Details of the Drug

General Information of Drug (ID: DMZSWQC)

Drug Name

Flunisolide

Synonyms

Aerobid; Aerospan; Bronalide; Flunisolida; Flunisolidum; Lunis; Nasalide; Nasarel; Nisolid; Rhinalar; Rhinolar; Soluzione; Synaclyn; Syntaris; Aerobid M; Aerospan HFA; Flunisolide HFA; Flunisolide [INN]; Flunisolide [anhydrous]; Flunisolide anhydrous; F0437; RS 3999; AeroBid (TN); Flunisolida [INN-Spanish]; Flunisolide (anhydrous); Flunisolidum [INN-Latin]; Nasalide (TN); Nasarel (TN); RS-3999; AeroBid, Nasalide, Nasarel,Flunisolide; Pregna-1,4-diene-3,20-dione, 6-alpha-fluoro-11-beta,16-alpha,17,21-tetrahydroxy-, cyclic 16,17-acetal with acetone; Pregna-1,4-diene-3,20-dione, 6-alpha-fluoro-11-beta,16-alpha,17,21-tetrahydroxy-,cyclic 16,17-acetal with acetone; 6 alpha-fluoro-11 beta,16 alpha,17,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16, 17-acetal with acetone; 6 alpha-fluorodihydroxy-16 alpha,17 alpha-isopropylidenedioxy-1,4-pregnadiene-3,20-dione; 6-Fluoro-11,21-dihydroxy-16,17-(isopropylidenedioxy)pregna-1,4-diene-3,20-dione; 6alpha-Fluoro-11beta,16alpha,17,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16, 17-acetal with acetone; 6alpha-fluoro-11beta,21-dihydroxy-16alpha,17alpha-(isopropylidenedioxy)pregna-1,4-diene-3,20-dione

Indication

Disease Entry	ICD 11	Status	REF
Allergic rhinitis	CA08.0	Approved	[1], [2]

Therapeutic Class

Antiasthmatic Agents

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 0

Molecular Weight (mw)

434.5

Topological Polar Surface Area (xlogp)

2.5

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

Absorption: The drug is rapidly absorbed [3]
Clearance: The drug present in the plasma can be removed from the body at the rate of 9.5 mL/min/kg [4]
Half-life: The concentration or amount of drug in body reduced by one-half in 1.8 hours [4]
Metabolism: The drug is metabolized via the hepatic [3]
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.06576 micromolar/kg/day [5]
Unbound Fraction: The unbound fraction of drug in plasma is 0.24% [4]
Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 1.08 L/kg [4]

Chemical Identifiers

Formula: C24H31FO6
IUPAC Name: (1S,2S,4R,8S,9S,11S,12S,13R,19S)-19-fluoro-11-hydroxy-8-(2-hydroxyacetyl)-6,6,9,13-tetramethyl-5,7-dioxapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one
Canonical SMILES: C[C@]12C[C@@H]([C@H]3[C@H]([C@@H]1C[C@@H]4[C@]2(OC(O4)(C)C)C(=O)CO)C[C@@H](C5=CC(=O)C=C[C@]35C)F)O
InChI: InChI=1S/C24H31FO6/c1-21(2)30-19-9-14-13-8-16(25)15-7-12(27)5-6-22(15,3)20(13)17(28)10-23(14,4)24(19,31-21)18(29)11-26/h5-7,13-14,16-17,19-20,26,28H,8-11H2,1-4H3/t13-,14-,16-,17-,19+,20+,22-,23-,24+/m0/s1
InChIKey: XSFJVAJPIHIPKU-XWCQMRHXSA-N

Cross-matching ID

PubChem CID: 82153
ChEBI ID: CHEBI:5106
CAS Number: 3385-03-3
DrugBank ID: DB00180
TTD ID: D0FM2P
INTEDE ID: DR0710
ACDINA ID: D01088

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Glucocorticoid receptor (NR3C1)	TTYRL6O	GCR_HUMAN	Agonist	[6]

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Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4)_{Main DME}	DE4LYSA	CP3A4_HUMAN	Substrate	[7]

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Molecular Interaction Atlas (MIA)

MIA Detail

Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease

Allergic rhinitis

ICD Disease Classification

CA08.0

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Cytochrome P450 3A4 (CYP3A4)	DME	CYP3A4	9.85E-01	2.24E-02	7.33E-02

Molecular Expression Atlas (MEA)

MEA Detail

Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Flunisolide (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Voriconazole	DMAOL2S	Moderate	Decreased metabolism of Flunisolide caused by Voriconazole mediated inhibition of CYP450 enzyme.	Aspergillosis [1F20]	[24]
Posaconazole	DMUL5EW	Moderate	Decreased metabolism of Flunisolide caused by Posaconazole mediated inhibition of CYP450 enzyme.	Aspergillosis [1F20]	[24]
Levalbuterol	DM5YBO1	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Levalbuterol.	Asthma [CA23]	[25]
Terbutaline	DMD4381	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Terbutaline.	Asthma [CA23]	[24]
Pirbuterol	DMI5678	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Pirbuterol.	Asthma [CA23]	[25]
Isoetharine	DMITSEH	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Isoetharine.	Asthma [CA23]	[25]
Salbutamol	DMN9CWF	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Salbutamol.	Asthma [CA23]	[25]
Formoterol	DMSOURV	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Formoterol.	Asthma [CA23]	[24]
Erythromycin	DM4K7GQ	Moderate	Decreased metabolism of Flunisolide caused by Erythromycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[24]
Clarithromycin	DM4M1SG	Moderate	Decreased metabolism of Flunisolide caused by Clarithromycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[24]
Troleandomycin	DMUZNIG	Moderate	Decreased metabolism of Flunisolide caused by Troleandomycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[26]
Telithromycin	DMZ4P3A	Moderate	Decreased metabolism of Flunisolide caused by Telithromycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[26]
Tucatinib	DMBESUA	Moderate	Decreased metabolism of Flunisolide caused by Tucatinib mediated inhibition of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[26]
Vilanterol	DMF5EK1	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Vilanterol.	Chronic obstructive pulmonary disease [CA22]	[25]
Salmeterol	DMIEU69	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Salmeterol.	Chronic obstructive pulmonary disease [CA22]	[24]
Indacaterol	DMQJHR7	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Indacaterol.	Chronic obstructive pulmonary disease [CA22]	[24]
Arformoterol	DMYM974	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Arformoterol.	Chronic obstructive pulmonary disease [CA22]	[24]
Isoproterenol	DMK7MEY	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Isoproterenol.	Conduction disorder [BC63]	[25]
Mifepristone	DMGZQEF	Major	Decreased metabolism of Flunisolide caused by Mifepristone mediated inhibition of CYP450 enzyme.	Cushing syndrome [5A70]	[27]
Nefazodone	DM4ZS8M	Moderate	Decreased metabolism of Flunisolide caused by Nefazodone mediated inhibition of CYP450 enzyme.	Depression [6A70-6A7Z]	[24]
Itraconazole	DMCR1MV	Moderate	Decreased metabolism of Flunisolide caused by Itraconazole mediated inhibition of CYP450 enzyme.	Fungal infection [1F29-1F2F]	[24]
Miconazole	DMPMYE8	Moderate	Decreased metabolism of Flunisolide caused by Miconazole mediated inhibition of CYP450 enzyme.	Fungal infection [1F29-1F2F]	[26]
Ketoconazole	DMPZI3Q	Moderate	Decreased metabolism of Flunisolide caused by Ketoconazole mediated inhibition of CYP450 enzyme.	Fungal infection [1F29-1F2F]	[24]
Boceprevir	DMBSHMF	Moderate	Decreased metabolism of Flunisolide caused by Boceprevir mediated inhibition of CYP450 enzyme.	Hepatitis virus infection [1E50-1E51]	[26]
Telaprevir	DMMRV29	Moderate	Decreased metabolism of Flunisolide caused by Telaprevir mediated inhibition of CYP450 enzyme.	Hepatitis virus infection [1E50-1E51]	[26]
Indinavir	DM0T3YH	Moderate	Decreased metabolism of Flunisolide caused by Indinavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Delavirdine	DM3NF5G	Moderate	Decreased metabolism of Flunisolide caused by Delavirdine mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[26]
Fosamprenavir	DM4W9B3	Moderate	Decreased metabolism of Flunisolide caused by Fosamprenavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Cobicistat	DM6L4H2	Moderate	Decreased metabolism of Flunisolide caused by Cobicistat mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Saquinavir	DMG814N	Moderate	Decreased metabolism of Flunisolide caused by Saquinavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Amprenavir	DMLMXE0	Moderate	Decreased metabolism of Flunisolide caused by Amprenavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[26]
Darunavir	DMN3GCH	Moderate	Decreased metabolism of Flunisolide caused by Darunavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Atazanavir	DMSYRBX	Moderate	Decreased metabolism of Flunisolide caused by Atazanavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Ritonavir	DMU764S	Moderate	Decreased metabolism of Flunisolide caused by Ritonavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Conivaptan	DM1V329	Moderate	Decreased metabolism of Flunisolide caused by Conivaptan mediated inhibition of CYP450 enzyme.	Hypo-osmolality/hyponatraemia [5C72]	[24]
Ceritinib	DMB920Z	Moderate	Decreased metabolism of Flunisolide caused by Ceritinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[24]
Cladribine	DM3JDRP	Major	Additive immunosuppressive effects by the combination of Flunisolide and Cladribine.	Mature B-cell leukaemia [2A82]	[28]
Idelalisib	DM602WT	Moderate	Decreased metabolism of Flunisolide caused by Idelalisib mediated inhibition of CYP450 enzyme.	Mature B-cell leukaemia [2A82]	[24]
Fedratinib	DM4ZBK6	Moderate	Decreased metabolism of Flunisolide caused by Fedratinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[24]
Omacetaxine mepesuccinate	DMPU2WX	Moderate	Additive immunosuppressive effects by the combination of Flunisolide and Omacetaxine mepesuccinate.	Myeloproliferative neoplasm [2A20]	[29]
Lonafarnib	DMGM2Z6	Moderate	Decreased metabolism of Flunisolide caused by Lonafarnib mediated inhibition of CYP450 enzyme.	Premature ageing appearance [LD2B]	[24]
Ritodrine	DM4V6RL	Minor	Increased risk of hypokalemia by the combination of Flunisolide and Ritodrine.	Preterm labour/delivery [JB00]	[25]
Voxelotor	DMCS6M5	Moderate	Decreased metabolism of Flunisolide caused by Voxelotor mediated inhibition of CYP450 enzyme.	Sickle-cell disorder [3A51]	[26]
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⏷ Show the Full List of 43 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Ethanol	E00023	702	Antimicrobial preservative; Penetration agent; Solvent
Norflurane	E00221	13129	Aerosol propellant
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Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Flunisolide 0.078mg/inh aerosol	0.078mg/inh	Aerosol	Inhalation

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1	URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7076).
2	FDA Approved Drug Products from FDA Official Website. 2009. Application Number: (ANDA) 074805.
3	FDA approval: ado-trastuzumab emtansine for the treatment of patients with HER2-positive metastatic breast cancer. Clin Cancer Res. 2014 Sep 1;20(17):4436-41.
4	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
5	Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
6	The glucocorticoid receptor heterocomplex gene STIP1 is associated with improved lung function in asthmatic subjects treated with inhaled corticost... J Allergy Clin Immunol. 2009 Jun;123(6):1376-83.e7.
7	Metabolic pathways of inhaled glucocorticoids by the CYP3A enzymes. Drug Metab Dispos. 2013 Feb;41(2):379-89.
8	Expression levels and activation of a PXR variant are directly related to drug resistance in osteosarcoma cell lines. Cancer. 2007 Mar 1;109(5):957-65.
9	Contribution of human hepatic cytochrome P450 isoforms to regioselective hydroxylation of steroid hormones. Xenobiotica. 1998 Jun;28(6):539-47.
10	Comprehensive evaluation of tamoxifen sequential biotransformation by the human cytochrome P450 system in vitro: prominent roles for CYP3A and CYP2D6. J Pharmacol Exp Ther. 2004 Sep;310(3):1062-75.
11	Isoform-specific regulation of cytochromes P450 expression by estradiol and progesterone. Drug Metab Dispos. 2013 Feb;41(2):263-9.
12	Metabolic interactions between acetaminophen (paracetamol) and two flavonoids, luteolin and quercetin, through in-vitro inhibition studies. J Pharm Pharmacol. 2017 Dec;69(12):1762-1772.
13	Potent mechanism-based inhibition of CYP3A4 by imatinib explains its liability to interact with CYP3A4 substrates. Br J Pharmacol. 2012 Apr;165(8):2787-98.
14	Effects of morin on the pharmacokinetics of etoposide in rats. Biopharm Drug Dispos. 2007 Apr;28(3):151-6.
15	The metabolism of zidovudine by human liver microsomes in vitro: formation of 3'-amino-3'-deoxythymidine. Biochem Pharmacol. 1994 Jul 19;48(2):267-76.
16	Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675.
17	Interaction between the glucocorticoid and erythropoietin receptors in human erythroid cells. Exp Hematol. 2009 May;37(5):559-72.
18	Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services.
19	Aldosterone (mineralocorticoid) equivalent to prednisolone (glucocorticoid) in reversing hearing loss in MRL/MpJ-Fas1pr autoimmune mice. Laryngoscope. 2000 Nov;110(11):1902-6.
20	Fluticasone furoate nasal spray in allergic rhinitis. Drugs Today (Barc). 2008 Apr;44(4):251-60.
21	Cytochromes P450 (CYP) in the Poeciliopsis lucida hepatocellular carcinoma cell line (PLHC-1): dose- and time-dependent glucocorticoid potentiation of CYP1A induction without induction of CYP3A. ArchBiochem Biophys. 1996 May 1;329(1):113-22.
22	PXR-mediated induction of human CYP3A4 and mouse Cyp3a11 by the glucocorticoid budesonide. Eur J Pharm Sci. 2009 Mar 2;36(4-5):565-71.
23	The glucocorticoid agonist activities of mifepristone (RU486) and progesterone are dependent on glucocorticoid receptor levels but not on EC50 values. Steroids. 2007 Jun;72(6-7):600-8.
24	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
25	Cerner Multum, Inc. "Australian Product Information.".
26	Edsbacker S, Andersson T "Pharmacokinetics of budesonide (Entocort EC) capsules for Crohn's disease." Clin Pharmacokinet 43 (2004): 803-21. [PMID: 15355126]
27	Product Information. Korlym (mifepristone). Corcept Therapeutics Incorporated, Menlo Park, CA.
28	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
29	Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.