Ciclesonide-induced bronchospasm: an important but preventable side effect

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.