spray for chronic asthma maintenance
Quick facts about Ciclesonide Orifarm
Key takeaways about Ciclesonide Orifarm
- Prodrug activated in the lungs: Ciclesonide is converted to its active form (des-ciclesonide) directly in the airways, resulting in fewer local side effects like oral thrush compared to other inhaled steroids
- Once-daily dosing for most patients: The recommended maintenance dose provides effective asthma control, making it simple to incorporate into daily routine
- Not a rescue inhaler: Ciclesonide Orifarm is a preventer medicine for daily use and must not be used to relieve sudden asthma attacks – always keep a short-acting bronchodilator available
- Takes time to build full effect: Improvement may begin within 24 hours, but full benefit requires consistent daily use over 1–2 weeks
- Important drug interactions: Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, and ritonavir can significantly increase ciclesonide exposure and should be discussed with your doctor
What Is Ciclesonide Orifarm and What Is It Used For?
Ciclesonide Orifarm is a preventer inhalation spray containing ciclesonide, an inhaled corticosteroid that reduces inflammation in the airways. It is used for the long-term management of chronic persistent asthma in adults and adolescents aged 12 years and older. It must be taken daily, even when you feel well, and is not intended for relieving acute asthma attacks.
Ciclesonide Orifarm is supplied as a pressurised inhalation spray that delivers a fine aerosol solution of ciclesonide directly into the lungs when you breathe in through the mouthpiece. It belongs to the class of medicines known as inhaled corticosteroids (ICS), which are the cornerstone of asthma maintenance therapy according to current international guidelines, including the Global Initiative for Asthma (GINA) 2024 report. Ciclesonide Orifarm is a generic formulation manufactured by Orifarm and contains the same active ingredient as the originator brand Alvesco.
What makes ciclesonide unique among inhaled corticosteroids is its status as a prodrug. The molecule you inhale is pharmacologically inactive. It is only when ciclesonide reaches the small airways of the lungs that local esterase enzymes cleave the molecule to release des-ciclesonide (des-CIC), the pharmacologically active metabolite. Des-CIC has approximately 100 times greater affinity for the glucocorticoid receptor than the parent compound, meaning the medicine targets its anti-inflammatory action precisely where it is needed most.
This targeted activation mechanism provides a clinically meaningful advantage. Because the drug is not activated in the mouth and throat, patients using Ciclesonide Orifarm tend to experience a lower incidence of oropharyngeal side effects – particularly oral candidiasis (thrush) and dysphonia (hoarseness) – compared with conventional inhaled corticosteroids such as budesonide and fluticasone propionate. Several randomised controlled trials and head-to-head comparisons have confirmed this favourable local tolerability profile.
Ciclesonide Orifarm works by suppressing the chronic airway inflammation that underlies persistent asthma. The active metabolite des-CIC enters airway epithelial cells, binds to intracellular glucocorticoid receptors, and modulates the transcription of numerous pro-inflammatory genes. This reduces the production of inflammatory cytokines, chemokines, adhesion molecules, and inflammatory enzymes, ultimately decreasing airway hyperresponsiveness, mucosal oedema, and mucus hypersecretion. Regular use reduces both the frequency and severity of asthma symptoms including wheezing, breathlessness, chest tightness, and coughing.
The solution-based formulation of Ciclesonide Orifarm offers practical benefits. Unlike suspension-based inhalers, the solution formulation does not require shaking before use. It produces a slow-moving, fine-particle aerosol that promotes greater small-airway deposition compared to some conventional metered-dose inhalers. This enhanced lung deposition contributes to the clinical efficacy and the low required doses of the product.
Ciclesonide Orifarm is a maintenance preventer medicine and must not be used to treat a sudden asthma attack or episode of acute breathlessness. In such situations, use your quick-relief (rescue) bronchodilator inhaler (e.g. salbutamol/albuterol) as directed. If your rescue inhaler does not provide adequate relief, seek medical attention immediately.
What Should You Know Before Taking Ciclesonide Orifarm?
Before starting Ciclesonide Orifarm, tell your doctor about all medical conditions you have – especially a history of tuberculosis, fungal, viral, or bacterial infections – and all medications you are taking. Certain antifungal and antiviral drugs can interact with ciclesonide. Special care is needed when switching from oral corticosteroid tablets to Ciclesonide Orifarm.
It is important to discuss your full medical history with your prescribing physician before beginning treatment with any inhaled corticosteroid. While ciclesonide has a favourable safety profile overall, certain pre-existing conditions and concomitant medications require special consideration to ensure that the medicine is used safely and effectively.
Contraindications
Do not use Ciclesonide Orifarm if you are allergic (hypersensitive) to ciclesonide or any of the other ingredients in this medicine, including anhydrous ethanol and the propellant norflurane (HFA-134a). Allergic reactions, though rare, can include rash, itching, hives, and in very rare cases, swelling of the lips, tongue, or throat. If you experience any signs of a severe allergic reaction after using Ciclesonide Orifarm, stop taking the medicine and seek medical attention immediately.
There are no other absolute contraindications listed for inhaled ciclesonide. However, as with all inhaled corticosteroids, the medicine should be used with caution in specific clinical situations outlined below. Your doctor will assess whether the expected benefit of treatment outweighs any potential risks based on your individual circumstances.
Warnings and Precautions
Talk to your doctor or pharmacist before using Ciclesonide Orifarm if you have ever been treated for, or are currently receiving treatment for, pulmonary tuberculosis (TB) or any fungal, viral, or bacterial respiratory infection. These infections may need to be brought under control before inhaled corticosteroid therapy can be started safely. Inhaled corticosteroids can suppress local immune defences in the airways, potentially allowing latent infections to reactivate or existing infections to worsen.
During treatment with Ciclesonide Orifarm, contact your doctor immediately if you experience any of the following:
- Difficulty breathing or worsening symptoms (increased coughing, breathlessness, wheezing, chest tightness, or audible lung sounds) – use your quick-relief bronchodilator as usual
- Waking at night due to asthma symptoms more than once a week
- Your quick-relief inhaler no longer provides adequate symptom relief
- You need to use your quick-relief inhaler more frequently than usual or more than 2–3 times per week
- Blurred vision or other visual disturbances, which may indicate raised intraocular pressure or cataract formation
Patients with severe asthma are at increased risk of acute exacerbations and should undergo regular and careful monitoring, including periodic lung function tests (spirometry), to ensure optimal disease control. Your doctor may also monitor your adrenal function, particularly if you are on higher doses or have previously used oral corticosteroids.
Long-term use of any inhaled corticosteroid at high doses may cause systemic effects, though the risk with ciclesonide is considered lower than with many alternatives. Potential systemic effects include adrenal suppression, reduction in bone mineral density, growth retardation in children and adolescents, cataracts, and glaucoma. These effects are dose-dependent and are more likely with prolonged use at doses exceeding the recommended maximum.
If you are currently taking corticosteroid tablets (e.g. prednisolone), Ciclesonide Orifarm may be used as a replacement or to reduce your tablet requirement. Your doctor will supervise this transition carefully. You should begin tapering the oral corticosteroid dose approximately one week after starting Ciclesonide Orifarm inhalations. The dose reduction should be gradual, and you may temporarily feel generally unwell during the transition.
It is essential to continue using Ciclesonide Orifarm and to follow the tapering schedule precisely. Previously suppressed allergic conditions (such as allergic rhinitis or eczema) may re-emerge during the switch. The risk of adrenal insufficiency from prior oral corticosteroid use may persist for some time. Symptoms of adrenal insufficiency can include dizziness, fainting, nausea, decreased appetite, weakness, headache, and inability to cope with stress. During periods of physiological stress (e.g. surgery, severe illness, or acute asthma exacerbations), you may need supplementary oral corticosteroid tablets.
Pregnancy and Breastfeeding
If you are pregnant, think you may be pregnant, planning to become pregnant, or breastfeeding, consult your doctor before using Ciclesonide Orifarm. There is insufficient data from controlled clinical trials on the use of ciclesonide during human pregnancy. Animal reproduction studies have shown adverse effects at supratherapeutic doses, but the relevance of these findings to human use at therapeutic doses is uncertain.
The GINA 2024 guidelines emphasise that poorly controlled asthma during pregnancy poses significant risks to both mother and baby, including pre-eclampsia, preterm birth, low birth weight, and neonatal hypoxia. The risk of untreated or poorly controlled asthma generally outweighs the potential risk of using inhaled corticosteroids. If your doctor determines that continued treatment is appropriate, the lowest effective dose of ciclesonide should be used, and your asthma control should be reviewed regularly throughout pregnancy.
Adrenal function should be closely monitored in newborns whose mothers received corticosteroids during pregnancy. It is not known whether inhaled ciclesonide or its active metabolite passes into breast milk. The decision to prescribe Ciclesonide Orifarm during breastfeeding should weigh the expected benefit to the mother against the potential risk to the infant. Other inhaled corticosteroids with more established breastfeeding safety data (such as budesonide) may be preferred if an alternative is clinically appropriate.
Children Under 12 Years
Ciclesonide Orifarm is not recommended for children under the age of 12, as there is insufficient data on its safety and efficacy in this age group. For younger children with asthma, your doctor will recommend an alternative inhaled corticosteroid that has been studied and approved for paediatric use, such as fluticasone propionate or budesonide, which have well-established dosing regimens for children as young as 4–6 years.
Driving and Operating Machinery
Ciclesonide Orifarm and its ingredients have no known effect on the ability to drive or operate machinery. You can continue your normal activities while using this medicine.
How Does Ciclesonide Orifarm Interact with Other Drugs?
The most clinically important interactions are with strong CYP3A4 inhibitors – particularly ketoconazole, itraconazole, ritonavir, and nelfinavir – which can significantly increase systemic exposure to the active metabolite des-ciclesonide, raising the risk of corticosteroid side effects.
Ciclesonide is primarily metabolised in the liver by the cytochrome P450 enzyme CYP3A4. Medicines that potently inhibit this enzyme can slow the clearance of des-ciclesonide (the active metabolite), leading to increased systemic corticosteroid exposure. While ciclesonide itself has minimal systemic absorption due to its prodrug nature and high first-pass metabolism, the risk of systemic corticosteroid side effects – including adrenal suppression, Cushing’s syndrome features, and metabolic effects – cannot be excluded when strong CYP3A4 inhibitors are co-administered over prolonged periods.
Tell your doctor or pharmacist about all medicines you are taking, have recently taken, or might take, before starting Ciclesonide Orifarm. This includes over-the-counter medicines, herbal products, and dietary supplements.
Major Interactions
| Interacting Drug | Drug Class | Effect | Clinical Recommendation |
|---|---|---|---|
| Ketoconazole | Antifungal (azole) | Increases des-ciclesonide exposure by approximately 3.5-fold via CYP3A4 inhibition | Avoid concurrent use if possible. If co-administration is unavoidable, monitor closely for corticosteroid side effects |
| Itraconazole | Antifungal (azole) | Significantly increases systemic ciclesonide exposure via CYP3A4 inhibition | Avoid concurrent use if possible. Monitor for signs of adrenal suppression |
| Ritonavir | Antiretroviral (protease inhibitor) | Potent CYP3A4 inhibition increases systemic corticosteroid levels substantially | Co-administration not recommended. Consider alternative ICS with fewer CYP3A4-dependent metabolic pathways |
| Nelfinavir | Antiretroviral (protease inhibitor) | CYP3A4 inhibition may increase des-ciclesonide exposure | Avoid if possible. If used, monitor adrenal function and watch for systemic steroid effects |
Minor Interactions and Considerations
Other moderate CYP3A4 inhibitors – such as erythromycin, clarithromycin, diltiazem, verapamil, and grapefruit juice – may also increase des-ciclesonide levels to some extent, though the clinical significance is generally considered lower than with strong inhibitors. Inform your doctor if you regularly consume large amounts of grapefruit juice.
Ciclesonide Orifarm is not affected by food or drink. There are no known clinically significant interactions with short-acting beta-agonists (SABAs such as salbutamol), long-acting beta-agonists (LABAs such as formoterol or salmeterol), leukotriene receptor antagonists (such as montelukast), or other common asthma medicines. Ciclesonide Orifarm can be safely used as part of a step-up asthma treatment regimen alongside these medications in accordance with GINA guidelines.
No clinically relevant interactions have been reported with antihistamines, proton pump inhibitors, or common analgesics. Ciclesonide does not significantly inhibit or induce major CYP450 enzymes at therapeutic doses, which means it is unlikely to affect the metabolism of other medicines you may be taking.
This medicine contains a small amount of alcohol (ethanol) as an excipient. The amount in a single dose is equivalent to less than 1 ml of beer or wine. This small amount of alcohol has no noticeable effects and does not interact with other medications at clinically relevant levels.
What Is the Correct Dosage of Ciclesonide Orifarm?
The standard recommended dose of Ciclesonide Orifarm (80 mcg/dose) is typically 1–2 puffs once or twice daily, depending on asthma severity and previous treatment. Always follow your doctor’s prescribed dosage. The aim is to find the lowest effective dose that maintains asthma control.
Always use Ciclesonide Orifarm exactly as your doctor has prescribed. Do not change the dose without consulting your doctor. The goal is to find the lowest effective dose that controls your asthma symptoms, in line with the GINA stepwise approach to asthma management. Once asthma control is achieved and maintained for several months, your doctor may consider reducing the dose gradually.
Adults and Adolescents (12 Years and Older)
Standard Maintenance Dose
160 micrograms once daily (two puffs of the 80 mcg/dose inhaler), taken either in the morning or evening at a consistent time each day. This dose achieves asthma control in the majority of patients with mild to moderate persistent asthma.
Lower Maintenance Dose
80 micrograms once daily (one puff of the 80 mcg/dose inhaler). Some patients with mild persistent asthma who are well-controlled may be adequately maintained on the lower dose. Your doctor may step you down to this dose once good asthma control has been sustained.
Higher Dose for Severe Asthma
Up to 320 micrograms twice daily (four puffs of the 80 mcg/dose inhaler, twice daily, for a maximum of 640 mcg/day). This higher dose may be used for a limited period during severe exacerbations or when stepping down from oral corticosteroid therapy. Your doctor will reduce the dose as soon as asthma control permits.
| Patient Group | Dose | Frequency | Notes |
|---|---|---|---|
| Adults (mild-moderate asthma) | 160 mcg (2 puffs) | Once daily | Standard starting dose for most patients |
| Adults (well-controlled, step-down) | 80 mcg (1 puff) | Once daily | Minimum effective maintenance dose |
| Adults (severe asthma) | 320 mcg (4 puffs) | Twice daily | Maximum 640 mcg/day; short-term use |
| Adolescents (12–17 years) | 80–160 mcg (1–2 puffs) | Once daily | Same as adult dosing; use lowest effective dose |
| Children (<12 years) | Not recommended | – | Insufficient safety data; use alternative ICS |
| Elderly | Same as adults | Once daily | No dose adjustment needed |
Missed Dose
If you forget to take a dose of Ciclesonide Orifarm, simply take your next dose at the usual time. Do not take a double dose to make up for a missed one. Missing a single dose is unlikely to cause a significant change in asthma control, but repeated missed doses will reduce the anti-inflammatory protection and may lead to worsening symptoms over time.
If you find you are regularly forgetting doses, consider linking your inhaler use to a consistent daily routine – for example, placing it next to your toothbrush or setting a daily reminder on your phone. Speak with your doctor or pharmacist for additional adherence strategies.
Overdose
There is limited data on acute overdose with inhaled ciclesonide. Due to its prodrug nature and the mechanism of activation in the lungs, a single accidental overdose is unlikely to cause acute harm requiring emergency treatment. However, chronic administration of substantially higher-than-recommended doses may lead to systemic corticosteroid effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.
If you suspect that you or someone else has taken significantly more than the prescribed dose over a prolonged period, contact your doctor. Treatment of chronic overdose involves gradually reducing the dose under medical supervision while monitoring adrenal function. There is no specific antidote for ciclesonide overdose.
What Are the Side Effects of Ciclesonide Orifarm?
Like all medicines, Ciclesonide Orifarm can cause side effects, although not everybody gets them. The most commonly reported side effect is headache. Ciclesonide has a favourable side effect profile compared to many other inhaled corticosteroids, with notably lower rates of oral thrush and hoarseness due to its prodrug activation mechanism.
The side effects listed below are based on data from clinical trials and post-marketing surveillance of ciclesonide inhalation products. The frequencies are classified according to the standard international convention: very common (more than 1 in 10 users), common (1 in 10 to 1 in 100), uncommon (1 in 100 to 1 in 1,000), rare (less than 1 in 1,000), and not known (frequency cannot be estimated from available data).
One of the key clinical advantages of ciclesonide over older inhaled corticosteroids is its significantly lower incidence of oropharyngeal side effects. A systematic review published in the Journal of Asthma and Allergy (2020) confirmed that the rate of oral candidiasis with ciclesonide is substantially lower than with equipotent doses of budesonide or fluticasone propionate, and that dysphonia occurs less frequently as well. This benefit is attributable to the prodrug mechanism, which ensures that the compound remains pharmacologically inactive in the mouth and throat.
Common
Affects 1 to 10 in every 100 users
- Headache
- Nasopharyngitis (common cold symptoms)
- Unpleasant taste in the mouth (dysgeusia)
Uncommon
Affects 1 to 10 in every 1,000 users
- Oral candidiasis (oral thrush) – white patches in the mouth or throat
- Dysphonia (hoarseness or voice changes)
- Cough after inhalation
- Nausea
- Oropharyngeal pain (sore throat)
- Dry mouth
Rare
Affects 1 to 10 in every 10,000 users
- Bronchospasm (paradoxical tightening of the airways immediately after inhalation)
- Skin rash, urticaria (hives), or pruritus (itching)
- Angioedema (swelling of the face, lips, tongue, or throat)
- Hypersensitivity reactions
Not Known
Frequency cannot be estimated from available data
- Adrenal suppression (with prolonged high-dose use)
- Growth retardation in children and adolescents (class effect of all ICS)
- Reduction in bone mineral density (with long-term high-dose use)
- Posterior subcapsular cataracts
- Glaucoma or increased intraocular pressure
- Sleep disturbances, depression, anxiety, restlessness, or behavioural changes (including hyperactivity and irritability, particularly in children)
If you experience paradoxical bronchospasm (sudden worsening of wheezing or breathing immediately after using the inhaler), stop using Ciclesonide Orifarm immediately, use your rescue bronchodilator, and contact your doctor. This is a rare but recognised side effect of all inhaled medicines and may require a change in your treatment.
If any of the side effects listed above become severe, or if you notice any side effects not mentioned in this guide, tell your doctor or pharmacist. You can also report side effects directly to your national pharmacovigilance authority to help provide more information on the safety of this medicine.
Although oral thrush is uncommon with ciclesonide due to its prodrug design, some clinicians still recommend rinsing your mouth with water (without swallowing) after each use as an additional precaution. This simple step can further reduce the already low risk of oral candidiasis and dysgeusia. If you notice persistent white patches in your mouth, sore throat, or difficulty swallowing, consult your doctor.
How Should You Store Ciclesonide Orifarm?
Store Ciclesonide Orifarm at room temperature below 25°C (77°F), away from direct heat and sunlight. Do not freeze. Keep the inhaler out of the reach and sight of children. Do not use the inhaler after the expiry date printed on the label.
Proper storage of your inhaler is essential to ensure that each dose delivers the correct amount of medicine. The pressurised canister contains a solution under pressure, and incorrect storage can affect both the consistency and the efficacy of the delivered dose.
Store the inhaler in a cool, dry place at a temperature not exceeding 25°C (77°F). Avoid leaving the inhaler in direct sunlight, near radiators, or in a car on a hot day, as excessive heat can cause the pressurised canister to rupture or the formulation to degrade. Do not store the inhaler in the refrigerator or freezer, as temperatures below 15°C may affect the spray performance.
Keep the protective mouthpiece cap in place when the inhaler is not in use to prevent dust and debris from entering the mouthpiece. Clean the outside of the mouthpiece once a week with a dry tissue or cloth. Do not wash the inhaler in water or immerse it in liquid, as this can damage the valve mechanism.
Do not puncture, break, or burn the canister, even when it appears empty. The canister contains a pressurised propellant that can be hazardous if exposed to heat or flame. When you have finished using the inhaler, dispose of it according to your local waste disposal regulations or return it to your pharmacy for safe disposal.
The inhaler has a dose counter or indicator. When the counter reaches zero or the indicator shows that the canister is empty, discard the inhaler and obtain a new one from your pharmacy. Do not attempt to use the inhaler beyond the indicated number of doses, as later actuations may not deliver the full therapeutic dose.
What Does Ciclesonide Orifarm Contain?
Each actuation of Ciclesonide Orifarm delivers 80 micrograms of ciclesonide, the active substance. The other ingredients are anhydrous ethanol and the propellant norflurane (HFA-134a), which replaces the older ozone-depleting CFC propellants.
Ciclesonide Orifarm is a solution-based pressurised metered-dose inhaler. Unlike suspension-based inhalers (which contain particles of drug suspended in propellant), the solution formulation ensures that the active ingredient is fully dissolved. This eliminates the need to shake the inhaler before use and provides consistent dosing with each actuation.
Active Ingredient
Ciclesonide – 80 micrograms per metered dose (the amount delivered from the valve). Ciclesonide is a synthetic glucocorticoid prodrug with the molecular formula C32H44O7 and a molecular weight of 540.7 g/mol. It is a white to off-white powder that is practically insoluble in water but soluble in ethanol, which is used as a co-solvent in the formulation.
Inactive Ingredients (Excipients)
- Norflurane (HFA-134a) – The propellant gas that generates the aerosol spray when the canister is actuated. HFA-134a is an environmentally friendly hydrofluoroalkane propellant that does not deplete the ozone layer, replacing the chlorofluorocarbon (CFC) propellants used in older inhaler formulations.
- Anhydrous ethanol – Used as a co-solvent to dissolve ciclesonide in the propellant. The amount of ethanol per dose is very small (a few milligrams) and has no clinically relevant effects.
Ciclesonide Orifarm does not contain lactose, gluten, preservatives, or any other common allergens as excipients. Patients with lactose intolerance or gluten sensitivity can use this inhaler without concern. If you have a known allergy to any of the listed ingredients, consult your doctor or pharmacist before using this medicine.
Frequently Asked Questions About Ciclesonide Orifarm
Ciclesonide Orifarm is a preventer inhalation spray used for the long-term control of chronic persistent asthma in adults and adolescents aged 12 years and older. It reduces airway inflammation and helps prevent symptoms such as wheezing, breathlessness, chest tightness, and coughing. It is not suitable for relieving acute asthma attacks – for that, you need a separate rescue inhaler (such as salbutamol).
Ciclesonide Orifarm contains the prodrug ciclesonide, which is only activated in the lungs where local esterases convert it to the active form des-ciclesonide. This targeted activation means less active drug reaches the mouth and throat, resulting in fewer oropharyngeal side effects such as oral thrush (candidiasis) and hoarseness compared to conventional inhaled corticosteroids like budesonide or fluticasone propionate. The solution-based formulation also does not require shaking before use.
Ciclesonide Orifarm and Alvesco both contain the same active ingredient, ciclesonide, and belong to the same drug class (inhaled corticosteroids). Ciclesonide Orifarm is a generic version manufactured by Orifarm. They have the same pharmacological properties and clinical effects. Your doctor or pharmacist may substitute one for the other depending on availability and local prescribing practices. Note that Ciclesonide Orifarm is available in the 80 mcg/dose strength.
Some patients may notice improvement in asthma symptoms within 24 hours of starting Ciclesonide Orifarm. However, the full anti-inflammatory benefit builds up over time with regular daily use. It typically takes 1 to 2 weeks of consistent use to achieve the maximum therapeutic effect. It is essential to use the inhaler every day, even when you feel well, to maintain long-term asthma control.
Because ciclesonide is a prodrug that is activated primarily in the lungs rather than in the mouth or throat, the risk of oral thrush is significantly lower than with many other inhaled corticosteroids. Rinsing your mouth after use is generally not required. However, some clinicians still recommend rinsing with water and spitting it out as an additional precaution, especially if you are on higher doses or have previously experienced oral candidiasis with other inhalers.
There is limited clinical data on ciclesonide use during pregnancy. However, the GINA guidelines emphasise that poorly controlled asthma poses greater risks to both mother and baby than using inhaled corticosteroids. Your doctor will assess the benefits and risks individually. If treatment is needed, the lowest effective dose should be used and asthma control should be reviewed regularly throughout pregnancy.
References
All medical information in this guide is based on the following peer-reviewed sources and international guidelines:
- Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2024 Report. Available at: ginasthma.org/gina-reports/
- European Medicines Agency (EMA). Summary of Product Characteristics: Ciclesonide inhalation products. 2024.
- U.S. Food and Drug Administration (FDA). Prescribing Information: Ciclesonide Inhalation Aerosol. 2023.
- British National Formulary (BNF). Ciclesonide monograph. National Institute for Health and Care Excellence (NICE). 2024.
- Dahl R. Ciclesonide for the treatment of asthma. Therapeutics and Clinical Risk Management. 2006;2(1):25–37.
- Nave R, Mueller H. From inhaler to lung: clinical implications of the formulations of ciclesonide and other inhaled corticosteroids. International Journal of General Medicine. 2013;6:99–107.
- Derendorf H et al. Ciclesonide: a pro-soft drug approach for the treatment of asthma. Current Pharmaceutical Design. 2004;10(28):3549–3561.
- Mutch E et al. Efficacy and safety of ciclesonide in the treatment of asthma: a systematic review. Journal of Asthma and Allergy. 2020;13:173–185.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. 2023.
- National Asthma Education and Prevention Program (NAEPP). Expert Panel Report 4: Guidelines for the Diagnosis and Management of Asthma. 2020.
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