Skip to Accessibility Tools Skip to Content Skip to Footer

Alvesco (ciclesonide)

Alvesco (ciclesonide) is an inhaled corticosteroid. Alvesco is approved for the long-term treatment of asthma for people ages 12 years and up. Alvesco is taken via metered dose inhaler.1

Do not take Alvesco if you are having an asthma attack. It does not work quickly enough. Use a rescue inhaler (short-acting beta agonist) instead.

How does Alvesco work?

Inhaled corticosteroids such as Alvesco reduce inflammation in the airways.1 Corticosteroids affect many different types of inflammatory cells, including eosinophils and mast cells. They also affect signaling chemicals that have a role in inflammation such as histamine, leukotrienes, and cytokines.

How is Alvesco taken?

Ask your health care provider or respiratory therapist to show you how to use your inhaler properly.

Alvesco comes in two strengths: 80 mcg (brown inhaler) or 160 mcg (red inhaler). Alvesco should be taken twice daily (Table).2 Your health care provider will tell you how many puffs to take.

When you remove the inhaler from the package, look at the dose indicator on the cap. The display window pointer should be before the “60” inhalation mark before the first use. You have to prime the inhaler before the first use. To do this, hold the inhaler upright, pointing away from your face. Press the canister down to release three puffs. The dose indicator should show that there are 60 sprays left. You need to prime the inhaler again if you have not used it in ten days.

Table. Using your Alvesco metered dose inhaler

The steps for using your Alvesco metered dose inhaler are:

  1. You do not need to shake your inhaler before using it.
  2. Breathe out until your lungs are empty.
  3. Put the mouthpiece in your mouth and close your lips around it.
  4. Begin to breathe in deeply and slowly through your mouth. Press the canister down to release a “puff” as you breathe in. Press down until the canister stops moving.
  5. Hold your breath for 10 seconds.
  6. Lift your finger off the canister and remove the inhaler from your mouth. Breathe out gently.
  7. Rinse your mouth with water and spit out the water. This step will help to prevent thrush, a fungal infection of the mouth.

  • Read the Patient Information that comes with your inhaler for complete instructions.
  • The dose indicator moves every 10th spray (eg, 60 left, 50 left, 40 left, etc.).
  • The inhaler is best used at room temperature.
  • You can use a spacer or valved holding chamber with a metered dose inhaler. These devices help the medications to get into your lungs.

Alvesco® [patient information]. Marlborough, MA: Sunovion Pharmaceuticals; 2013.

What should I do if I miss a dose of Alvesco?

Ask your health care provider what you should do if you miss a dose of Alvesco.

What are the recommendations for storing, cleaning, and discarding Alvesco?

Alvesco comes in a brown or red plastic inhaler with a separate metal canister containing the medication.1 Do not use the Alvesco inhaler with other medications. Do not use other inhalers with the Alvesco canister.

Wipe the mouthpiece once a week with a clean, dry tissue.2 Wipe in front of the small hole where the medicine comes out.

Throw away the canister when the counter reads 0.1 You have used all the medication. Store your Alvesco inhaler at 77˚F. Avoid high heat or flames.

What are the possible side effects of taking Alvesco?

Taking Alvesco could cause your airways to tighten suddenly (“bronchospasm”).1 This side effect can happen right after using the inhaler. Take your rescue inhaler and call your health care provider.

Common side effects of taking Alvesco are headache; swelling of the nose, throat, or sinuses; sore throat, stuffy nose, and colds; pain in the arms, legs, back, and joints.2 This is not an exhaustive list of side effects.

Inhaled corticosteroids, such as Alvesco, can cause thrush, a fungal infection in your mouth.2 You can help to prevent this by rinsing your mouth with water after using the inhaler and spitting out the water.

Corticosteroids can lower your immune system, so you are more likely to get an infection.2 Symptoms of an infection are fever, pain, aches, chills, fatigue, nausea, or vomiting. Avoid contact with people who have chickenpox, measles, or other contagious diseases. Tell your provider if you have not had or been vaccinated for chickenpox or measles. Let your provider know if you have any infections such as tuberculosis or herpes simplex of the eye.

Children who use corticosteroids may grow more slowly.2 Your child’s growth should be checked regularly.

Are there people who should not take Alvesco?

Do not take Alvesco if you are having an asthma attack.1 Alvesco does not work quickly enough. Use a rescue inhaler instead.

Tell your health care provider if you have had problems with your eyes, immune system, or osteoporosis. Taking corticosteroids may worsen these conditions. Extra monitoring or an alternative treatment may be needed.

Tell your health care provider about any prescription medications you are taking, particularly steroid medications you take by mouth. Also tell your provider about over-the-counter medications or supplements that you take.

Alvesco has not been well studied in pregnant or breastfeeding women.2 Little is known about whether this medication passes into breast milk. Talk to your doctor about if you become pregnant or wish to breastfeed while taking Alvesco.

If you are allergic to any ingredient in Alvesco, you should not take this medication.2

What evidence do we have that Alvesco works?

Alvesco was compared with a fake treatment (placebo) in six high-quality studies.1 These studies included 2,843 people ages 12 years and older. People had better results when they took Alvesco twice a day instead of once a day.

The results showed that people who took Alvesco had better lung function than people who took placebo. This outcome was seen for people with mild, moderate, and severe asthma. Treatment with Alvesco also reduced asthma symptoms and use of rescue medications. One study involved people with severe asthma who needed oral corticosteroids to control their symptoms. The people treated with Alvesco were able to reduce their oral corticosteroids without loss of asthma control.

Is there a generic alternative to Alvesco?

There is no generic alternative to Alvesco.

Written by: Sarah O'Brien | Last Reviewed: April 2019.
  1. Alvesco® [prescribing information]. Marlborough, MA: Sunovion Pharmaceuticals; 2013.
  2. Alvesco® [patient information]. Marlborough, MA: Sunovion Pharmaceuticals; 2013.