Zetonna
Zetonna (ciclesonide) is a prescription intranasal corticosteroid. It's used to treat nasal allergy symptoms (e.g., runny nose, stuffy nose, itchy nose, sneezing) from seasonal and year-round allergies in people ages 12 years and older. It comes as a pressurized canister that's sprayed directly into the nose. The typical dose is 1 spray in each nostril once per day. Side effects are rare, but can include nasal discomfort and headache.
What is Zetonna (ciclesonide)?
What is Zetonna (ciclesonide) used for?
Nasal allergy symptoms (e.g., runny nose, stuffy nose, itchy nose, sneezing) related to seasonal allergies or year-round allergies in people ages 12 years and older
How Zetonna (ciclesonide) works
Zetonna (ciclesonide) is an intranasal corticosteroid. It eases swelling and inflammation in the nasal passages to help relieve seasonal allergy symptoms, like stuffy or runny nose.
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What are the side effects of Zetonna (ciclesonide)?
Common Side Effects
- Nasal discomfort (3%)
- Headache (3%)
- Nose bleeds (3%)
Other Side Effects
- Nasal dryness
Serious Side Effects
- Nasal injury: crusting in the nose, sores (ulcers) in the nose, hole in the cartilage of the nose, slow wound healing
- Fungal infection in the nose or throat: pain, redness, white patches
- Serious allergic reaction: hives, rash, swelling of your face or throat, breathing problems
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloody nose
headache
muscle aches
nasal discomfort
stuffy or runny nose
unusual tiredness or weakness
Rare
blindness
blistering, burning, crusting, dryness, or flaking of the skin
bloody mucus or unexplained nosebleeds
blurred vision
change in vision
darkening of the skin
decreased vision
difficulty with breathing or troubled breathing
difficulty with swallowing
dizziness
fainting
itching, scaling, severe redness, soreness, or swelling of the skin
loss of appetite
loss of consciousness
loss of vision
menstrual changes
mental depression
reddening of the skin, especially around the ears
skin rash
swelling of the eyes, eyelids, face, or inside of the nose
tearing
tightness in the chest
vomiting
weight gain around the face, neck, and trunk
white patches inside the nose or throat
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Ear pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Zetonna (ciclesonide)
Pros
First-choice medication for treating nasal allergy symptoms
Sprayed once per day at any time of the day
Less side effects than corticosteroid pills
Cons
Not for children younger than 12 years old
Can take a couple weeks to feel the full effects of the medication
Can cause nasal discomfort and bleeds
Pharmacist tips for Zetonna (ciclesonide)
You might feel your allergy symptoms start to get better after using Zetonna (ciclesonide) for 2 to 3 days. But you need to use it daily for 1 to 2 weeks to get the most relief from this medication.
Zetonna (ciclesonide) can raise your risk for having a nosebleed. To stop a nose bleed, sit upright and lean forward. Pinch the soft part of your nose above your nostrils for at least 10 minutes while you breathe through your mouth. Get medical help right away if the bleeding is hard to stop or if you feel dizzy.
Store Zetonna (ciclesonide) at room temperature in the original container to protect it from light. Be careful not to expose the canister to extreme temperatures or open flames because it can burst.
Zetonna (ciclesonide) contains 60 sprays, which lasts about a month. Don't use the medication after 60 sprays, even if there's some medication left inside. The remaining medication might not contain the full dose per spray.
If you're pregnant or thinking of becoming pregnant, talk with your healthcare team about treatment options for allergy. More research is needed to understand how Zetonna (ciclesonide) affects pregnancy. Your care team might consider safer options pregnancy, such as budesonide (Rhinocort Allergy).
How to use Zetonna (ciclesonide) nasal aerosol:
If you're opening a new Zetonna (ciclesonide) canister, you need to prime the cansiter before using it. To do so, gently shake and then fully press down on the pump 3 times. If you haven't used a Zetonna (ciclesonide) canister for 10 days in a row, you'll need to re-prime it.
To use Zetonna (ciclesonide) nasal aerosol, blow your nose to clear your nostrils, if needed. Open the purple plastic dust cap and hold the nasal actuator upright. Tilt your head back a little and put the end of the nose piece into 1 nostril, pointing it away from the nasal septum.
When you're ready, press down on the Zetonna (ciclesonide) canister to release 1 spray. At the same time, breathe in gently through the nostril. Hold your breath for a few seconds, then breathe out slowly through your mouth. Repeat for the second spray in your other nostril. Try not to blow your nose for the next 15 minutes.
Throw away the Zetonna (ciclesonide) actuator and canister after the number in the indicator window reaches zero, since the amount of medication delivered per spray after this time may be less than the required dose.
Frequently asked questions about Zetonna (ciclesonide)
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What are the risks and warnings for Zetonna (ciclesonide)?
Zetonna (ciclesonide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Nosebleeds and risk of injury
Risk factors: Nasal surgery | Injury to the nose | Ulcers in the nose
People using Zetonna (ciclesonide) have experienced nosebleeds. This medication is a nasal steroid, which can thin the skin in the nasal passages, which raises the risk of bleeds. If you get a nosebleed, sit down and lean forward, and pinch the soft part of your nose to apply pressure. Continue to hold your nose for about 5 to 10 minutes to give it time for a clot to form. If your nose continues to bleed after this time or if you feel faint, get medical help right away.
Very rarely, people using Zetonna (ciclesonide) reported damage to the nasal septum (bony cartilage between your nostrils). To lower your risk, avoid spraying the medication towards this area. If you do have an injury in the nose, using an nasal steroid can slow down healing. Your healthcare team will examine your nose before you start Zetonna (ciclesonide) and then regularly during treatment to make to make sure there's no damages to your nasal septum.
Don't use this medication if you recently had nasal surgery or injury in the nose. Contact your healthcare team right away if you experience painful discomfort in your nose or have regular nosebleeds.
Risk of infection
Risk factors: Using Zetonna (ciclesonide) for several months | Taking other medications that weakens your immune system | Currently have an infection
Corticosteroids, like Zetonna (ciclesonide), can weaken your immune system and raise your risk for getting an infection. These infections can include fungal infections in the nose or throat area, which are more likely to happen when you use corticosteroid nasal sprays for several months. Other possible infections include viral infections like chickenpox. Once you develop an infection, you might have a harder time recovering from your illness.
Although there haven't been any reports of serious infections linked directly with Zetonna (ciclesonide), be on the lookout for any signs of infection while you're using this medication. Stop using Zetonna (ciclesonide) and contact your primary care provider if you have a fever, pain, aches, or chills, pain while swallowing, redness in the mouth, or white patches in your nose or throat. You might need to stop using Zetonna (ciclesonide) and take prescribed medication to treat the infection.
Altered stress hormone levels
Risk factors: Using Zetonna (ciclesonide) for a long time | Using too much of Zetonna (ciclesonide)
Using higher than the recommended dose of Zetonna (ciclesonide) or suddenly stopping this medication after using it over a long period of time can affect your body’s hormones, leading to too much cortisol or not enough cortisol (adrenal insufficiency).
Symptoms of too much cortisol might include changes in mood, muscle weakness, and round face. And having low cortisol level can lead to symptoms like irritability, nausea, and vomiting. If you experience any of these symptoms, your healthcare team might ask you to stop Zetonna (ciclesonide) slowly over time.
Delayed growth in children
Corticosteroids like Zetonna (ciclesonide) might slow down growth in children. If your child is taking this medication, their pediatrician will monitor their growth regularly. Discuss with your child's pediatrician or primary care provider if you're concerned about how Zetonna (ciclesonide) might affect your child's growth.
Allergic reactions
Allergic reactions to Zetonna (ciclesonide) are possible. These reactions can include life-threatening facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after you use Zetonna (ciclesonide).
Eye and vision problems
Risk factors: History of glaucoma or cataracts | History of high pressure in the eye
Using nasal corticosteroids might raise the pressure in your eyes and cause vision problems, including glaucoma or cataracts. These side effects haven't been reported by people using Zetonna (ciclesonide), but your healthcare team might want to monitor your vision during treatment. Talk to your optometrist (eye specialist) before you use Zetonna (ciclesonide) if you have glaucoma or cataracts. Contact your optometrist if you notice any concerning changes to your vision while you're using the medication.
Zetonna (ciclesonide) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 6.1g of 37mcg | 1 canister | $221.18 | $221.18 |
Typical dosing for Zetonna (ciclesonide)
Each spray of Zetonna contains 37 mcg of ciclesonide.
Adults and children ages 12 years and older: The typical dose is 1 spray per nostril once per day.
Interactions between Zetonna (ciclesonide) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bemiparin
- Lutetium Lu 177 Dotatate
- Macimorelin
- Nadroparin
- Ritonavir
- Sargramostim
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Auranofin
How much does Zetonna (ciclesonide) cost?
What are alternatives to Zetonna (ciclesonide)?
Nasal allergy symptoms (e.g., runny nose, stuffy nose, itchy nose, sneezing) related to seasonal allergies or year-round allergies in people ages 12 years and older
Hay fever and allergy symptoms (nasal congestion, runny nose, sneezing, and itchy nose)
Congestion
Runny nose
Sneezing
Itchy nose
Itchy, watery eyes
Zetonna (ciclesonide) images
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References
Best studies we foundCovid Pharma US, Inc. (2024). Zetonna- ciclesonide aerosol, metered [package insert]. DailyMed.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison’s disease.
Sur, D. K. C., et al. (2015). Treatment of allergic rhinitis. American Family Physician.
You and Your Hormones. (2019). Cortisol.
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