What is Alvesco: Uses, Warnings & Interactions

Updated Oct 1, 2025  •  Published Jun 8, 2021

Alvesco is a brand-name prescription asthma inhaler. Its active ingredient, ciclesonide, is a corticosteroid that helps prevent asthma attacks. Doses are administered through an aerosol inhaler twice daily.

Alvesco overview

BRAND NAMES:

  • Alvesco

Generic Names:

  • Ciclesonide

Uses:

  • Prevents asthma attacks

Therapeutic Classes:

  • Anti-inflammatory, anti-asthmatic, inhaled corticosteroid

Forms:

  • Aerosol inhaler

How it’s taken:

  • Inhalation

What is Alvesco used for?

Alvesco is a maintenance treatment for people 12 years of age and older with asthma. It is not suitable as a rescue inhaler.

What form(s) does Alvesco come in

  • Inhaler 

    • 80 mcg/act

    • 160 mcg/act

What are common Alvesco doses?

  • For asthma maintenance treatment in adults: 80–320 mcg twice daily (dosage will depend on current corticosteroid use)

Common Alvesco prescriptions

  • Alvesco
    6.1gm of 160mcg/act inhaler

  • Alvesco
    6.1gm of 160mcg/act (60 inhalations) inhaler

  • Alvesco
    6.1gm of 80mcg/act inhaler

  • Alvesco
    6.1gm of 80mcg/act (60 inhalations) inhaler

How to take Alvesco

  • Take this medication as directed.

  • Please read the Patient Information sheet before starting this medicine.

    • Please follow the step-by-step instructions in the Patient Information sheet when taking this medicine.

  • The inhaler will need to be primed when first used or whenever it has not been used for 10 days.

    • To prime the inhaler, release three sprays into the air.

  • To take a dose:

    • Remove the cap.

    • Hold the inhaler upright.

    • Breathe out as fully as you can.

    • Place the mouthpiece in your mouth and close your lips around it. 

    • Breathe in deeply and slowly while firmly pressing down on the top of the canister.

    • Hold your breath for 10 seconds.

    • Breathe out slowly.

    • When you have finished all your inhalations, rinse your mouth out with water. Spit out the water.

    • Replace the cap on the inhaler.

  • Clean the inhaler's mouthpiece and wipe the front of the small hole where the medicine comes out with a clean, dry tissue once weekly.

  • The dose indicator counts down by tens. It will move on every tenth dose.

  • When it turns red at 20 doses left, refill the prescription.

  • Throw the unit away when the dose counter reads “0.”

    • Do not throw the canister into a fire.

  • Store Alvesco at room temperature. Keep the inhaler dry.

    • Do not store near heat or flames.

    • Do not puncture the canister.

What to do if you miss a dose of Alvesco

  • Ask the prescriber how to handle a missed dose.

  • Do not take extra doses to make up for a missed dose.

Alvesco contraindications

  • Alvesco is contraindicated in anyone who has had an allergic reaction to ciclesonide. 

  • This medicine is not to be used during an asthma attack.

Alvesco warnings

  • Tell other doctors or healthcare providers who treat you that you are using this medicine.

  • The prescriber will need to regularly check on your progress and perform lab tests to monitor the effects of this treatment. Some people may also need regular eye exams. Keep all appointments.

  • Tell the prescriber if you are pregnant, breastfeeding, or if you have: 

    • Eye problems, including cataracts, glaucoma, or high eye pressure

    • Infections, particularly a herpes infection of the eye or tuberculosis

    • Osteoporosis or risk factors for osteoporosis

    • Been vaccinated for chickenpox or measles

  • This medicine may cause serious side effects, including:

    • Infections

    • Yeast infections of the mouth

    • Underactive adrenal gland

    • Decreased bone density 

    • Eye problems, including cataracts and glaucoma

    • Slowed growth (in children)

  • You may get infections more easily while using this medicine. 

    • Avoid people who are sick or have infections. 

    • Immediately inform the prescriber if you or your child has been exposed to someone with chickenpox or measles.

  • It may take a few weeks for asthma symptoms to improve.

    • Talk to the prescriber if symptoms do not improve or worsen after four weeks of treatment.

  • Alvesco will not stop an asthma attack that has already started. Always carry a rescue inhaler.

Alvesco interactions

  • To avoid potentially serious drug interactions, tell the prescribing healthcare provider about all the prescription drugs, over-the-counter medications, and supplements being taken.

  • Tell other healthcare professionals about Alvesco before they prescribe new medications, particularly ketoconazole.

  • For people currently taking oral corticosteroids as an asthma treatment, switching to Alvesco may cause withdrawal symptoms. 

    • The dose of oral corticosteroids will need to decrease gradually while transitioning. 

    • During the transition, patients may need to restart oral corticosteroids in times of stress or acute symptoms.

Alvesco side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • Worsening of asthma symptoms

  • Increased wheezing after taking an Alvesco dose

  • Vision changes

  • Tiredness, weakness, dizziness, nausea that does not go away, vomiting that does not go away

  • Redness, sores, or white patches in your mouth or throat

  • Infection: fever, chills, pain, aches, feeling tired, nausea, vomiting 

  • Allergic reaction: Skin rash, hives, itching, swelling of the face, mouth, or tongue, trouble breathing, trouble swallowing

Less serious side effects

  • Headache

  • Swelling of the nose and throat

  • Sinus swelling

  • Throat pain

  • Nasal congestion

  • Upper respiratory tract infection

  • Joint pain

  • Arm, leg, or back pain

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