Alvesco is a man-made corticosteroid. It prevents the release of substances in the body that cause inflammation.

Alvesco is used to prevent asthma attacks in adults and children who are at least 12 years. When used regularly, as prescribed by your health care provider, it will help to prevent and control symptoms of asthma.

Alvesco may also be used for purposes not listed in this medication guide.

Alvesco inhalation will not work fast enough to treat an asthma attack. Use only a fast acting inhalation medicine for an asthma attack. Tell your doctor if it seems like your asthma medications don't work as well.

Steroid medication can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Before taking Alvesco, tell your doctor about any illness or infection you have had within the past several weeks.

Before using Alvesco, tell your doctor if you have tuberculosis, an infection of your mouth or throat (such as oral thrush), glaucoma or history of cataracts, herpes infection of your eyes, or a personal or family history of osteoporosis.

If you also use a steroid medication, do not stop using the steroid suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about slowly using less and less of the steroid before stopping completely. Call your doctor right away if you feel that Alvesco inhalation makes your condition worse.

Avoid being near people who are sick or have infections if possible. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Before using Alvesco

You should not use Alvesco if you are allergic to ciclesonide.

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

To make sure Alvesco is safe for you, tell your doctor if you have:

• tuberculosis;

• an infection of your mouth or throat (such as oral thrush);

• glaucoma or history of cataracts;

• herpes infection of your eyes; or

• a personal or family history of osteoporosis.

FDA pregnancy category C. It is not known whether Alvesco will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether ciclesonide inhalation passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Alvesco can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medicine.

Use Alvesco exactly as it was prescribed for you. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Alvesco will not work fast enough to treat an asthma attack. Use only a fast acting inhalation medicine for an asthma attack. Tell your doctor if it seems like your asthma medications don't work as well.

Alvesco comes with patient instructions for safe and effective use, and directions for priming the inhaler device. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Alvesco is most often used twice daily, in the morning and evening. Follow your doctor's instructions. Rinse your mouth after inhaling this medication.

The Alvesco inhaler device must be primed before your first use or any time you have not used the inhaler for 10 days or longer. For instructions on how to prime the inhaler, refer to the patient instructions provided with your medication.

It may take 4 weeks or longer before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Your dose needs may change if you have surgery, are ill, are under stress, or have recently had an asthma attack. Do not change your medication dose or schedule without your doctor's advice.

Call your doctor right away if you feel that Alvesco makes your condition worse.

You should not stop using Alvesco suddenly. Follow your doctor's instructions about tapering your dose.

Store Alvesco at room temperature away from moisture and heat. Keep the medicine canister away from open flame or high heat, such as in a car on a hot day. The canister may explode if it gets too hot. Do not puncture or burn an empty inhaler canister.

You should not use Alvesco if you are allergic to ciclesonide.

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

To make sure Alvesco is safe for you, tell your doctor if you have:

• tuberculosis;

• an infection of your mouth or throat (such as oral thrush);

• glaucoma or history of cataracts;

• herpes infection of your eyes; or

• a personal or family history of osteoporosis.

FDA pregnancy category C. It is not known whether Alvesco will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether ciclesonide inhalation passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Alvesco can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medicine.

Use the Alvesco inhaler as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

An overdose of ciclesonide is not expected to produce life threatening symptoms. However, long term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Get emergency medical help if you have any of these signs of an allergic reaction to Alvesco: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• wheezing, choking, or other breathing problems after using this medication;

• bronchospasm (wheezing, chest tightness, trouble breathing);

• sores or white patches in your mouth or throat;

• vision problems, such as tunnel vision or blurred vision; or

• worsening asthma symptoms.

Common Alvesco side effects may include:

• unpleasant taste in your mouth;

• dry mouth, burning or irritation in your mouth;

• runny or stuffy nose, sore throat;

• hoarse voice;

• mild itching or skin rash;

• joint pain, back pain; or

• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Alvesco, especially:

• an antibiotic--clarithromycin, erythromycin, telithromycin;

• an antifungal medication--clotrimazole, itraconazole, ketoconazole, voriconazole;

• HIV/AIDS medicine--atazanavir, delavirdine, indinavir, nelfinavir, saquinavir, ritonavir (Norvir); or

• an antidepressant such as nefazodone, paroxetine, sertraline.

This list is not complete. Other drugs may interact with Alvesco, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.