Flunisolide

Identification

Summary

Flunisolide is an inhaled corticosteroid used as a prophylactic therapy in the maintenance treatment of asthma.

Generic Name
Flunisolide
DrugBank Accession Number
DB00180
Background

Flunisolide (marketed as AeroBid, Nasalide, Nasarel) is a corticosteroid with anti-inflammatory actions. It is often prescribed as treatment for allergic rhinitis and its principle mechanism of action involves activation of glucocorticoid receptors.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Weight
Average: 434.4977
Monoisotopic: 434.210466929
Chemical Formula
C24H31FO6
Synonyms
  • Flunisolida
  • Flunisolide
  • Flunisolide anhydrous
  • Flunisolidum

Pharmacology

Indication

For the maintenance treatment of asthma as a prophylactic therapy.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Treatment ofAllergic rhinitis••••••••••••
Treatment ofAsthma••••••••••••••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Flunisolide is a synthetic corticosteroid. It is administered either as an oral metered-dose inhaler for the treatment of asthma or as a nasal spray for treating allergic rhinitis. Corticosteroids are naturally occurring hormones that prevent or suppress inflammation and immune responses. When given as an intranasal spray, flunisolide reduces watery nasal discharge (rhinorrhea), nasal congestion, postnasal drip, sneezing, and itching oat the back of the throat that are common allergic symptoms.

Mechanism of action

Flunisolide is a glucocorticoid receptor agonist. The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. 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. Flunisolide binds to plasma transcortin, and it becomes active when it is not bound to transcortin.

TargetActionsOrganism
AGlucocorticoid receptor
agonist
Humans
Absorption

Absorbed rapidly

Volume of distribution

Not Available

Protein binding

Approximately 40% after oral inhalation

Metabolism

Primarily hepatic, converted to the S beta-OH metabolite.

Route of elimination

Not Available

Half-life

1.8 hours

Clearance

Not Available

Adverse Effects
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Toxicity

Not Available

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbametapirThe serum concentration of Flunisolide can be increased when it is combined with Abametapir.
AbataceptThe risk or severity of adverse effects can be increased when Flunisolide is combined with Abatacept.
AbemaciclibThe metabolism of Abemaciclib can be increased when combined with Flunisolide.
AcalabrutinibThe metabolism of Acalabrutinib can be increased when combined with Flunisolide.
AcarboseThe risk or severity of hyperglycemia can be increased when Flunisolide is combined with Acarbose.
Food Interactions
No interactions found.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Flunisolide hemihydrateQK4DYS664X77326-96-6MIXMJCQRHVAJIO-TZHJZOAOSA-N
International/Other Brands
Bronalide (Krewel) / Nasalide (Teva Santé) / Syntaris (Teva)
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
AerobidAerosol, metered250 ug/1Respiratory (inhalation)Forest Laboratories2005-03-022012-03-21US flag
AerobidAerosol, metered250 ug/1Respiratory (inhalation)Physicians Total Care, Inc.1995-11-292011-05-31US flag
AerobidAerosol, metered250 ug/1Respiratory (inhalation)Physicians Total Care, Inc.2005-05-162011-06-30US flag
Aerobid-MAerosol, metered250 ug/1Respiratory (inhalation)Forest Laboratories2005-03-022011-06-30US flag
AerospanAerosol, metered80 ug/1Respiratory (inhalation)MEDA Pharmaceuticals2012-03-012019-04-30US flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Apo-flunisolide Nasal SpraySpray, metered0.25 mg / mLNasalApotex Corporation2000-03-102018-02-20Canada flag
FlunisolideSpray, metered0.25 mg/1mLNasalRising Pharmaceuticals2006-08-03Not applicableUS flag
FlunisolideSolution0.25 mg/1mLNasalREMEDYREPACK INC.2017-08-18Not applicableUS flag
FlunisolideSpray, metered0.25 mg/1mLNasalRising Pharmaceuticals2006-11-282014-11-19US flag
FlunisolideSolution0.25 mg/1mLNasalIngenus Pharmaceuticals, LLC2022-06-23Not applicableUS flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
PLENAERFlunisolide (10 MG) + Salbutamol (25 MG)Aerosol; SuspensionRespiratory (inhalation)Valeas Spa Industria Chimica E Farmaceutica2014-07-08Not applicableItaly flag
PLENAERFlunisolide (0.5 MG) + Salbutamol (0.5 MG)SprayRespiratory (inhalation)Valeas Spa Industria Chimica E Farmaceutica2014-07-08Not applicableItaly flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
AerobidFlunisolide hemihydrate (250 ug/1)Aerosol, meteredRespiratory (inhalation)Physicians Total Care, Inc.2005-05-162011-06-30US flag
AerobidFlunisolide hemihydrate (250 ug/1)Aerosol, meteredRespiratory (inhalation)Physicians Total Care, Inc.1995-11-292011-05-31US flag

Categories

ATC Codes
R01AD04 — FlunisolideR03BA03 — Flunisolide
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as 21-hydroxysteroids. These are steroids carrying a hydroxyl group at the 21-position of the steroid backbone.
Kingdom
Organic compounds
Super Class
Lipids and lipid-like molecules
Class
Steroids and steroid derivatives
Sub Class
Hydroxysteroids
Direct Parent
21-hydroxysteroids
Alternative Parents
Gluco/mineralocorticoids, progestogins and derivatives / 20-oxosteroids / 11-beta-hydroxysteroids / 3-oxo delta-1,4-steroids / Halogenated steroids / Delta-1,4-steroids / Ketals / 1,3-dioxolanes / Alpha-hydroxy ketones / Secondary alcohols
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Substituents
11-beta-hydroxysteroid / 11-hydroxysteroid / 20-oxosteroid / 21-hydroxysteroid / 3-oxo-delta-1,4-steroid / 3-oxosteroid / 6-halo-steroid / Acetal / Alcohol / Aliphatic heteropolycyclic compound
show 24 more
Molecular Framework
Aliphatic heteropolycyclic compounds
External Descriptors
11beta-hydroxy steroid, cyclic ketal, 20-oxo steroid, fluorinated steroid, 3-oxo-Delta(1),Delta(4)-steroid, 21-hydroxy steroid (CHEBI:5106)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
78M02AA8KF
CAS number
3385-03-3
InChI Key
XSFJVAJPIHIPKU-XWCQMRHXSA-N
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
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[10.8.0.0^{2,9}.0^{4,8}.0^{13,18}]icosa-14,17-dien-16-one
SMILES
[H][C@@]12C[C@@]3([H])[C@]4([H])C[C@H](F)C5=CC(=O)C=C[C@]5(C)[C@@]4([H])[C@@H](O)C[C@]3(C)[C@@]1(OC(C)(C)O2)C(=O)CO

References

Synthesis Reference

Richard E. Jones, Jacquelyn A. Smithers, "Process for preparing flunisolide." U.S. Patent US4273710, issued July, 1965.

US4273710
General References
Not Available
Human Metabolome Database
HMDB0014326
KEGG Compound
C07005
PubChem Compound
82153
PubChem Substance
46507894
ChemSpider
74144
BindingDB
50248007
RxNav
1546428
ChEBI
5106
ChEMBL
CHEMBL1512
ZINC
ZINC000004097305
Therapeutic Targets Database
DAP001046
PharmGKB
PA449661
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
PDRhealth
PDRhealth Drug Page
Wikipedia
Flunisolide
FDA label
Download (4.31 MB)
MSDS
Download (74.3 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
3CompletedTreatmentPerennial Allergic Rhinitis (PAR)1
1, 2Unknown StatusDiagnosticAsthma / Distal Lung Inflammation1
Not AvailableCompletedTreatmentChildhood Asthma1

Pharmacoeconomics

Manufacturers
  • Roche palo alto llc
  • Acton pharmaceuticals inc
  • Apotex inc richmond hill
  • Bausch and lomb pharmaceuticals inc
  • Qpharma llc
  • Ivax research inc
  • Teva branded pharmaceutical products r and d inc
Packagers
  • 3M Health Care
  • Apotex Inc.
  • Bausch & Lomb Inc.
  • Dispensing Solutions
  • Elan Pharmaceuticals Inc.
  • Forest Pharmaceuticals
  • Patheon Inc.
  • PD-Rx Pharmaceuticals Inc.
  • Pharmedix
  • Physicians Total Care Inc.
  • QPharm Inc.
  • Rising Pharmaceuticals
  • Teva Pharmaceutical Industries Ltd.
Dosage Forms
FormRouteStrength
SprayRespiratory (inhalation)0.5 mg/ml
Aerosol, meteredRespiratory (inhalation)250 ug/1
Aerosol, meteredRespiratory (inhalation)80 ug/1
Spray, meteredNasal0.25 mg / mL
Solution / dropsRespiratory (inhalation)1 mg/2ml
Solution / dropsRespiratory (inhalation)2 mg/2ml
SprayRespiratory (inhalation)0.1 %
SprayRespiratory (inhalation)0.5 MG/1ML
SprayRespiratory (inhalation)1 MG/1ML
Aerosol, meteredRespiratory (inhalation)250 mcg / act
Solution / dropsRespiratory (inhalation)
SolutionRespiratory (inhalation)1 MG/ML
SolutionRespiratory (inhalation)1 MG/2ML
SolutionRespiratory (inhalation)2 MG/2ML
SprayNasal0025 %
SprayNasal; Respiratory (inhalation)0025 %
SprayRespiratory (inhalation)0.05 %
SolutionNasal0.25 mg/1mL
Spray, meteredNasal0.25 mg/1mL
Spray, meteredNasal29 ug/1
SprayRespiratory (inhalation)1 mg/ml
SprayRespiratory (inhalation)30 MG/30ML
SolutionNasal29 ug/1
SprayRespiratory (inhalation)
SprayNasal25 mcg / dose
SprayRespiratory (inhalation)1 MG/2ML
SprayRespiratory (inhalation)2 MG/2ML
Aerosol; suspensionRespiratory (inhalation)
SprayRespiratory (inhalation)
SprayNasal0.025 %
Aerosol, meteredRespiratory (inhalation)250 MICROGRAMMI
Solution / dropsNasal25 MG/100ML
SuspensionRespiratory (inhalation)250 MCG
SprayNasal25 mcg / act
SprayNasal.025 %
Solution; sprayNasal25 mcg / act
Aerosol, meteredRespiratory (inhalation)
SprayNasal
SprayNasal0.025 mg/0.1mL
Prices
Unit descriptionCostUnit
Aerobid 250 mcg/act Aerosol 7 gm Inhaler101.95USD inhaler
Aerobid-M 250 mcg/act Aerosol 7 gm Inhaler101.95USD inhaler
Flunisolide 29 mcg/act Solution 25ml Bottle57.16USD bottle
Flunisolide 0.025% Solution 25ml Bottle48.35USD bottle
Aerobid aerosol with adapter14.0USD g
Aerobid-m aerosol with adapter14.0USD g
Flunisolide 29 mcg-0.025% spray2.2USD ml
Nasarel 29 mcg-0.025% spray1.98USD ml
Apo-Flunisolide 0.025 % Spray0.62USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5776433No1998-07-072015-07-07US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)226-230American Cyanamid Co.; British Patent 933,867; August 14, 1963.
water solubilityPractically insolubleNot Available
logP1.1Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0374 mg/mLALOGPS
logP2.2ALOGPS
logP1.56Chemaxon
logS-4.1ALOGPS
pKa (Strongest Acidic)13.73Chemaxon
pKa (Strongest Basic)-2.9Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count6Chemaxon
Hydrogen Donor Count2Chemaxon
Polar Surface Area93.06 Å2Chemaxon
Rotatable Bond Count2Chemaxon
Refractivity111.89 m3·mol-1Chemaxon
Polarizability44.67 Å3Chemaxon
Number of Rings5Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.9865
Blood Brain Barrier+0.9683
Caco-2 permeable+0.5
P-glycoprotein substrateSubstrate0.7912
P-glycoprotein inhibitor INon-inhibitor0.5674
P-glycoprotein inhibitor IINon-inhibitor0.8383
Renal organic cation transporterNon-inhibitor0.8304
CYP450 2C9 substrateNon-substrate0.8679
CYP450 2D6 substrateNon-substrate0.8856
CYP450 3A4 substrateSubstrate0.6964
CYP450 1A2 substrateNon-inhibitor0.9327
CYP450 2C9 inhibitorNon-inhibitor0.9394
CYP450 2D6 inhibitorNon-inhibitor0.9559
CYP450 2C19 inhibitorNon-inhibitor0.9311
CYP450 3A4 inhibitorNon-inhibitor0.8309
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.8806
Ames testNon AMES toxic0.7682
CarcinogenicityNon-carcinogens0.9174
BiodegradationNot ready biodegradable1.0
Rat acute toxicity2.7033 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9838
hERG inhibition (predictor II)Non-inhibitor0.671
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSsplash10-0699-1692600000-5bf41a0d7e86f018bde8
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSsplash10-00di-3980000000-62e8761f1d0a95a28586
MS/MS Spectrum - , positiveLC-MS/MSsplash10-00di-3980000000-62e8761f1d0a95a28586
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-00p0-0017900000-4b75c51982b67f037778
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-001i-0000900000-c852b6d987e1c636b5c1
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-0690-0257900000-30116b848e56771e2d88
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-0pdi-1009500000-1c77a2c48bfee1bda3ac
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-0a5c-7220900000-64cb0f6a2c9c9d120a02
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-004i-2293000000-b4754cf97fae0737f708
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-208.7729484
predicted
DarkChem Lite v0.1.0
[M-H]-207.59612
predicted
DeepCCS 1.0 (2019)
[M+H]+208.5122484
predicted
DarkChem Lite v0.1.0
[M+H]+209.37834
predicted
DeepCCS 1.0 (2019)
[M+Na]+208.1585484
predicted
DarkChem Lite v0.1.0
[M+Na]+216.09761
predicted
DeepCCS 1.0 (2019)

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Agonist
General Function
Zinc ion binding
Specific Function
Receptor for glucocorticoids (GC). Has a dual mode of action: as a transcription factor that binds to glucocorticoid response elements (GRE), both for nuclear and mitochondrial DNA, and as a modula...
Gene Name
NR3C1
Uniprot ID
P04150
Uniprot Name
Glucocorticoid receptor
Molecular Weight
85658.57 Da
References
  1. Hochhaus G, Moellmann HW: Binding affinities of rimexolone (ORG 6216), flunisolide and their putative metabolites for the glucocorticoid receptor of human synovial tissue. Agents Actions. 1990 Jun;30(3-4):377-80. [Article]
  2. Johnson M: Development of fluticasone propionate and comparison with other inhaled corticosteroids. J Allergy Clin Immunol. 1998 Apr;101(4 Pt 2):S434-9. [Article]
  3. Valotis A, Hogger P: Significant receptor affinities of metabolites and a degradation product of mometasone furoate. Respir Res. 2004 Jul 22;5:7. [Article]
  4. Hogger P, Erpenstein U, Rohdewald P, Sorg C: Biochemical characterization of a glucocorticoid-induced membrane protein (RM3/1) in human monocytes and its application as model system for ranking glucocorticoid potency. Pharm Res. 1998 Feb;15(2):296-302. [Article]
  5. Badia L, Lund V: Topical corticosteroids in nasal polyposis. Drugs. 2001;61(5):573-8. [Article]
  6. Philibert D, Bouchoux F, Cerede E, Corallo F, Allaire JM: [Pharmacologic study of the glucocorticoid activity of flunisolide compared with other steroids in the rat]. Allerg Immunol (Paris). 1993 Feb;25(2):77-81. [Article]
  7. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inducer
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Usui T, Saitoh Y, Komada F: Induction of CYP3As in HepG2 cells by several drugs. Association between induction of CYP3A4 and expression of glucocorticoid receptor. Biol Pharm Bull. 2003 Apr;26(4):510-7. doi: 10.1248/bpb.26.510. [Article]
  2. Pichard L, Fabre I, Daujat M, Domergue J, Joyeux H, Maurel P: Effect of corticosteroids on the expression of cytochromes P450 and on cyclosporin A oxidase activity in primary cultures of human hepatocytes. Mol Pharmacol. 1992 Jun;41(6):1047-55. [Article]
  3. Matoulkova P, Pavek P, Maly J, Vlcek J: Cytochrome P450 enzyme regulation by glucocorticoids and consequences in terms of drug interaction. Expert Opin Drug Metab Toxicol. 2014 Mar;10(3):425-35. doi: 10.1517/17425255.2014.878703. Epub 2014 Jan 23. [Article]
  4. Litt J. (2016). Litt's Drug eruption & reaction manual (22nd ed.). CRC Press LLc.

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Binder
General Function
Steroid binding
Specific Function
Major transport protein for glucocorticoids and progestins in the blood of almost all vertebrate species.
Gene Name
SERPINA6
Uniprot ID
P08185
Uniprot Name
Corticosteroid-binding globulin
Molecular Weight
45140.49 Da
References
  1. Gardill BR, Vogl MR, Lin HY, Hammond GL, Muller YA: Corticosteroid-binding globulin: structure-function implications from species differences. PLoS One. 2012;7(12):e52759. doi: 10.1371/journal.pone.0052759. Epub 2012 Dec 26. [Article]

Drug created at June 13, 2005 13:24 / Updated at March 18, 2024 16:48