When This Medicine Should Not Be Used:
Do not use this medicine if you have had an allergic reaction to ciclesonide.

How to Use This Medicine:
Spray

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Only use this medicine in the nose. Do not get it in your eyes, on the nasal septum (the wall between the nostrils), or on your skin. If it does get on these areas, rinse it off right away.
• You may need to use this medicine for a few days before you start to feel better.
• If you are using the nasal spray for the first time, you will need to prime the spray. To do this, pump or squeeze the bottle until some of the medicine sprays out. Now it is ready to use. Prime the spray after each time you clean the pump, or if you have not used the medicine for 5 days or longer. Shake the canister gently before each use.
• Before using the medicine, gently blow your nose to clear the nostrils.
• After using the nasal spray, wipe the tip of the bottle with a clean tissue and put the cap back on. Do not wash or put any part of Zetonna™ nasal spray in water.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

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 also use ketoconazole (Nizoral®) or other steroid medicines (such as prednisone, Orasone®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding or if you have tuberculosis (now or in the past), an infection (including a cold or the flu), a herpes simplex eye infection, a history of glaucoma or cataracts, or a recent exposure to chickenpox or measles.
• Make sure your doctor knows if you have had nose surgery, a nose injury, or sores or ulcers in your nose. You may need to stop using the medicine to allow your nose to heal.
• This medicine may cause nasal side effects. Check with your doctor right away if you have bloody mucus, sores inside the nose, unexplained nosebleeds, or a whistling sound when you breathe while you are using this medicine.
• This medicine may cause thrush (a fungus infection) in the nose or throat. Tell your doctor right away if you have white patches in your throat or mouth or pain when you swallow.
• Check with your doctor right away if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an eye doctor.
• You may get infections more easily while you use this medicine. Avoid close contact with anyone who has chickenpox or measles if you have never had these infections. Tell your doctor right away if you think you have been exposed to chickenpox or measles.
• Talk to your doctor if you have more than one of these symptoms while you are using this medicine: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or weight loss. These may be symptoms of adrenal gland problems, which can happen if you use this medicine for a long time or use too much of it.
• This medicine may cause children to grow more slowly than normal. Talk with your child's doctor if you think your child is not growing properly or if you have any questions about this.
• 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
• Changes in vision
• Fever, chills, cough, sneezing, sore throat, and body aches
• Heavy bleeding from your nose
• Red or white patches on your tongue, mouth, or throat
• Unusual tiredness or weakness, diarrhea, loss of appetite, nausea, or vomiting

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

• 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