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Precautions and Warnings With Ciclesonide

There are many precautions and warnings with ciclesonide to be aware of before beginning treatment. For example, ciclesonide can weaken the immune system and suppress the body's ability to make natural steroids. It may also slow down the growth of children or worsen some existing medical conditions. Before using ciclesonide, tell your healthcare provider about any medical conditions you have and all medications you are taking.

Ciclesonide: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking ciclesonide (Omnaris®, Zetonna™) if you have:
  • Tuberculosis, herpes, or any other infections
  • Not had chickenpox or the measles (and have not been vaccinated against them)
  • Recently had nasal surgery
  • Sores or injury to the inside of your nose
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Ciclesonide

Warnings and precautions to be aware of prior to taking ciclesonide include the following:
  • There were many cases of nosebleeds and a few cases of nasal ulceration (sores) or even perforation of the nasal septum (the cartilage that divides the nose in two halves, between the nostrils) in certain ciclesonide clinical trials. Let your healthcare provider know right away if you develop nosebleeds or nasal sores, as catching this early may help prevent nasal septum perforation. Also, avoid spraying the medicine toward the nasal septum; instead, aim the spray toward the outside of the nostrils.


  • Ciclesonide is a steroid and may, therefore, suppress the immune system. Although this is more likely to occur with oral steroids, it is still possible with nasal steroids such as ciclesonide. Taking steroids may put you at a higher risk for infections. Certain infections (such as chickenpox or the measles) may be more dangerous if you are taking ciclesonide. Let your healthcare provider know right away if you are exposed to chickenpox or the measles if you have not had these infections and have not been vaccinated against them. In rare cases, ciclesonide can lead to yeast infections in the nose and throat as a result of suppressing the immune system.


  • Ciclesonide has been reported to cause yeast infections of the nose and throat, although such infections occur rarely. 


  • If you are switching from an oral steroid to ciclesonide (which is a nasal steroid), your healthcare provider should slowly decrease your dose of the oral steroid. Stopping an oral steroid too quickly can be dangerous.
  • Ciclesonide can suppress the body's ability to make natural steroids. Usually, this happens when too much medication is taken or if you are very sensitive to it. In such circumstances, ciclesonide should be stopped slowly to give your body a chance to begin making natural steroids again.
  • Before starting ciclesonide, tell your healthcare provider if you have any type of infection. Also, let your healthcare provider know if you have ever had tuberculosis or a herpes infection of the eye, as the drug may weaken the immune system, allowing these infections to worsen.
  • Like all steroids, ciclesonide may slow down the growth rate of children and teenagers. Contact your child's healthcare provider if you are concerned about a slow growth rate in your child.
  • Corticosteroids (such as ciclesonide) can delay healing. Therefore, if you have had recent nasal surgery or nasal sores, you should wait until healing has occurred before taking the drug. Also, corticosteroids can cause nosebleeds and nasal sores or irritation.
  • Ciclesonide can potentially interact with at least one other medication (see Drug Interactions With Ciclesonide).
  • Ciclesonide is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not currently known (see Omnaris and Pregnancy or Zetonna and Pregnancy).
  • It is unknown if ciclesonide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Omnaris and Breastfeeding or Zetonna and Breastfeeding).
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