Ciclohale
✅ Reduces airway inflammation
✅ Controls asthma symptoms
✅ Improves lung function
✅ Prevents asthma attacks
✅ Minimizes respiratory discomfort
Ciclohale contains Ciclesonide.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Ciclohale?
Ciclohale contains ciclesonide, an inhaled corticosteroid (ICS) that reduces airway inflammation in asthma and (selectively) in chronic obstructive pulmonary disease (COPD). Ciclohale is a pressurised metered-dose inhaler (HFA pMDI) from Cipla, delivering 80 mcg or 160 mcg per actuation per dose. Unlike a reliever inhaler (Asthalin, Levolin, Bonair), Ciclohale is a preventer (controller) — used twice daily, every day, even when you feel well. Maximum benefit takes 1–2 weeks. Rinse mouth and gargle with water after every dose to prevent oral thrush and hoarseness.
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What Is Ciclohale?
Ciclohale is an Indian-manufactured generic pressurised metered-dose inhaler (HFA pMDI) of ciclesonide, the same active drug used in international brand Alvesco. Each dose delivers 80 mcg or 160 mcg per actuation. Cipla manufactures Ciclohale at WHO-GMP certified facilities to bioequivalence standards.
How Does Ciclohale Work?
ciclesonide is a topical glucocorticoid delivered directly to the bronchial mucosa. It binds intracellular glucocorticoid receptors, translocates to the nucleus, and:
- Suppresses inflammatory gene transcription — reduces IL-4, IL-5, IL-13, TNF-α, eosinophil and lymphocyte recruitment
- Stabilises airway epithelium — reduces vascular permeability and mucus hypersecretion
- Restores β2-adrenergic receptor responsiveness — reverses tachyphylaxis to relievers
- Reduces airway hyperreactivity — fewer attacks triggered by exercise, cold air, allergens
Effect builds over 1–2 weeks of consistent twice-daily dosing. ciclesonide has high topical potency and undergoes extensive first-pass hepatic metabolism, minimising systemic glucocorticoid effects at standard doses.
Uses and Indications
- Persistent asthma — first-line preventer at all severity levels (GINA Step 1 onward)
- Exercise-induced asthma — daily ICS reduces exercise-triggered bronchospasm
- Cough-variant asthma and eosinophilic bronchitis
- COPD with frequent exacerbations — added to LAMA + LABA when exacerbations recur (selective use; not for COPD without exacerbation history)
- Allergic asthma triggered by pollen, dust, animal dander — daily prevention through allergy season
Ciclohale Dosage
| Patient | Dose | Frequency |
|---|---|---|
| Adults — mild | 80–160 mcg/day | Once daily |
| Adults — moderate | 160–320 mcg/day | Once or twice daily |
| Adults — severe | 320–640 mcg/day | Twice daily |
| Children 6–12 yr | 80–160 mcg/day | Once daily |
How to Use Ciclohale Properly
- Shake the inhaler; remove cap.
- Breathe out fully away from device.
- Seal lips around mouthpiece.
- Press canister at start of slow deep breath (3–5 seconds).
- Hold breath 10 seconds; breathe out gently.
- Rinse mouth, gargle, spit — though ciclesonide produces noticeably less oropharyngeal deposition than older ICS.
Side Effects of Ciclohale
Common (local, dose-related):
- Oral thrush (white candidal plaques in the mouth or throat)
- Hoarse voice / dysphonia
- Sore throat, mild cough on inhalation
- Occasional dry mouth
Less common:
- Slight reduction in growth velocity in children at higher doses (catch-up growth occurs; final adult height largely unaffected)
- Easy bruising of skin at high cumulative doses
- Possible adrenal suppression with high doses or strong CYP3A4 inhibitor co-prescription
- Cataracts and glaucoma at very high cumulative inhaled doses (rare)
- Mild weight gain (much less than with oral steroid)
Serious (stop and seek emergency help):
- Severe allergic reaction / angio-oedema
- Paradoxical bronchospasm immediately after inhalation
- Adrenal crisis during illness or surgery (rare, with high-dose long-term use)
- Pneumonia signs in COPD users (fever, productive cough, breathlessness change) — ICS slightly raises pneumonia risk in COPD
Warnings and Precautions
- {$brand} is a preventer, not a reliever. Do not use during an acute attack — use a SABA (Asthalin, Levolin) instead.
- Take it every day, even when you feel well. Effect builds over 1–2 weeks; it wears off if you skip doses.
- Rinse mouth and brush teeth after every dose to prevent thrush and hoarseness.
- Strong CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin) raise systemic ICS exposure — seek alternative or monitor for Cushing-like effects.
- Do not stop suddenly after months of high-dose use — taper down to allow HPA-axis recovery.
- Pregnancy and breastfeeding: ciclesonide is the most data-supported ICS in pregnancy (especially budesonide). Inhaled at standard doses is far safer than uncontrolled asthma.
- COPD users: ICS slightly raises pneumonia risk — ensure ICS adds value (eosinophilic phenotype, frequent exacerbations).
Contraindications
- Known hypersensitivity to ciclesonide or any formulation excipient
- Untreated active fungal, bacterial, mycobacterial (TB), or viral respiratory infection — treat infection first
- Use with caution in active or quiescent pulmonary tuberculosis
Drug Interactions
| Interacting drug | Effect | What to do |
|---|---|---|
| Strong CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin) | Increase systemic ICS exposure → adrenal suppression / Cushing risk | Avoid prolonged co-use; monitor cortisol if essential |
| Other inhaled or systemic corticosteroids | Additive HPA-axis suppression | Use lowest effective dose; monitor for systemic steroid effects |
| Live vaccines | Reduced immune response if high-dose ICS | Inactivated vaccines preferred during high-dose use |
Storage
- Store below 25°C, protected from direct sunlight and heat.
- Do not refrigerate. Do not freeze.
- Do not puncture the canister; even an empty canister can explode if heated.
- Keep out of reach of children. Use within the expiry date printed on the canister.
Related Alternatives on MedsBase
- Foracort Inhaler — budesonide + formoterol ICS-LABA combo
- Seretide Accuhaler — fluticasone + salmeterol ICS-LABA
- Asthalin Inhaler — salbutamol reliever
- Symbicort Turbohaler — budesonide + formoterol
- Montair — montelukast oral preventer
Frequently Asked Questions
How is ciclesonide different from budesonide or beclomethasone?
Ciclesonide is a prodrug — inactive in the mouth and throat. It is converted to active des-ciclesonide by lung esterases only after deposition in the airway. This dramatically reduces oropharyngeal candidiasis (oral thrush) and dysphonia compared with older ICS, and gives once-daily dosing.
Can I take Ciclohale just once a day?
Yes — once-daily evening dosing is licensed for mild-to-moderate asthma. More severe asthma may need twice-daily.
Do I still need to rinse my mouth?
Less critical than for budesonide or beclomethasone, because ciclesonide is inactive in the mouth — but a quick rinse is still good practice and recommended in product literature.
How fast does Ciclohale work?
Symptom improvement begins within 24 hours; lung function gains accumulate over 1–2 weeks of consistent dosing.
Is Ciclohale safer for children’s growth?
Studies suggest ciclesonide has less effect on growth velocity than older ICS at equivalent doses, because of its low oral bioavailability and high local activation. Final adult height effect of all standard-dose ICS is small.
Can I use Ciclohale in COPD?
Ciclesonide has limited COPD data compared to budesonide and fluticasone. Budesonide-formoterol or fluticasone-salmeterol combinations are preferred for COPD.
Is Ciclohale the same as Alvesco?
Yes — both deliver ciclesonide via HFA pMDI. Alvesco (AstraZeneca) is the international brand; Ciclohale is the Indian-market generic by Cipla.
Can I use a spacer with Ciclohale?
Yes — spacers improve delivery for everyone but are particularly useful in children, the elderly, and during acute attacks.
Why does Ciclohale cost more than Beclate?
Ciclesonide is a newer molecule with more complex chemistry. Per-dose cost is higher, but the side-effect advantage (less thrush, easier once-daily compliance) often justifies the choice for selected patients.
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| Strength | 160 mcg |
|---|---|
| Quantity | 1 Inhaler/s, 2 Inhaler/s, 3 Inhaler/s, 6 Inhaler/s |
Ciclohale
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