Alvesco (ciclesonide) is a prescription drug used to prevent asthma symptoms. The drug comes as an aerosol inhaler that’s usually used twice daily.
Alvesco is used in adults and certain children as a maintenance treatment to help prevent asthma symptoms.
Alvesco is not meant to treat immediate symptoms of an asthma attack. For this, your doctor will prescribe a rescue inhaler.
The active ingredient in Alvesco is ciclesonide. An active ingredient is what makes a drug work. Alvesco belongs to a group of drugs called corticosteroids.
This article describes the dosages of Alvesco, as well as its strengths and how to use it. To learn more about Alvesco, see this in-depth article.
The table below highlights the basics of Alvesco’s dosage. All doses are listed in micrograms (mcg).
| Prior asthma treatment | Starting dosage | Maximum dosage |
|---|---|---|
| if using bronchodilators alone | 80 mcg twice daily | 160 mcg twice daily |
| if using inhaled corticosteroids | 80 mcg twice daily | 320 mcg twice daily |
| if taking oral corticosteroids | 320 mcg twice daily | 320 mcg twice daily |
Keep reading for more details about Alvesco’s dosage.
What is Alvesco’s form?
Alvesco comes in an aerosol inhaler which releases the medication as a fine mist into your lungs.
What strengths does Alvesco come in?
Alvesco comes in two strengths:
- 80 mcg per dose
- 160 mcg per dose
Each Alvesco inhaler contains 60 puffs or inhalations.
What are the usual dosages of Alvesco?
Your dosage of Alvesco depends on the severity of your condition and other asthma medications you’ve used in the past. Your doctor will start you on the best dose to meet your needs.
They may increase your dose slowly if you don’t respond to the starting dose after 4 weeks of treatment. Ultimately, they’ll prescribe the lowest dosage that provides the desired effect to manage your symptoms.
The information below describes dosages that are commonly used or recommended. But it’s important to follow your doctor’s directions for Alvesco.
Alvesco is not meant to be used for an immediate asthma attack when you have trouble breathing. It’s only used to prevent asthma symptoms. Your doctor will likely prescribe arescue inhaler to treat any asthma attacks during your Alvesco treatment.
Dosage for asthma
The typical Alvesco dosage for adults depends on your prior asthma treatment and the severity of your symptoms.
- If you used a bronchodilator: The recommended starting dosage is 80 mcg (one inhalation) twice per day. The maximum dosage is 160 mcg twice per day. Examples of bronchodilators include:
- albuterol (ProAir, Ventolin HFA, Proventil)
- levalbuterol (Xopenex)
- If you used an inhaled corticosteroid: The recommended starting dosage is 80 mcg inhaled twice per day. The maximum dosage is 320 mcg twice per day. Examples of inhaled corticosteroids include:
- fluticasone propionate (Flovent)
- budesonide (Pulmicort)
- If you took an oral corticosteroid: The recommended starting dosage is 320 mcg inhaled twice per day. The maximum dosage is also 320 mcg twice per day. (Your doctor may try to lower your dose of the oral corticosteroid slowly after you’ve been on Alvesco for a week. They’ll monitor you closely to see how you respond to Alvesco treatment.) Examples of oral corticosteroids include:
If you have questions about your dosage of Alvesco, talk with your doctor to learn more.
What’s the dosage of Alvesco for children?
Alvesco is used to help prevent asthma symptoms in children ages 12 years and older. The dosage for children is the same as the dosage for adults. To learn more, see the “What are the usual dosages of Alvesco?” section above.
For more information about Alvesco’s dosage for children, talk with your child’s doctor or a pharmacist.
Is Alvesco used long term?
Yes, Alvesco is usually used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely use it long term.
The dosage of Alvesco you’re prescribed may depend on several factors. These include:
- the severity of your asthma
- other medications you may be taking to manage your asthma symptoms
Alvesco is released as a fine mist into your lungs using an aerosol inhaler. Your doctor or pharmacist will show you how to use the inhaler when you first start treatment.
You’ll need to prime your Alvesco inhaler three times before you use it for the first time. You’ll also need to prime the inhaler if you haven’t used it for more than 10 days. You can see detailed instructions on how to prime and use your Alvesco inhaler on the manufacturer’s website. Your doctor or pharmacist can also show you how to do this.
You’ll likely use Alvesco twice per day. Try to use the inhaler around the same times daily to best help manage your asthma symptoms.
Be sure to rinse or gargle your mouth with water and spit after using your Alvesco inhaler. This will help prevent oral thrush (a fungal infection in your mouth).
For information on the expiration, storage, and disposal of Alvesco, check out the “Expiration” section of this article or talk with your doctor or pharmacist.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print
- use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you miss a dose of Alvesco, talk with your doctor or pharmacist. They may suggest using your Alvesco inhaler, or skipping your missed dose and continuing with your next regularly scheduled dose.
If you need help remembering to use your Alvesco inhaler on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not use more Alvesco than your doctor prescribes, as this can lead to harmful effects.
What to do in case you use too much Alvesco
Call your doctor right away if you think you’ve inhaled too much Alvesco. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
Below are answers to some commonly asked questions about Alvesco’s dosage.
Is Alvesco’s dosage similar to that of Advair HFA?
Alvesco and Advair HFA have similar forms and frequency of use. Both drugs come in aerosol inhalers that spray a fine mist of medication you inhale into your lungs to help prevent asthma symptoms.
But there are also important differences between these two drugs.
Alvesco contains one active ingredient* (ciclesonide), which is a corticosteroid. Alvesco’s dosage is based on the severity of your symptoms and other medications you’ve taken in the past. It’s typically inhaled twice per day to help prevent asthma.
Advair HFA contains two active ingredients:
- fluticasone, a corticosteroid
- salmeterol, a long-acting beta2-agonist
Your dosage of Advair HFA depends on your age and the severity of your symptoms. A dose is typically inhaled twice per day to help prevent asthma symptoms.
The dose in micrograms for each drug also differs.
Alvesco comes in two strengths: 80 mcg and 160 mcg per puff. Each inhaler contains 60 puffs.
Advair HFA comes in three strengths:
- 45 mcg fluticasone propionate and 21 mcg salmeterol per puff (45/21)
- 115 mcg fluticasone propionate and 21 mcg salmeterol per puff (115/21)
- 230 mcg fluticasone propionate and 21 mcg salmeterol per puff (230/21)
Each Advair HFA inhaler may contain either 60 puffs or 120 puffs.
Your doctor will prescribe the drug and the dosage that’s right for you. Talk with them to learn more about how these drugs compare.
* An active ingredient is what makes a drug work.
How long does it take for Alvesco to start working?
Based on studies of Alvesco, it may take up to 4 weeks or more for the drug to start working to prevent asthma symptoms. Your doctor will monitor how you respond to the starting dose of Alvesco. Then they may slowly increase your dose after 4 weeks if the starting dose isn’t managing your symptoms.
Do not stop using Alvesco on your own. If you feel the medication isn’t managing your symptoms, talk with your doctor. They can discuss your symptoms with you and determine whether this is the best medication for treating your condition.
If you have other questions about what to expect from Alvesco treatment, talk with your doctor.
The sections above describe the usual dosages provided by the manufacturer. If your doctor recommends Alvesco, they’ll prescribe the dosage that’s right for you. You should not change your dosage without their recommendation. Only use this drug exactly as prescribed.
Talk with your doctor if you have questions or concerns about your current dosage. Examples of questions you may want to ask include:
- Is my risk of side effects higher with the maximum dose of Alvesco?
- Does my cost for the medication depend on my dosage?
- How does the dosage of Alvesco compare with that of Wixela?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.