Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C24H30F2O6 |
Molecular Weight | 452.4882 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 9 / 9 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CC1(C)O[C@@H]2C[C@H]3[C@@H]4C[C@H](F)C5=CC(=O)C=C[C@]5(C)[C@@]4(F)[C@@H](O)C[C@]3(C)[C@@]2(O1)C(=O)CO
InChI
InChIKey=FEBLZLNTKCEFIT-VSXGLTOVSA-N
InChI=1S/C24H30F2O6/c1-20(2)31-19-9-13-14-8-16(25)15-7-12(28)5-6-21(15,3)23(14,26)17(29)10-22(13,4)24(19,32-20)18(30)11-27/h5-7,13-14,16-17,19,27,29H,8-11H2,1-4H3/t13-,14-,16-,17-,19+,21-,22-,23-,24+/m0/s1
Molecular Formula | C24H30F2O6 |
Molecular Weight | 452.4882 |
Charge | 0 |
Count |
|
Stereochemistry | ABSOLUTE |
Additional Stereochemistry | No |
Defined Stereocenters | 9 / 9 |
E/Z Centers | 0 |
Optical Activity | UNSPECIFIED |
DescriptionSources: http://www.drugbank.ca/drugs/DB00591Curator's Comment: Description was created based on several sources, including
http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/012787s071lblrev.pdf
Sources: http://www.drugbank.ca/drugs/DB00591
Curator's Comment: Description was created based on several sources, including
http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/012787s071lblrev.pdf
Fluocinolone Acetonide is a corticosteroid that binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes. The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. This leads to diminished eicosanoid production. Cyclooxygenase (both COX-1 and COX-2) expression is also suppressed, potentiating the effect. In another words, the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst and the release of various inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen activator, chemokines etc.) from neutrophils, macrophages and mastocytes. Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding. Like other glucocorticoid agents Fluocinolone acetonide acts as a physiological antagonist to insulin by decreasing glycogenesis (formation of glycogen). It also promotes the breakdown of lipids (lipolysis), and proteins, leading to the mobilization of extrahepatic amino acids and ketone bodies. This leads to increased circulating glucose concentrations (in the blood). There is also decreased glycogen formation in the liver. Fluocinolone Acetonide is used for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Also for the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye (Retisert). Preparations containing Fluocinolone Acetonide were first marketed under the name Synalar.
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2034 Sources: http://www.drugbank.ca/drugs/DB00591 |
2.0 nM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | SYNALAR Approved UseSYNALAR® Cream is indicated for the relief of the inflammatory and pruritic manifestations of corticosteriod-responsive dermatoses. Launch Date1963 |
|||
Primary | Retisert Approved UseRetisert is indicated for the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye. Launch Date2005 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1.5 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20202684/ |
0.5 μg 1 times / day multiple, intraocular dose: 0.5 μg route of administration: Intraocular experiment type: MULTIPLE co-administered: |
FLUOCINOLONE ACETONIDE aqueous humor | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
|
0 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/35988360/ |
0.25 mL 2 times / day multiple, auricular (otic) dose: 0.25 mL route of administration: Auricular (otic) experiment type: MULTIPLE co-administered: CIPROFLOXACIN |
FLUOCINOLONE ACETONIDE plasma | Homo sapiens population: UNHEALTHY age: CHILD sex: UNKNOWN food status: UNKNOWN |
|
54 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/1874579 |
0.8 mg single, topical dose: 0.8 mg route of administration: Topical experiment type: SINGLE co-administered: |
FLUOCINOLONE ACETONIDE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
354.8 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/1874579 |
0.8 mg single, topical dose: 0.8 mg route of administration: Topical experiment type: SINGLE co-administered: |
FLUOCINOLONE ACETONIDE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
250 day EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20202684/ |
0.5 μg 1 times / day multiple, intraocular dose: 0.5 μg route of administration: Intraocular experiment type: MULTIPLE co-administered: |
FLUOCINOLONE ACETONIDE aqueous humor | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
|
14.8 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/1874579 |
0.8 mg single, topical dose: 0.8 mg route of administration: Topical experiment type: SINGLE co-administered: |
FLUOCINOLONE ACETONIDE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
6 ug 1 times / day multiple, intravitreal Highest studied dose Dose: 6 ug, 1 times / day Route: intravitreal Route: multiple Dose: 6 ug, 1 times / day Sources: |
unhealthy, 24 –51 |
Disc. AE: Central retinal vein occlusion... AEs leading to discontinuation/dose reduction: Central retinal vein occlusion (16.7%) Sources: |
2 ug 1 times / day multiple, intravitreal Studied dose Dose: 2 ug, 1 times / day Route: intravitreal Route: multiple Dose: 2 ug, 1 times / day Sources: |
unhealthy, 43.2 |
|
0.6 ug 1 times / day multiple, intravitreal Recommended Dose: 0.6 ug, 1 times / day Route: intravitreal Route: multiple Dose: 0.6 ug, 1 times / day Sources: |
unhealthy |
Disc. AE: Increased intraocular pressure... AEs leading to discontinuation/dose reduction: Increased intraocular pressure (2.4%) Sources: |
2 ug 1 times / day multiple, intravitreal Studied dose Dose: 2 ug, 1 times / day Route: intravitreal Route: multiple Dose: 2 ug, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Other AEs: Intraocular pressure abnormal... Other AEs: Intraocular pressure abnormal Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Central retinal vein occlusion | 16.7% Disc. AE |
6 ug 1 times / day multiple, intravitreal Highest studied dose Dose: 6 ug, 1 times / day Route: intravitreal Route: multiple Dose: 6 ug, 1 times / day Sources: |
unhealthy, 24 –51 |
Increased intraocular pressure | 2.4% Disc. AE |
0.6 ug 1 times / day multiple, intravitreal Recommended Dose: 0.6 ug, 1 times / day Route: intravitreal Route: multiple Dose: 0.6 ug, 1 times / day Sources: |
unhealthy |
Intraocular pressure abnormal | 2 ug 1 times / day multiple, intravitreal Studied dose Dose: 2 ug, 1 times / day Route: intravitreal Route: multiple Dose: 2 ug, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
yes |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
yes | ||||
yes |
PubMed
Title | Date | PubMed |
---|---|---|
Flunisolide HFA vs flunisolide CFC: pharmacokinetic comparison in healthy volunteers. | 2001 Dec |
|
Cost analysis of the use of inhaled corticosteroids in the treatment of asthma: a 1-year follow-up. | 2001 Dec |
|
Evidence of P-glycoprotein mediated apical to basolateral transport of flunisolide in human broncho-tracheal epithelial cells (Calu-3). | 2001 Dec |
|
Effective control of asthma with hydrofluoroalkane flunisolide delivered as an extrafine aerosol in asthma patients. | 2001 Nov |
|
Suppression of hypothalamic-pituitary-adrenal axis activity with inhaled flunisolide and fluticasone propionate in adult asthma patients. | 2001 Nov |
|
Adrenal suppression with inhaled corticosteroids. | 2001 Nov |
|
Deposition and pharmacokinetics of flunisolide delivered from pressurized inhalers containing non-CFC and CFC propellants. | 2001 Summer |
|
Poor sleep and daytime somnolence in allergic rhinitis: significance of nasal congestion. | 2002 |
|
Flunisolide HFA. | 2002 |
|
Nasal cellularity in 183 unselected schoolchildren aged 9 to 11 years. | 2002 Dec |
|
Single-dose study to compare the pharmacokinetics of HFA flunisolide and CFC flunisolide. | 2002 Feb |
|
Gateways to clinical trials. | 2002 Jul-Aug |
|
Gateways to clinical trials. | 2002 May |
|
Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis. | 2002 Nov |
|
Supercritical fluids crystallization of budesonide and flunisolide. | 2002 Oct |
|
Comparison of high-dose inhaled flunisolide to systemic corticosteroids in severe adult asthma. | 2002 Oct |
|
Multiple-dose proportionality study of flunisolide hydrofluoroalkane. | 2002 Sep-Oct |
|
A curious keloid of the penis. | 2003 |
|
Fluocinolone acetonide 0.01% in peanut oil: therapy for childhood atopic dermatitis, even in patients who are peanut sensitive. | 2003 Apr |
|
Effect of HFA-flunisolide on peripheral lung inflammation in asthma. | 2003 Jul |
|
Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up. | 2003 Jul |
|
Recurrent oral ulceration. | 2003 Jun |
|
Triple inhaled drug protocol for the treatment of acute severe asthma. | 2003 Jun |
|
Common hyperpigmentation disorders in adults: Part II. Melanoma, seborrheic keratoses, acanthosis nigricans, melasma, diabetic dermopathy, tinea versicolor, and postinflammatory hyperpigmentation. | 2003 Nov 15 |
|
Effect of topical nasal corticosteroids on patients with chronic fatigue syndrome and rhinitis. | 2003 Sep |
|
Asthma steroid pharmacogenetics: a study strategy to identify replicated treatment responses. | 2004 |
|
Fluocinolone acetonide topical oil for scalp psoriasis. | 2004 Dec |
|
A comparative study of punch grafting followed by topical corticosteroid versus punch grafting followed by PUVA therapy in stable vitiligo. | 2004 Jan |
|
Ocular pharmacokinetics of fluocinolone acetonide after Retisert intravitreal implantation in rabbits over a 1-year period. | 2004 Jun |
|
Rationale for the use of topical corticosteroids in melasma. | 2004 Mar-Apr |
|
Flunisolide HFA for the treatment of asthma: an old friend reformulated. | 2004 May |
|
Treatment with inhaled flunisolide. | 2004 May |
|
In vitro effects of flunisolide on MMP-9, TIMP-1, fibronectin, TGF-beta1 release and apoptosis in sputum cells freshly isolated from mild to moderate asthmatics. | 2004 Sep |
|
Enhanced anti-inflammatory potency of a nitric oxide-releasing derivative of flunisolide: role of nuclear factor-kappaB. | 2004 Sep |
|
Utilizing combination therapy to optimize melasma outcomes. | 2004 Sep-Oct |
|
Hydroquinone 4%, tretinoin 0.05%, fluocinolone acetonide 0.01%: a safe and efficacious 12-month treatment for melasma. | 2005 Jan |
|
Comparison of the analysis of corticosteroids using different techniques. | 2005 Jan |
|
Effects of drug treatment on inflammation and hyperreactivity of airways and on immune variables in cats with experimentally induced asthma. | 2005 Jul |
|
Gateways to clinical trials. | 2005 Jun |
|
The safety profile of long-term, high-dose intraocular corticosteroid delivery. | 2005 Mar |
|
Photochemistry and phototoxicity of fluocinolone 16,17-acetonide. | 2005 Mar-Apr |
|
A large 12-month extension study of an 8-week trial to evaluate the safety and efficacy of triple combination (TC) cream in melasma patients previously treated with TC cream or one of its dyads. | 2005 Sep-Oct |
|
Intravitreal steroids in the management of macular oedema. | 2006 Dec |
|
Inhaled flunisolide suppresses the hypothalamic-pituitary-adrenocortical axis, but has minimal systemic immune effects in healthy cats. | 2006 Jan-Feb |
|
Efficacy of low-release-rate fluocinolone acetonide intravitreal implants to treat experimental uveitis. | 2006 Jul |
|
Fluocinolone acetonide intravitreal sustained release device--a new addition to the armamentarium of uveitic management. | 2007 |
|
Compressor/nebulizers differences in the nebulization of corticosteroids. The CODE study (Corticosteroids and Devices Efficiency). | 2007 Jul-Aug |
|
Vitreous band formation and the sustained-release, intravitreal fluocinolone (Retisert) implant. | 2007 Jun |
|
A comparison of triple combination cream and hydroquinone 4% cream for the treatment of moderate to severe facial melasma. | 2007 Mar |
|
Retisert: is the new advance in treatment of uveitis a good one? | 2007 Mar |
Sample Use Guides
In Vivo Use Guide
Curator's Comment: can also be used as intravitreal implant http://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/021737s000_PRNTLBL.pdf
generally applied to the affected area as a thin film from two
to four times daily depending on the severity of the condition. In hairy sites, the
hair should be parted to allow direct contact with the lesion.
Route of Administration:
Topical
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/26734587
Fluocinolone Acetonide (10(−6) M) inhibited the expression of inflammatory cytokines and matrix metalloproteinases in murine immortalized keratinocytes
Substance Class |
Chemical
Created
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Record UNII |
0CD5FD6S2M
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Record Status |
Validated (UNII)
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WHO-VATC |
QS02CA05
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QC05AA10
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EU-Orphan Drug |
EU/3/16/1647
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NCI_THESAURUS |
C521
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WHO-VATC |
QD07CC02
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QS01BA15
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D07BC02
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NDF-RT |
N0000175576
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QD07AC04
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S02BA08
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S02CA05
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D07AC04
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S01CA10
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WHO-VATC |
QS01CA10
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NDF-RT |
N0000175450
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WHO-VATC |
QD07BC02
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WHO-ATC |
D07CC02
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C05AA10
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QS02BA08
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WHO-ATC |
S01BA15
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D005446
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SUB07714MIG
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DB00591
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C29055
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7077
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DTXSID0040674
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FLUOCINOLONE ACETONIDE
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67-73-2
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m5451
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CHEMBL989
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DEGRADENT -> PARENT |
Degradant product of Norris Type I photoreaction.
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BASIS OF STRENGTH->SUBSTANCE |
ASSAY (UV)
EP
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BASIS OF STRENGTH->SUBSTANCE |
ASSAY (HPLC)
USP
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TARGET -> AGONIST | |||
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SALT/SOLVATE -> PARENT |
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SOLVATE->ANHYDROUS |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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ACTIVE MOIETY |
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