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Zetonna (ciclesonide) is a man-made steroid that prevents the release of substances in the body that cause inflammation.

Zetonna nasal spray is used to treat nasal symptoms (congestion, sneezing, runny nose) caused by seasonal allergies in adults and children as young as 6 years old. Zetonna is also used to treat nasal symptoms caused by year-round allergies in adults and children who are at least 12 years old.

Zetonna may also be used for purposes not listed in this medication guide.

Important information

Before using Zetonna, tell your doctor if you have asthma, glaucoma, tuberculosis or other infection of the lungs, an open sore inside your nose, or a recent nose injury or surgery. Tell your doctor if you are or have been using any other steroid medications: oral, inhaled, or injected.

Zetonna comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

It may take 1 to 2 days before your symptoms improve. Keep using Zetonna as directed and tell your doctor if your symptoms do not improve after 2 to 5 weeks of treatment.

If you stopped using another steroid medication when you started using Zetonna, you may have steroid withdrawal symptoms. These symptoms include joint or muscle pain, depression, and weakness. Do not stop using any steroid medication without first talking to your doctor. You may need to use less and less before you stop Zetonna completely.

Although it is not likely that your body will absorb enough ciclesonide, when receiving doses of Zetonna nasal spray, to cause serious side effects, tell your doctor if you have any steroid-related symptoms such as irregular menstrual periods, acne, increased hair growth, swelling, rapid weight gain, roundness of the face, increased sweating, depression, anxiety, or unusual thoughts or behavior.

Call your doctor at once if you have sores or white patches inside or around your nostrils, or if you have any vision problems, such as tunnel vision.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using steroid medication such as Zetonna.

Before using this medicine

You should not use Zetonna if you are allergic to ciclesonide.

To make sure Zetonna is safe for you, tell your doctor if you have:

  • asthma, tuberculosis, or other lung problems;

  • any type of infection caused by bacteria, virus, fungus, or parasites;

  • glaucoma, cataracts, or herpes infection of the eyes;

  • a sore inside your nose that has not yet healed;

  • a recent nose injury or surgery; or

  • if you have recently used any other steroid medicine (methylprednisolone, prednisone, beclomethasone, fluticasone, dexamethasone, and others).

It is not known whether Zetonna will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether ciclesonide nasal passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Steroid medicine can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using Zetonna.

How should I use Zetonna?

Use Zetonna exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

If you switched to Zetonna from another steroid medicine, do not stop using the other steroid suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about tapering your steroid dose before stopping completely.

The usual dose of Zetonna is 1 spray in each nostril once daily. Carefully follow your doctor"s dosing instructions.

Before you use Zetonna nasal spray for the first time or if you have not used your medicine for 10 days in a row, you will need to prime the aerosol.

  1. Open the purple plastic dust cap by gently squeezing both sides and pulling the cap away from the nasal actuator.

  2. Hold the nasal actuator upright.

  3. Spray 3 times into the air away from the face, by pressing down fully on the top of the canister three times. Make sure the canister returns to its original position after each spray.

Using Zetonna nasal spray.

  1. Open the purple plastic dust cap.

  2. Hold the nasal actuator upright, with the nose piece pointing upwards, between your thumb and forefinger (and middle finger).

  3. Tilt your head back slightly and insert the end of the nose piece into 1 nostril, pointing it slightly toward the outside nostril wall away from the nasal septum (the wall between the 2 nostrils), while holding your other nostril closed with 1 finger. Do not get any spray in your eyes or directly on your nasal septum.

  4. Press down on the canister to release 1 spray and at the same time breathe in gently through the nostril. Hold your breath for a few seconds then breathe out slowly through your mouth.

  5. Remove the nose piece from your nostril. Make sure the canister has returned to its original position and repeat steps 2-4 for the second spray in your other nostril.

  6. Replace the protective purple dust cap on the nasal actuator.

  7. Avoid blowing your nose for the next 15 minutes.

Store Zetonna in an upright position at room temperature, away from moisture and heat. Do not allow the medicine to freeze. Keep the spray bottle clean and dry.

Keep the Zetonna canister away from open flame or high heat, such as in a car on a hot day. The canister may explode if it gets too hot. Do not puncture or burn an empty canister.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Zetonna?

Avoid getting Zetonna in your eyes. If this does happen, rinse with water and call your doctor.

Steroid medicine can weaken your immune system. Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using Zetonna.

Zetonna side effects

Get emergency medical help if you have signs of an allergic reaction to Zetonna: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Nasal steroid medicine can be absorbed into your bloodstream, which may cause steroid side effects throughout the body. Tell your doctor if you have:

  • weight gain (especially in your face or your upper back and torso);

  • slow wound healing, thinning skin, increased body hair;

  • irregular menstrual periods, changes in sexual function; or

  • muscle weakness, tired feeling, depression, anxiety, feeling irritable.

Call your doctor at once if you have:

  • runny or bloody nose, crusting inside the nose, whistling sound when you breathe;

  • sores or white patches in or around your nostrils;

  • fever, chills, body aches, nausea, vomiting;

  • blurred vision, tunnel vision, eye pain, seeing halos around lights; or

  • signs of a hormonal disorder--worsening tiredness or weakness, feeling light-headed, vomiting, loss of appetite, diarrhea, and weight loss.

Common Zetonna side effects may include:

  • headache, dizziness;

  • nosebleed, nasal irritation;

  • stuffy nose, sore throat; or

  • ear pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Zetonna?

Other drugs may interact with ciclesonide nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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