Ciclesonide used, Side, Doses, mechanism of action & more

 Ciclesonide

Brand name:- Ciclez 80ûg and 160ûg per metered inhaler.

Ciclesonide is a steroid which works by blocking the production of certain chemical messengers in the body that cause inflammation (redness and swelling) and allergies.

Pharmacodynamic:- 

Ciclesonide is a pro-drug that is enzymatically hydrolyzed to a pharmacologically active metabolite, C21- desisobutyryl- ciclesonide (des- ciclesonide or RM1) following intranasal application. Des- ciclesonide has anti-inflammatory activity with affinity for the glucocorticoid receptor that is 120 times higher than the parent compound. The precise mechanism through which ciclesonide affects allergic rhinitis symptoms is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in allergic inflammation.

Mechanism of action:- 

Glucocorticoids such as ciclesonide can inhibit leukocyte infiltration at the site of inflammation, interfere with mediators of inflammatory response, and suppress humoral immune responses. The antiinflammatory actions of glucocorticoids are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes. Ciclesonide reduces inflammatory reaction by limiting the capillary dilatation and permeability of the vascular structures. These compounds restrict the accumulation of polymorphonuclear leukocytes and macrophages and reduce the release of vasoactive kinins. Recent research suggests that corticosteroids may inhibit the release of arachidonic acid from phospholipids, thereby reducing the formation of prostaglandins. Ciclesonide is a glucocorticoid receptor agonist. On binding, the corticoreceptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing an increase or decrease in expression of specific target genes, including suppression of IL2 (interleukin 2) expression.

Used:-

Used in the treatment of allergic conditions.

 Side Effects:-   

Joint pain, Headache, Nasal congestion (stuffy nose), Nasopharyngitis (inflammation of the throat and nasal passages), Sinus inflammation, Pharyngolaryngeal pain, Upper respiratory tract infection, Pain in extremity, Back pain, Nasal discomfort, Nosebleeds.

Dose:-  80-160ug by inhalation OD , preferably in the evening. As directed by your doctor.