Comparative Pharmacology
Head-to-head clinical analysis: ALVESCO versus QVAR REDIHALER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALVESCO versus QVAR REDIHALER.
ALVESCO vs QVAR REDIHALER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ciclesonide is a prodrug that is converted to the active metabolite des-ciclesonide, which has anti-inflammatory activity by binding to glucocorticoid receptors, thereby inhibiting inflammatory mediators such as cytokines and leukotrienes.
Beclomethasone dipropionate is a prodrug that is hydrolyzed by esterases to the active metabolite beclomethasone-17-monopropionate (17-BMP). 17-BMP is a glucocorticoid receptor agonist that binds to the glucocorticoid receptor, leading to modulation of gene expression involved in inflammatory pathways, including inhibition of pro-inflammatory cytokines, reduction of eosinophil survival and migration, and suppression of mast cell mediators.
Inhalation: 160 mcg twice daily (morning and evening). May be increased to 320 mcg twice daily if inadequate response. Maximum 640 mcg twice daily.
Inhalation: 40-80 mcg twice daily; maximum 320 mcg twice daily.
None Documented
None Documented
Terminal elimination half-life is approximately 2-3 hours for the systemically absorbed fraction; however, the receptor occupancy half-life is significantly longer due to lipophilic tissue binding, providing therapeutic duration of 12 hours.
1.5-2.0 hours (terminal half-life) after inhalation; supports twice-daily dosing.
Primarily hepatic metabolism (CYP3A4) to less active metabolites; renal excretion accounts for <10% unchanged; fecal excretion as metabolites ~80%.
Primarily hepatic metabolism via CYP3A4; metabolites are excreted in feces (~64%) and urine (~12%).
Category C
Category C
Inhaled Corticosteroid
Inhaled Corticosteroid