What is the recommended dose of Alvesco (Ciclesonide) for a 6-year-old child?

From the Guidelines

For a 6-year-old child, Alvesco (ciclesonide) is not typically recommended as it is not FDA-approved for children under 12 years of age in the United States. Instead, the clinician's judgment of the patient's response to therapy is crucial in determining the appropriate dose of an inhaled corticosteroid 1. The recommended dose for a 6-year-old child would likely be an age-appropriate inhaled corticosteroid such as Flovent (fluticasone) or Pulmicort (budesonide), which are approved for children as young as 4 years old.

• Key considerations for dosing include:
  • The dose should be carefully titrated to the minimum dose required to maintain control of asthma
  • Preparations are not interchangeable on a mcg or per-puff basis
  • The safety and efficacy of ICSs in children <1 year has not been established
  • Children <4 years of age generally require delivery of ICS through a face mask that should fit snugly over nose and mouth
• The typical starting dose for these medications in a 6-year-old would be Flovent 44-88 mcg twice daily or Pulmicort 0.25-0.5 mg twice daily, but the exact dose should be determined by the child's physician based on asthma severity, as stated in the expert panel report 3 (epr-3): guidelines for the diagnosis and management of asthma-summary report 2007 1.
• It's essential to monitor for side effects such as oral thrush, which can be prevented by having the child rinse their mouth after each use, and to never adjust the child's asthma medication without consulting their healthcare provider.

From the Research

Recommended Dose of Alvesco (Ciclesonide) for a 6-year-old Child

• The recommended dose of Alvesco (Ciclesonide) for a 6-year-old child is not explicitly stated in the provided studies, but the studies suggest that ciclesonide can be effective in children with asthma at doses of 80 or 160 µg/day 2, 3.
• A study comparing ciclesonide with fluticasone propionate in children with asthma found that ciclesonide 160 µg once daily was not inferior to fluticasone propionate 176 µg twice daily in terms of efficacy 3.
• Another study found that ciclesonide 160 µg once daily was effective in children with asthma and had a similar efficacy profile to budesonide 400 µg once daily 4.
• The studies suggest that the dose of ciclesonide for children with asthma should be individualized based on the severity of the disease and the patient's response to treatment 2, 3, 4.

Efficacy and Safety of Ciclesonide in Children with Asthma

• Ciclesonide has been shown to be effective in improving lung function, reducing asthma symptoms, and decreasing the need for rescue medication in children with asthma 2, 3, 4.
• The safety profile of ciclesonide in children with asthma is similar to that of other inhaled corticosteroids, with a low incidence of adverse events 3, 4, 5.
• Ciclesonide has been found to have a favorable effect on growth in children with asthma, with less reduction in body height compared to budesonide 4.

Comparison with Other Inhaled Corticosteroids

• Ciclesonide has been compared to other inhaled corticosteroids, such as budesonide and fluticasone, in children with asthma, and has been found to have a similar efficacy profile 2, 3, 4.
• The studies suggest that ciclesonide may have a more favorable safety profile compared to other inhaled corticosteroids, with less suppression of cortisol production and less effect on growth 3, 4, 5.