Local side effects

Owing to its small particle size Alvesco^® has low oropharyngeal deposition (Figure 1). Together with the fact that Alvesco^® is delivered as a prodrug that leads to  very low steroid activity in the mouth and throat (Figure 2).^1-3 This improved oral tolerability contributes to better treatment adherence and quality of life (owing to reduced side effects in the mouth and throat), as well as a reduction in the need for spacers and mouth rinsing following administration.⁴

Figure 1: Alvesco^® has lower oropharyngeal deposition than fluticasone propionate¹
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Figure 2: Alvesco^® is associated with a lower incidence of oropharyngeal side effects than fluticasone propionate²
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References:

1. Richter K, Kanniess F, Biberger C, et al. Comparison of the oropharyngeal deposition of inhaled ciclesonide and fluticasone propionate in patients with asthma. J Clin Pharmacol 2005;45:146-152
2. Bateman ED, Linnhof AE, Homik L, et al. Comparison of twice-daily inhaled ciclesonide and fluticasone propionate in patients with moderate-to-severe persistent asthma. Pulm Pharmacol Ther 2008;21:264-275
3. Newman S, Salmon A, Nave R, et al. High lung deposition of 99mTc-labeled ciclesonide administered via HFA-MDI to patients with asthma. Respir Med 2006;100:375-384
4. Buhl R. Local oropharyngeal side effects of inhaled corticosteroids in patients with asthma. Allergy 2006;61:518-526