When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to ciclesonide. This medicine should not be used during an asthma attack.

How to Use This Medicine:
Liquid Under Pressure

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• This medicine is used with a special inhaler and usually comes with patient instructions. Read and follow these instructions carefully before using this medicine. If you do not understand the directions or you are not sure how to use the inhaler, ask your doctor or pharmacist.
• This medicine has a dose indicator that keeps track of how many more times you can use the inhaler before you need to open a new one. If the dose indicator is not working correctly, do not use the inhaler and return it to your pharmacy or doctor.
• Test spray in the air before using for the first time or if the inhaler has not been used for a while.
• Remove the cap and look at the mouthpiece to make sure it is clean.
• To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.
• Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down on the top of the canister once.
• Hold your breath for about 5 to 10 seconds, and then breathe out slowly.
• When you have finished all your inhalations, rinse your mouth out with water. Do not swallow the water after rinsing.
• You may need to use this medicine for four weeks or longer before you notice improvement in your asthma. Tell your doctor if you do not begin to feel better after using the medicine for four weeks.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are taking ketoconazole (Nizoral®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have bone disease, any type of infection (especially tuberculosis or herpes infection of the eye), or if you have a history of eye problems (such as cataracts or glaucoma).
• This medicine will not stop an asthma attack that has already started. Your doctor may prescribe another medicine for you to use in case of an acute asthma attack.
• You may get infections more easily while using this medicine. Avoid people who are sick or have infections. Tell your doctor right away if you have been exposed to measles or chickenpox.
• If you use a corticosteroid medicine to control your asthma, keep using it as instructed by your doctor.
• If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
• The amount of medicine you need may change during periods of stress, illness, surgery, or after a serious asthma attack. Tell your doctor if you are in any of these situations.
• This medicine may slow down a child's growth. If you think your child is not growing properly while using this medicine, talk with your doctor.
• This medicine may also increase your risk of having infections or sores in your mouth or throat. Check with your doctor right away if you notice any signs of a throat infection.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. Also, you may need to have your eyes checked at regular visits.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Call your doctor if your symptoms do not improve or if they get worse.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Fever, chills, cough, runny or stuffy nose, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting.
• Problems with vision.
• Sores or white patches on your lips, mouth, or throat.
• Worsening of asthma symptoms.

If you notice these less serious side effects, talk with your doctor:

• Back, arm, leg, or joint pains.
• Dry mouth or throat, hoarseness, or voice changes.
• Headache.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088