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ciclesonide + montelukast is a combination therapy used for the management of asthma and exercise-induced bronchoconstriction. Ciclesonide is an inhaled corticosteroid (ICS) that functions as a prodrug; it is cleaved by endogenous esterases in the lung to its active metabolite, desisobutyryl-ciclesonide, which is a potent agonist of the glucocorticoid receptor. This action leads to a reduction in airway inflammation. Montelukast is an orally administered leukotriene receptor antagonist (LTRA) that selectively inhibits the cysteinyl leukotriene receptor 1 (CysLT1). By blocking the binding of cysteinyl leukotrienes (such as LTD4), montelukast prevents leukotriene-mediated effects including bronchoconstriction, mucous secretion, and vascular permeability. The combination of these two agents provides complementary anti-inflammatory effects through different pathways, targeting both the steroid-responsive and leukotriene-mediated components of airway disease.
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