Zetonna Warnings and Precautions

Because some people may have an increased risk for certain problems with Zetonna, make sure your healthcare provider knows if you have recently had nasal surgery or any type of infection. There are other precautions for using Zetonna safely, including important warnings for women who are pregnant or breastfeeding and people who are taking certain medications.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to using Zetonna™ (ciclesonide) if you have:
  • Tuberculosis, herpes, or any other infections
  • Not had chickenpox or the measles, and have not been vaccinated against them
  • Recently had nasal surgery
  • Sores or injury to the inside of your nose
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Zetonna

Some warnings and precautions to be aware of prior to using this nasal spray include the following:
  • In studies, there were many cases of nosebleeds and a few cases of nasal ulceration (sores) or even perforation of the nasal septum (the cartilage that divides the nose in two halves, between the nostrils). Let your healthcare provider know right away if you develop nosebleeds or nasal sores, as catching this early may help prevent nasal septum perforation. Also, avoid spraying the medicine toward the nasal septum; instead, aim the spray toward the outside of the nostrils.
  • Zetonna is a steroid and may suppress the immune system. Although this is more likely to occur with oral or injectable steroids, it is still possible with nasal steroids like Zetonna. Taking steroids may increase your risk for infections. Certain infections, such as chickenpox or the measles, may be more dangerous if you are using this nasal spray. Let your healthcare provider know right away if you are exposed to chickenpox or the measles if you have not had these infections and have not been vaccinated against them.
  • If you are switching from an oral steroid to Zetonna, which is a nasal steroid, your healthcare provider should slowly decrease your dose of the oral steroid. Stopping an oral steroid too quickly can be quite dangerous.
  • This medication can suppress the body's ability to make natural steroids. This usually happens when too much Zetonna is used or if you are very sensitive to the medication. In such circumstances, Zetonna should be stopped gradually to give your body a chance to begin making natural steroids again.
  • Before starting Zetonna, make sure to tell your healthcare provider if you currently have any type of infection. Also, let him or her know if you have ever had tuberculosis or a herpes infection of the eye; this drug may weaken the immune system, allowing these infections to worsen.
  • Like all steroids, Zetonna may slow down the growth rate of children and teenagers. Contact your child's healthcare provider if you are concerned about a slow growth rate in your child.
  • Corticosteroids, including Zetonna, can slow healing. Therefore, if you have had recent nasal surgery or nasal sores, you should wait until healing has occurred before using Zetonna. Also, corticosteroids can cause nosebleeds and nasal sores or irritation.
  • Zetonna is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are currently unknown (see Zetonna and Pregnancy).
  • It is unknown if ciclesonide, the active ingredient in Zetonna, passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider before using this product (see Zetonna and Breastfeeding).
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