ciclomate 320 mcg/4.5 mcg transcaps - Ciclesonide (320mcg) + Formoterol (4.5mcg) medicine

Ciclomate 320 mcg/4.5 mcg Transcaps: Complete Medicine Guide

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🏭 Lupin Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 24, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for asthma; moderate for COPD.
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Difficulty breathing or worsening of asthma symptoms after use
  • Chest pain or palpitations
  • Severe allergic reaction (rash, swelling, difficulty breathing)
  • Signs of adrenal insufficiency (fatigue, weakness, nausea)
  • Vision changes or eye pain
  • Increased thirst or frequent urination

If experiencing severe symptoms, call emergency services immediately.

What is ciclomate 320 mcg/4.5 mcg transcaps used for?

This medicine is a combination inhaler used for maintenance treatment of asthma and COPD. It contains ciclesonide (a steroid) and formoterol (a long-acting bronchodilator). It is not for sudden breathing attacks.

  • Generic Name: Ciclesonide + Formoterol
  • Manufacturer: Lupin Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 ciclomate 320 mcg/4.5 mcg transcaps के बारे में (Hindi Summary)

उपयोग: यह दवा अस्थमा और क्रोनिक ऑब्सट्रक्टिव पल्मोनरी डिजीज (सीओपीडी) के रखरखाव उपचार के लिए उपयोग की जाती है। यह सूजन को कम करती है और श्वास नलियों को खोलती है। यह तुरंत राहत के लिए नहीं है।

साइड इफेक्ट्स: आम दुष्प्रभावों में सिरदर्द, गले में जलन, आवाज में भारीपन और कंपन शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं लेकिन एलर्जी, दिल की धड़कन बढ़ना और अधिवृक्क ग्रंथि की कमी हो सकती है।

सुरक्षा सलाह: इस दवा का उपयोग केवल डॉक्टर के निर्देशानुसार करें। उपयोग के बाद मुँह को पानी से धोएं। आपातकालीन राहत इनहेलर हमेशा साथ रखें। दवा अचानक बंद न करें।

💡 Did You Know? India is the largest provider of generic medicines globally, supplying over 50% of global vaccine demand.

💊 ciclomate 320 mcg/4.5 mcg transcaps Uses & Benefits

[{"condition":"Asthma","description":"Maintenance treatment to control symptoms and prevent exacerbations in adults with persistent asthma.","evidence":"Well-established"},{"condition":"Chronic Obstructive Pulmonary Disease (COPD)","description":"May be used to improve lung function and reduce symptoms in selected patients with COPD.","evidence":"Moderate"}]

Off-label uses: []

Primary treatment for: Asthma

Also treats: Chronic Obstructive Pulmonary Disease (COPD)

📋 Drug Information

Generic Name(s)Ciclesonide + Formoterol
Brand NameAlveocic-FT Rotacap
ManufacturerLupin Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassRESPIRATORY
Action ClassCorticosteroid + Long-acting beta2-agonist
Route of AdministrationOral inhalation
StorageStore at room temperature (15-30°C) in a dry place. Protect from light and moisture. Keep out of reach of children.
Shelf Life24 months from date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Rinse your mouth with water after each use to prevent oral thrush.
2
Always carry a rescue inhaler for sudden breathing problems.
3
Do not exceed the prescribed dose; serious heart effects may occur.
4
Inform your doctor if you have heart disease, diabetes, or thyroid problems.
5
Do not stop this medicine suddenly without consulting your doctor.
6
Keep a diary of your symptoms and inhaler use to discuss with your doctor.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Chronic asthma symptoms
This medicine is commonly prescribed for this.
Likely Use
Acute breathing difficulty
This medicine is not for immediate relief.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionCiclesonide is absorbed from the lungs after inhalation; systemic absorption is low. Formoterol is rapidly absorbed from the lungs, with peak plasma levels occurring within 10-20 minutes after inhalation.
DistributionCiclesonide and its active metabolite are highly protein-bound (approximately 99%). Formoterol is distributed widely in the body, with a volume of distribution of about 4 L/kg.
Protein BindingCiclesonide active metabolite: >99%; Formoterol: approximately 50%
MetabolismCiclesonide is metabolized in the liver by CYP3A4 and other esterases to its active metabolite. Formoterol is metabolized primarily by glucuronidation and O-demethylation.
Half-LifeCiclesonide active metabolite: approximately 3-4 hours; Formoterol: approximately 10-12 hours
ExcretionCiclesonide metabolites are excreted mainly in feces and urine. Formoterol is excreted in urine and feces.
BioavailabilityCiclesonide: low systemic bioavailability (less than 1% for swallowed portion). Formoterol: approximately 25-30% after inhalation.
Onset of ActionFormoterol provides bronchodilation within 5-15 minutes. Ciclesonide's anti-inflammatory effects develop over days to weeks.
Peak Plasma TimeFormoterol: 10-20 minutes; Ciclesonide active metabolite: 1-2 hours
Duration of ActionFormoterol: at least 12 hours; Ciclesonide: anti-inflammatory effect persists with regular use.

How It Works

Ciclesonide is a prodrug that is converted to its active metabolite, desisobutyryl-ciclesonide, which binds to glucocorticoid receptors and reduces inflammation in the airways. Formoterol is a selective long-acting beta-2 adrenergic agonist that relaxes bronchial smooth muscle by stimulating beta-2 receptors, leading to bronchodilation. Together, they provide both anti-inflammatory and bronchodilator effects.

Mechanism Steps

1
Ciclesonide activation: Inhaled ciclesonide is converted in the lungs to desisobutyryl-ciclesonide, its active form.
2
Glucocorticoid receptor binding: The active metabolite binds to glucocorticoid receptors in airway cells, leading to anti-inflammatory gene expression changes.
3
Formoterol binding: Formoterol binds to beta-2 adrenergic receptors on bronchial smooth muscle.
4
Bronchodilation: Beta-2 receptor stimulation increases cyclic AMP, causing smooth muscle relaxation and airway widening.

💡 How to Take ciclomate 320 mcg/4.5 mcg transcaps

Strength: Transcaps containing 320 mcg ciclesonide and 4.5 mcg formoterol.

1Wash your hands before handling the transcaps.
2Place the transcaps in the inhalation device as instructed.
3Exhale completely away from the device.
4Place the mouthpiece in your mouth and inhale deeply and steadily.
5Hold your breath for 10 seconds, then exhale slowly.
6Rinse your mouth with water and spit it out.
7Clean the device as per instructions.

Dosage Information

Adult DosageThe usual adult dose is one transcaps (320 mcg ciclesonide/4.5 mcg formoterol) inhaled orally twice daily. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageNo specific dose adjustment is required for elderly patients, but use with caution due to increased risk of cardiovascular effects.
Renal ImpairmentNo dose adjustment is required for renal impairment, but monitor closely.
Hepatic ImpairmentUse with caution in patients with hepatic impairment. Dose adjustment may be necessary.
Maximum Daily DoseThe maximum recommended daily dose is one transcaps twice daily (total 640 mcg ciclesonide/9 mcg formoterol).

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
No specific timing required
This medicine is inhaled, so food does not affect it.
Grapefruit
Avoid
May increase ciclesonide levels.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of ciclomate 320 mcg/4.5 mcg transcaps

✅ Common Side Effects

Headache (Common (5-10%))
Usually resolves on its own. Consult doctor if persistent.
Throat irritation (Common (5-10%))
Rinse mouth after use. Consult doctor if severe.
Hoarseness (Common (5-10%))
Rinse mouth and throat after use. Consult doctor if persistent.
Tremor (Common (5-10%))
Usually mild and transient. Consult doctor if bothersome.

🚨 Serious Side Effects

Severe allergic reactions (Rare (<0.1%))
Seek immediate medical attention if you experience rash, hives, swelling of face, lips, or throat, or difficulty breathing.
Adrenal suppression (Rare (<0.1%))
Contact doctor if you experience fatigue, weakness, nausea, or low blood pressure.
Increased heart rate or palpitations (Uncommon (0.1-1%))
Seek medical attention if persistent or accompanied by chest pain.

⚠️ Rare Side Effects

Paradoxical bronchospasm
Stop use and seek immediate medical help if breathing worsens after use.
Glaucoma or increased eye pressure
Report eye pain or vision changes to doctor.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Ketoconazole Major
Propranolol Major
Furosemide Moderate
Theophylline Minor

🚨 Major Interactions

  • Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
  • Beta-blockers (e.g., propranolol)

⚡ Moderate Interactions

  • Diuretics (e.g., furosemide)
  • Monoamine oxidase inhibitors (MAOIs)

🍷 Alcohol Interaction

Alcohol may increase the risk of dizziness and tremors. Limit alcohol consumption while using this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Hypersensitivity to ciclesonide, formoterol, or any component of the formulation.","Not for acute bronchospasm or status asthmaticus.","Not for children under 12 years unless specifically prescribed."]

⚠️ Warnings & Precautions

["Do not use for acute asthma attacks; use a short-acting beta-2 agonist instead.","Do not exceed recommended dose; serious cardiovascular effects may occur.","Rinse mouth after inhalation to prevent oral thrush.","Use with caution in patients with cardiovascular disorders, seizure disorders, thyroid disease, or diabetes.","May cause adrenal insufficiency after long-term use; taper gradually if discontinuing.","Not for use in patients with severe milk protein allergy due to lactose content in some formulations."]

🤱 Lactation Safety

It is not known whether ciclesonide or formoterol are excreted in human milk. Consult your doctor before breastfeeding.

💊 Overdose Management

Overdose may cause tachycardia, tremor, hypokalemia, and hyperglycemia. Seek immediate medical attention. Treatment is supportive and symptomatic.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.

Additional Safety Advice

General Safety

Use this medicine only as prescribed. Do not exceed the recommended dose. Rinse your mouth with water after each use to prevent oral thrush. Carry a rescue inhaler at all times. Inform your doctor if you have heart disease, diabetes, thyroid problems, or liver disease. Do not stop this medicine suddenly without medical advice.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to cardiovascular effects. Monitor heart rate and blood pressure regularly.

🤰 Pregnancy Planning (TTC)

Consult your doctor before planning pregnancy. Use effective contraception if appropriate. This medicine should be used during pregnancy only if clearly needed.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist about this medicine. It may need to be continued or adjusted perioperatively.

🦷 Dental Procedures

Inform your dentist about this medicine. Rinsing with water after use can help prevent oral thrush, which may be confused with other oral lesions.

💚 Lifestyle Tips for Better Results

🏃
Avoid triggers like smoke, dust, and pollen.
🥗
Maintain a healthy weight.
😴
Practice breathing exercises.
💧
Get vaccinated against flu and pneumonia.
🧘
Use a peak flow meter to monitor lung function.

🏋️ Exercise Considerations

Exercise may trigger asthma symptoms. Use your rescue inhaler before exercise if advised. Warm up and cool down properly.

🥗 Diet Recommendations

Eat a balanced diet rich in fruits and vegetables.
Avoid foods that trigger allergies.
Stay hydrated.

💼 Impact on Daily Work & Life

This medicine may cause tremor or dizziness in some people. Avoid driving or operating machinery until you know how it affects you.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. Stopping suddenly can worsen asthma or COPD. Your doctor may taper the dose gradually.

📅 Long-Term Use Effects

Long-term use may lead to adrenal suppression, oral thrush, and increased risk of pneumonia. Regular monitoring of lung function and adrenal function is recommended. Do not stop suddenly without medical advice.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Pulmonary rehabilitation

Exercise and education program to improve breathing and quality of life.

Evidence: Well-established
Allergen avoidance

Reducing exposure to triggers can help control symptoms.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

Annual influenza vaccination and pneumococcal vaccination are recommended for patients with asthma or COPD.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

Carry your medicine in its original packaging with a copy of your prescription. Store at room temperature and protect from extreme heat or cold. If crossing time zones, adjust dosing times gradually as advised by your doctor. Keep a rescue inhaler accessible at all times.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 45-year-old man with moderate persistent asthma
He was prescribed this medicine twice daily. After a few weeks, his night-time symptoms decreased, and he could exercise without wheezing. He learned to rinse his mouth after each dose to avoid throat irritation.
💡 Lesson: Consistent use and proper inhalation technique are key to controlling asthma symptoms.
👤 A 60-year-old woman with COPD
She started this medicine along with pulmonary rehabilitation. Her breathing improved, and she could walk further without getting breathless. She monitored her heart rate as advised.
💡 Lesson: Combining medication with lifestyle changes can significantly improve quality of life in COPD.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Formoterol provides bronchodilation within 5-15 minutes, but the full anti-inflammatory effect of ciclesonide may take days to weeks.

Q: Can I use this medicine for an asthma attack?

A: No, this medicine is for maintenance only. Use a rescue inhaler for acute attacks.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my heart?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🛑 Myths vs. Facts

  • Myth: This medicine can be used for immediate relief of asthma attacks.
    Fact: This medicine is a maintenance therapy and should not be used for acute attacks. A rescue inhaler is needed.
  • Myth: This medicine is addictive.
    Fact: This medicine is not addictive. It is a prescribed medication for chronic respiratory conditions.

📊 Comparison with Similar Medicines

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