The Medical Letter on Drugs and Therapeutics
Ciclesonide (Alvesco) - A New Inhaled Corticosteroid for Asthma
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The FDA has approved the marketing of the corticosteroid ciclesonide (Alvesco – Sepracor) in a hydrofluoroalkane (HFA) metered-dose inhaler formulation for maintenance treatment of asthma in patients ≥12 years old. Ciclesonide is also available in the US as a nasal spray for allergic rhinitis (Omnaris),1 and has been available for asthma in Europe since 2003.

PHARMACOLOGY — Ciclesonide is inactive in vivo until it is inhaled and converted by endogenous esterases to an active metabolite, desisobutyrylciclesonide, which forms conjugates with fatty acids.2 These conjugates retain the active metabolite in the lung for a longer time than would be expected from its half-life of 3.5 hours. Both ciclesonide and its metabolite are more than 99% protein-bound in the blood. Both are excreted mainly in bile.

CLINICAL STUDIES — Dose Finding ... more      

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Title: Ciclesonide (Alvesco) - A New Inhaled Corticosteroid for Asthma
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