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]
Asthma CA23 Investigative [2]
Therapeutic Class
Antiasthmatic Agents
Affected Organisms
Humans and other mammals
ATC Code
R01AD04: Flunisolide
R01AD: Corticosteroids
R01A: DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE
R01: NASAL PREPARATIONS
R: RESPIRATORY SYSTEM
R03BA03: Flunisolide
R03BA: Glucocorticoids
R03B: OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS
R03: DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES
R: RESPIRATORY SYSTEM
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 434.5
Logarithm of the Partition Coefficient (xlogp) 2.5
Rotatable Bond Count (rotbonds) 2
Hydrogen Bond Donor Count (hbonddonor) 2
Hydrogen Bond Acceptor Count (hbondacc) 7
ADMET Property
Absorption
The drug is rapidly absorbed []
Clearance
The drug present in the plasma can be removed from the body at the rate of 9.5 mL/min/kg [3]
Half-life
The concentration or amount of drug in body reduced by one-half in 1.8 hours [3]
Metabolism
The drug is metabolized via the hepatic []
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.06576 micromolar/kg/day [4]
Unbound Fraction
The unbound fraction of drug in plasma is 0.24% [3]
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 [3]
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
UNII
78M02AA8KF
DrugBank ID
DB00180
TTD ID
D0FM2P
INTEDE ID
DR0710
ACDINA ID
D01088
Repurposed Drugs (RPD) Click to Jump to the Detailed RPD Information of This Drug

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 [5]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Cytochrome P450 3A4 (CYP3A4)
Main DME 		DE4LYSA CP3A4_HUMAN Substrate [6]

Drug Off-Target (DOT)
DOT Name DOT ID UniProt ID Interaction REF
Cytochrome P450 2S1 (CYP2S1) OTKHX4RF CP2S1_HUMAN Gene/Protein Processing [7]
Cytochrome P450 3A5 (CYP3A5) OTSXFBXB CP3A5_HUMAN Gene/Protein Processing [8]
Nuclear receptor subfamily 1 group I member 2 (NR1I2) OTC5U0N5 NR1I2_HUMAN Gene/Protein Processing [9]
Molecular Interaction Atlas (MIA) 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
Glucocorticoid receptor (NR3C1) DTT NR3C1 7.57E-01 -0.04 -0.07
Cytochrome P450 3A4 (CYP3A4) DME CYP3A4 6.06E-01 -2.42E-02 -1.64E-01
Molecular Expression Atlas (MEA) 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] [10]
Posaconazole DMUL5EW Moderate Decreased metabolism of Flunisolide caused by Posaconazole mediated inhibition of CYP450 enzyme. Aspergillosis [1F20] [10]
Levalbuterol DM5YBO1 Minor Increased risk of hypokalemia by the combination of Flunisolide and Levalbuterol. Asthma [CA23] [11]
Terbutaline DMD4381 Minor Increased risk of hypokalemia by the combination of Flunisolide and Terbutaline. Asthma [CA23] [10]
Pirbuterol DMI5678 Minor Increased risk of hypokalemia by the combination of Flunisolide and Pirbuterol. Asthma [CA23] [11]
Isoetharine DMITSEH Minor Increased risk of hypokalemia by the combination of Flunisolide and Isoetharine. Asthma [CA23] [11]
Salbutamol DMN9CWF Minor Increased risk of hypokalemia by the combination of Flunisolide and Salbutamol. Asthma [CA23] [11]
Formoterol DMSOURV Minor Increased risk of hypokalemia by the combination of Flunisolide and Formoterol. Asthma [CA23] [10]
Erythromycin DM4K7GQ Moderate Decreased metabolism of Flunisolide caused by Erythromycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [10]
Clarithromycin DM4M1SG Moderate Decreased metabolism of Flunisolide caused by Clarithromycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [10]
Troleandomycin DMUZNIG Moderate Decreased metabolism of Flunisolide caused by Troleandomycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [12]
Telithromycin DMZ4P3A Moderate Decreased metabolism of Flunisolide caused by Telithromycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [12]
Tucatinib DMBESUA Moderate Decreased metabolism of Flunisolide caused by Tucatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [12]
Vilanterol DMF5EK1 Minor Increased risk of hypokalemia by the combination of Flunisolide and Vilanterol. Chronic obstructive pulmonary disease [CA22] [11]
Salmeterol DMIEU69 Minor Increased risk of hypokalemia by the combination of Flunisolide and Salmeterol. Chronic obstructive pulmonary disease [CA22] [10]
Indacaterol DMQJHR7 Minor Increased risk of hypokalemia by the combination of Flunisolide and Indacaterol. Chronic obstructive pulmonary disease [CA22] [10]
Arformoterol DMYM974 Minor Increased risk of hypokalemia by the combination of Flunisolide and Arformoterol. Chronic obstructive pulmonary disease [CA22] [10]
Isoproterenol DMK7MEY Minor Increased risk of hypokalemia by the combination of Flunisolide and Isoproterenol. Conduction disorder [BC63] [11]
Mifepristone DMGZQEF Major Decreased metabolism of Flunisolide caused by Mifepristone mediated inhibition of CYP450 enzyme. Cushing syndrome [5A70] [13]
Nefazodone DM4ZS8M Moderate Decreased metabolism of Flunisolide caused by Nefazodone mediated inhibition of CYP450 enzyme. Depression [6A70-6A7Z] [10]
Itraconazole DMCR1MV Moderate Decreased metabolism of Flunisolide caused by Itraconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [10]
Miconazole DMPMYE8 Moderate Decreased metabolism of Flunisolide caused by Miconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [12]
Ketoconazole DMPZI3Q Moderate Decreased metabolism of Flunisolide caused by Ketoconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [10]
Boceprevir DMBSHMF Moderate Decreased metabolism of Flunisolide caused by Boceprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [12]
Telaprevir DMMRV29 Moderate Decreased metabolism of Flunisolide caused by Telaprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [12]
Indinavir DM0T3YH Moderate Decreased metabolism of Flunisolide caused by Indinavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Delavirdine DM3NF5G Moderate Decreased metabolism of Flunisolide caused by Delavirdine mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [12]
Fosamprenavir DM4W9B3 Moderate Decreased metabolism of Flunisolide caused by Fosamprenavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Cobicistat DM6L4H2 Moderate Decreased metabolism of Flunisolide caused by Cobicistat mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Saquinavir DMG814N Moderate Decreased metabolism of Flunisolide caused by Saquinavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Amprenavir DMLMXE0 Moderate Decreased metabolism of Flunisolide caused by Amprenavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [12]
Darunavir DMN3GCH Moderate Decreased metabolism of Flunisolide caused by Darunavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Atazanavir DMSYRBX Moderate Decreased metabolism of Flunisolide caused by Atazanavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Ritonavir DMU764S Moderate Decreased metabolism of Flunisolide caused by Ritonavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [10]
Conivaptan DM1V329 Moderate Decreased metabolism of Flunisolide caused by Conivaptan mediated inhibition of CYP450 enzyme. Hypo-osmolality/hyponatraemia [5C72] [10]
Ceritinib DMB920Z Moderate Decreased metabolism of Flunisolide caused by Ceritinib mediated inhibition of CYP450 enzyme. Lung cancer [2C25] [10]
Cladribine DM3JDRP Major Additive immunosuppressive effects by the combination of Flunisolide and Cladribine. Mature B-cell leukaemia [2A82] [14]
Idelalisib DM602WT Moderate Decreased metabolism of Flunisolide caused by Idelalisib mediated inhibition of CYP450 enzyme. Mature B-cell leukaemia [2A82] [10]
Fedratinib DM4ZBK6 Moderate Decreased metabolism of Flunisolide caused by Fedratinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [10]
Omacetaxine mepesuccinate DMPU2WX Moderate Additive immunosuppressive effects by the combination of Flunisolide and Omacetaxine mepesuccinate. Myeloproliferative neoplasm [2A20] [15]
Lonafarnib DMGM2Z6 Moderate Decreased metabolism of Flunisolide caused by Lonafarnib mediated inhibition of CYP450 enzyme. Premature ageing appearance [LD2B] [10]
Ritodrine DM4V6RL Minor Increased risk of hypokalemia by the combination of Flunisolide and Ritodrine. Preterm labour/delivery [JB00] [11]
Voxelotor DMCS6M5 Moderate Decreased metabolism of Flunisolide caused by Voxelotor mediated inhibition of CYP450 enzyme. Sickle-cell disorder [3A51] [12]
⏷ 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
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 Flunisolide FDA Label
3 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
4 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
5 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.
6 Metabolic pathways of inhaled glucocorticoids by the CYP3A enzymes. Drug Metab Dispos. 2013 Feb;41(2):379-89.
7 CYP2S1 is negatively regulated by corticosteroids in human cell lines. Toxicol Lett. 2012 Feb 25;209(1):30-4.
8 Regulation of CYP3A genes by glucocorticoids in human lung cells. F1000Res. 2013 Aug 13;2:173.
9 Identification and validation of novel human pregnane X receptor activators among prescribed drugs via ligand-based virtual screening. Drug Metab Dispos. 2011 Feb;39(2):337-44. doi: 10.1124/dmd.110.035808. Epub 2010 Nov 10.
10 Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
11 Cerner Multum, Inc. "Australian Product Information.".
12 Edsbacker S, Andersson T "Pharmacokinetics of budesonide (Entocort EC) capsules for Crohn's disease." Clin Pharmacokinet 43 (2004): 803-21. [PMID: 15355126]
13 Product Information. Korlym (mifepristone). Corcept Therapeutics Incorporated, Menlo Park, CA.
14 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
15 Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.