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Dosing

Dosing Information1

  • Alvesco® (ciclesonide) Inhalation Aerosol should be administered by oral inhalation.
  • Alvesco Inhalation Aerosol is available in 2 strengths — 80 mcg or 160 mcg. Both are pressurized, metered-dose aerosol units fitted with a dose indicator.
  • Prime Alvesco Inhalation Aerosol by actuating 3 times prior to using the first dose from a new canister or when the inhaler has not been used for more than 10 days.
  • Individual patients will experience a variable time to onset and degree of symptom relief. Maximum benefit may not be achieved for four weeks or longer after initiation.
  • After asthma stability has been achieved, it is desirable to titrate to the lowest effective dosage to reduce the possibility of side effects.
  • For patients who do not respond adequately to the starting dose after 4 weeks of therapy, higher doses may provide additional asthma control. The safety and efficacy of Alvesco when administered in excess of the highest recommended doses has not been established.
  • Patients should be advised to use Alvesco at regular intervals, since its effectiveness depends on regular use. Patients should be instructed not to stop Alvesco use abruptly.

Recommended Dosages1

The recommended starting dose and the highest recommended dose of Alvesco Inhalation Aerosol are listed in the following table.

1Prednisone should be reduced gradually, no faster than 2.5 mg/day on a weekly basis, beginning after at least 1 week of therapy with Alvesco. Patients should be carefully monitored for signs of asthma instability, including monitoring of serial objective measures of airflow, and for signs of adrenal insufficiency during steroid taper and following discontinuation of oral corticosteroid therapy [see Warnings and Precautions (5.1) in Full Prescribing Information].

Reference:

  1. Alvesco® Inhalation Aerosol Prescribing Information. Marlborough, United Kingdom: Sunovion Pharmaceuticals Inc.; January 2013.

Administration

How to take Alvesco1

Prime the Inhaler

  • Patients will need to prime their Alvesco Inhalation Aerosol by actuating 3 times prior to using the first dose from a new canister or when the inhaler has not been used for more than 10 days.
  • The dose indicator display should be at the “60” inhalation mark before after priming but before using Alvesco for the first time.

Using the Inhaler

  • Instruct patients to breathe out fully through the mouth, letting as much air out of their lungs as possible.
  • Then they should put their lips around the mouthpiece, above the tongue.
  • While breathing in deeply and slowly through the mouth, patients should press down on the canister with their finger, and hold their breath for about 10 seconds, or for as long as is comfortable.
  • Then they should remove the inhaler from the mouth and breathe out gently.

Note: It’s normal to hear a soft click from the indicator as it counts down during use.

  • Instruct patients to rinse their mouth with water and spit it out, but not to swallow.

Reference:

  1. Alvesco® Inhalation Aerosol Prescribing Information. Marlborough, United Kingdom: Sunovion Pharmaceuticals Inc.; January 2013.