Can I use Omnaris (ciclesonide) nasal spray while breastfeeding?

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Last updated: March 23, 2026 • View editorial policy

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Omnaris (Ciclesonide) Use During Breastfeeding

Omnaris nasal spray can be used with caution during breastfeeding, though specific data on ciclesonide excretion in human milk are lacking.

Key Recommendation

Based on the FDA drug label and general corticosteroid safety data, ciclesonide nasal spray is likely compatible with breastfeeding, but caution is advised due to limited human lactation data. 1

Evidence-Based Rationale

Direct Evidence on Ciclesonide and Breastfeeding

  • The FDA label explicitly states that it is not known if ciclesonide is excreted in human milk 1
  • Animal studies in lactating rats showed minimal but detectable levels of ciclesonide recovered in milk 1
  • The label recommends that "caution should be used when OMNARIS Nasal Spray is administered to nursing women" 1

Extrapolation from Corticosteroid Class Data

  • Other corticosteroids are known to be excreted in human milk, but have been used extensively during breastfeeding with no evidence of adverse effects 2
  • The Association of Anaesthetists guideline (2020) notes that dexamethasone and other corticosteroids have been used extensively during breastfeeding with no evidence of any effects 2
  • Inhaled and nasal treatments for asthma and allergic rhinitis are unlikely to affect breastfed infants 3

Supporting Evidence for Intranasal Corticosteroids

  • A 2020 guideline on airways disease management states that ciclesonide (intranasal) is "probably safe" and "compatible" with breastfeeding, though it notes minimal experience during human lactation 4
  • The systemic absorption of intranasal corticosteroids is generally low, which reduces the theoretical risk of infant exposure through breast milk 3

Clinical Approach

When to Use

  • Omnaris can be considered when the maternal benefit of treating allergic rhinitis outweighs the theoretical risk to the infant 1
  • Prioritize use when symptoms significantly impact maternal quality of life or when non-pharmacologic measures have failed

Monitoring Considerations

  • Monitor the infant for any unusual symptoms, though adverse effects are unlikely given the low systemic absorption of intranasal corticosteroids 1
  • No specific "pump and dump" or feeding timing restrictions are necessary based on available evidence

Alternative Considerations

  • If there is significant concern, other intranasal corticosteroids with more established lactation safety data (such as budesonide or fluticasone) could be considered, though the practical difference in risk is likely minimal 4

Important Caveats

  • The lack of human lactation data for ciclesonide specifically means we must rely on class effects and animal data 1
  • The minimal systemic absorption with intranasal administration makes clinically significant infant exposure unlikely 3
  • Most maternal medications are compatible with breastfeeding, and the theoretical risks should be balanced against the known benefits of continued breastfeeding 5, 3

References

3
Research

Medication Safety in Breastfeeding.

American family physician, 2022

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.