Administer ZETONNA Nasal Aerosol by the intranasal route only. Prior to the initial use, ZETONNA Nasal Aerosol must be primed by actuating three times. If ZETONNA Nasal Aerosol is not used for ten consectutive days, it must be primed by actuating three times. If ZETONNA Nasal Aerosol is dropped, the canister and actuator may become separated. If this happens, reassemble ZETONNA Nasal Aerosol and test spray once into the air before using. Illustrated patient's instructions for proper use accompany each package of ZETONNA Nasal Aerosol.
Adults and Adolescents (12 Years of Age and Older)
The recommended dose of ZETONNA Nasal Aerosol is 1 actuation per nostril once daily (37 mcg per actuation). The maximum total daily dosage should not exceed 1 actuation in each nostril (74 mcg per day).
Stayability is a registered trademark of Sunovion Pharmaceuticals Inc.
In clinical studies local nasal effects of epistaxis, ulcerations, and nasal septal perforations were observed with ZETONNA® (ciclesonide) Nasal Aerosol. In the short-term and long term trials combined, nasal septal perforations were reported in 2 patients of 2335 treated with ZETONNA Nasal Aerosol compared with none of 892 treated with placebo. Both perforations occurred in 2 week SAR trials while none occurred in the longer term trials. In clinical trials with another formulation of ciclesonide, the development of localized infections of the nose or pharynx with Candida albicans has occurred. Corticosteroids can interfere with wound healing.
Prior to initiating therapy, examine patients for evidence of septal perforation, erosions, ulceration, nasal surgery, and trauma. Avoid spraying ZETONNA Nasal Aerosol directly onto the nasal septum. Avoid use in patients with recent septal perforation, nasal erosion, nasal ulcers, nasal surgery, or nasal trauma. Monitor patients periodically for signs of adverse reactions on the nasal mucosa. Discontinue ZETONNA Nasal Aerosol if erosions, ulcerations or perforations occur.
Nasal and inhaled corticosteroids may result in the development of glaucoma and cataracts. Monitor patients closely with a change in vision or with a history of increased intraocular pressure, glaucoma, or cataracts.
ZETONNA Nasal Aerosol is contraindicated in patients with a known hypersensitivity to ciclesonide or any of the ingredients of ZETONNA Nasal Aerosol. Cases of hypersensitivity reactions following administration of ciclesonide with manifestations such as angioedema, with swelling of the lips, tongue and pharynx have been reported.
Patients who are using immunosuppressant doses of corticosteroids are more susceptible to infections than healthy individuals. Chicken pox and measles can have a more serious or even fatal course in susceptible individuals. Inhaled corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculosis infections of the respiratory tract; untreated local or systemic fungal or bacterial infections, systemic viral or parasitic infections; or ocular herpes simplex because of the potential for worsening of these infections.
When intranasal corticosteroids are used at very high dosages or at the regular dosage in susceptible individuals, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear. If such changes occur, discontinue ZETONNA Nasal Aerosol slowly.
Corticosteroids may cause a reduction in growth velocity in children. Monitor growth routinely in pediatric patients receiving ZETONNA Nasal Aerosol.
In trials 2-6 weeks in duration, the most common adverse reactions that occurred with an incidence of at least 2% and more frequently with ZETONNA Nasal Aerosol than with placebo were nasal discomfort (3.2%), headache (3.1%) and epistaxis (2.9%).
For additional information, please see the ZETONNA Nasal Aerosol Full Prescribing Information.
ZETONNA® (ciclesonide) Nasal Aerosol is a corticosteroid indicated for the treatment of symptoms associated with seasonal and perennial allergic rhinitis in adults and adolescents 12 years of age and older.