ciclesonide
Brand names: Alvesco
Omnaris Nasal Spray is a medicine that helps treat nasal allergy symptoms. It contains a corticosteroid to reduce inflammation in your nose.
Drug Pricing (NADAC)
Brand Price
$43.10/unit
Generic Available
No
COVIS
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Omnaris Nasal Spray treats nasal symptoms from seasonal allergies in adults and kids 6 years and older.
Common side effects
Headache, Nosebleeds, Common cold
Key warnings
Omnaris may cause nosebleeds or Candida (fungal) infections in the nose.
How It Works
Omnaris contains ciclesonide, a corticosteroid. It works by reducing inflammation in your nasal passages. This helps to relieve allergy symptoms like congestion and runny nose.
How to Take It
Use Omnaris Nasal Spray only in your nose. Shake the bottle gently before each use. Prime the pump by spraying 8 times before the first use. If you haven't used it for 4 days, re-prime with 1 spray. Spray 2 times in each nostril once a day.
Pregnancy & Breastfeeding
There is not enough information about Omnaris use in pregnant women. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if Omnaris passes into breast milk.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store Omnaris at room temperature (77°F). Do not freeze. Keep out of reach of children.
Side Effects (from patient reports)
Based on 26,955 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 13,075 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2006–2025.
Total Reports
13,075
Death-Related Reports
576
Hospitalization Reports
5,864
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | ASTHMA | 5,711 |
| 2 | DYSPNOEA | 4,479 |
| 3 | WHEEZING | 3,589 |
| 4 | THERAPEUTIC PRODUCT EFFECT INCOMPLETE | 2,550 |
| 5 | COUGH | 2,483 |
| 6 | OBSTRUCTIVE AIRWAYS DISORDER | 1,752 |
| 7 | LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES | 1,734 |
| 8 | PNEUMONIA | 1,686 |
| 9 | DRUG INEFFECTIVE | 1,506 |
| 10 | PRODUCTIVE COUGH | 1,464 |
| 11 | SLEEP DISORDER DUE TO A GENERAL MEDICAL CONDITION | 1,439 |
| 12 | FATIGUE | 1,251 |
| 13 | CHEST DISCOMFORT | 1,169 |
| 14 | MALAISE | 1,112 |
| 15 | CONDITION AGGRAVATED | 1,056 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Omnaris may cause nosebleeds or Candida (fungal) infections in the nose. It could cause a hole in the nasal septum, or slow wound healing. It may also increase the risk of glaucoma or cataracts. Tell your doctor if you have vision changes or a history of eye problems. Omnaris may worsen existing infections like tuberculosis, herpes, or chickenpox. High doses can cause hormone and adrenal problems. It may slow down growth in children, so growth should be monitored.
Known Drug Interactions
betamethasone budesonide ciclesonide fluticasone methylprednisolone mometasone triamcinolone ↑ corticosteroids Co-administration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing's syndrome and adrenal suppression.
Mechanism: Darunavir blocks the enzymes that break down ciclesonide, leading to an increased risk of serious hormonal side effects.
What to do: Consult your healthcare provider about adjusting your dose or watching for symptoms like unusual weight gain.
Corticosteroids primarily metabolized by CYP3A betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, triamcinolone ↑ corticosteroid Co-administration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing’s syndrome and adrenal suppression.
Mechanism: Ritonavir blocks the enzyme that breaks down ciclesonide, which causes the steroid to build up to high levels in your body. This increase can lead to serious hormonal issues like Cushing's syndrome.
What to do: Your doctor may need to monitor you closely for side effects or consider adjusting your steroid dose.
In a drug interaction study, co-administration of orally inhaled ciclesonide and oral ketoconazole, a potent inhibitor of cytochrome P450 3A4, increased the exposure (AUC) of des-ciclesonide by approximately 3.6-fold at steady state, while levels of ciclesonide remained unchanged.
Mechanism: Ketoconazole blocks the enzyme that breaks down the active part of this medicine. This causes the drug levels in your body to rise significantly.
What to do: Your doctor should monitor you closely for side effects. They may need to adjust your treatment if you experience problems.
Erythromycin, a moderate inhibitor of cytochrome P450 3A4, had no effect on the pharmacokinetics of either des-ciclesonide or erythromycin following oral inhalation of ciclesonide [see Clinical Pharmacology ( 12.3 )] .
Mechanism: Erythromycin does not interfere with how your body handles this medicine.
What to do: No special changes are needed when taking these two drugs at the same time.
7 DRUG INTERACTIONS In vitro studies and clinical pharmacology studies suggested that des-ciclesonide has no potential for metabolic drug interactions or protein binding-based drug interactions [see Clinical Pharmacology ( 12.3 )] . In a drug interaction study, co-administration of orally inhaled ciclesonide and oral ketoconazole, a potent inhibitor of cytochrome P450 3A4, increased the exposure (AUC) of des-ciclesonide by approximately 3.6-fold at steady state, while levels of ciclesonide remained unchanged. Erythromycin, a moderate inhibitor of cytochrome P450 3A4, had no effect on the ph...
Mechanism: This drug does not seem to change how other medicines are broken down or carried in the blood.
What to do: You generally do not need to worry about this drug causing interactions with other medications.
Common Questions
How long does it take for Omnaris to work?
Can I use Omnaris if I have a cold?
Can Omnaris cause nosebleeds?
Can I use Omnaris with other allergy medicines?
How long can I use Omnaris?
What should I do if Omnaris doesn't seem to be working?
Can Omnaris affect my vision?
Is it okay to share my Omnaris nasal spray with someone else?
What do I do if I spray Omnaris in my eyes?
How often should I clean the Omnaris nasal spray nozzle?
What are the common side effects of ciclesonide?
Does ciclesonide interact with other medications?
What drug class is ciclesonide?
Is ciclesonide safe during pregnancy?
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for ciclesonide
The FDA label for ciclesonide (sold under brand names such as Alvesco) classifies it as a prescription-only medication in the Inhaled Corticosteroid class. Omnaris Nasal Spray treats nasal symptoms from seasonal allergies in adults and kids 6 years and older. Official labeling lists 5 commonly reported side effects, including Headache, Nosebleeds, Common cold.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 26,955 voluntary reports. The database also lists 6 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: November 8, 2022
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages