ALVESCO

Ciclesonide

ALVESCO

ICS MDI

Ciclesonide · Covis Pharma

Clinical Reference

Active Medication & Mechanism

Ciclesonide ICS
80 mcg or 160 mcg per actuation

Pro-drug that is enzymatically hydrolyzed in the lungs to its active metabolite desisobutyryl-ciclesonide (des-CIC), which has high glucocorticoid receptor affinity and anti-inflammatory activity.

FDA-Approved Dosing by Indication

// approval varies by strength + age

Asthma

3/4 approved regimens

Strength	Population	Dose & Frequency	Total Daily	Status
80 mcg	Patients ≥12 years (previously on bronchodilators alone)	1 inhalation twice daily or 2 inhalations once daily Starting dose for patients previously using bronchodilators alone.	160 mcg	FDA Approved
80 mcg	Patients ≥12 years (previously on inhaled corticosteroids)	1 inhalation twice daily or 2 inhalations once daily Starting dose for patients previously maintained on other inhaled corticosteroids.	160 mcg	FDA Approved
160 mcg	Patients ≥12 years (previously on oral corticosteroids)	2 inhalations twice daily Higher dose for patients previously on oral corticosteroids. Maximum recommended dose is 320 mcg twice daily (640 mcg/day).	640 mcg	FDA Approved
Any strength	Acute bronchospasm	—	—	Not Approved Not a bronchodilator and should not be used for relief of acute bronchospasm.

80 mcg FDA Approved

Pop · Patients ≥12 years (previously on bronchodilators alone)

1 inhalation twice daily or 2 inhalations once daily

Starting dose for patients previously using bronchodilators alone.

Total · 160 mcg
80 mcg FDA Approved

Pop · Patients ≥12 years (previously on inhaled corticosteroids)

1 inhalation twice daily or 2 inhalations once daily

Starting dose for patients previously maintained on other inhaled corticosteroids.

Total · 160 mcg
160 mcg FDA Approved

Pop · Patients ≥12 years (previously on oral corticosteroids)

2 inhalations twice daily

Higher dose for patients previously on oral corticosteroids. Maximum recommended dose is 320 mcg twice daily (640 mcg/day).

Total · 640 mcg
Any strength Not Approved

Pop · Acute bronchospasm

—

Total · — Not a bronchodilator and should not be used for relief of acute bronchospasm.

COPD

0/1 approved regimens

Strength	Population	Dose & Frequency	Total Daily	Status
Any strength	Adults	—	—	Not Approved Alvesco is not indicated for COPD.

Any strength Not Approved

Pop · Adults

—

Total · — Alvesco is not indicated for COPD.

Acute Use

0/1 approved regimens

Strength	Population	Dose & Frequency	Total Daily	Status
Any strength	Acute bronchospasm / rescue	—	—	Not Approved Not a rescue inhaler. Not indicated for acute episodes. Use a SABA.

Any strength Not Approved

Pop · Acute bronchospasm / rescue

—

Total · — Not a rescue inhaler. Not indicated for acute episodes. Use a SABA.