Ciclesonide-induced bronchospasm: an important but preventable side effect

Payal H Mandaliya, Brendan Kennedy, Peter van Asperen and Paul D Robinson
Med J Aust 2015; 203 (5): . || doi: 10.5694/mja15.00014
Published online: 7 September 2015

Despite recent advances in its management, asthma remains a significant ongoing cause of morbidity1 and mortality2 in Australia. Ciclesonide, a newer inhaled corticosteroid, offers exciting potential to improve both asthma control and longer-term outcomes. This is because of its improved safety profile relative to other asthma medications, and the potential for improved adherence to treatment, given its proven efficacy as a once-daily medication.3 It is administered as a prodrug, activated within the lungs, and has lower oral bioavailability and extensive first-pass metabolism which reduces its systemic side effect profile.4 In Australia, ciclesonide is now available on the Pharmaceutical Benefits Scheme for use in children from the age of 6 years. Despite increasing use of this drug, side effects are infrequently reported.

  • 1 Children's Hospital at Westmead, Sydney, NSW
  • 2 University of Sydney, Sydney, NSW

Competing interests:

No relevant disclosures.

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  • 2. Ombudsman New South Wales. NSW Child Death Review Team Annual Report 2013. Sydney: Ombudsman New South Wales, 2014. (accessed Jun 2015).
  • 3. Gelfand EW, Georgitis JW, Noonan M, Ruff ME. Once-daily ciclesonide in children: efficacy and safety in asthma. J Pediatr 2006; 148: 377-383.
  • 4. Lipworth BJ, Kaliner MA, LaForce CF, et al. Effect of ciclesonide and fluticasone on hypothalamic–pituitary–adrenal axis function in adults with mild-to-moderate persistent asthma. Ann Allergy Asthma Immunol 2005; 94: 465-472.
  • 5. National Asthma Council Australia. Australian asthma handbook, Version 1.1. Melbourne: NAC Australia, 2014. (accessed Jun 2015).


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