Drug General Information (ID: D0672)
  Drug Name
Flunisolide
  Drug Type Small molecule
  Drug Synonymous
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
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  Disease Class CA08: Vasomotor/allergic rhinitis
  Therapeutic Class Antiasthmatic Agents
  Structure Could Not Find 2D Structure
3D Structure 2D Structure
  Formula C24H31FO6
  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
  Canonical SMILES CC1(OC2CC3C4CC(C5=CC(=O)C=CC5(C4C(CC3(C2(O1)C(=O)CO)C)O)C)F)C
  External Link
Pubchem ID 82153
CAS Number 542449
CHEBI ID 5106
TTD ID D0FM2P
INTEDE ID DR0710

Drug-Drug Interaction Network
  Sunburst Graph
AM001  Affected gastrointestinal absorption
AM003  Affected organization distribution
AM004  Affected intra/extra-hepatic metabolism
AM006  Pharmacodynamic additive effects
AM007  Pharmacodynamic antagonistic effects
BM009  Altered absorption (Unspecific)
BM014  Interference of cell/tissue uptake
BM017  CYP450 enzyme inhibition
BM043  Additive immunosuppressive effects
BM065  Increased risk of hypokalemia
BM067  Increased risk of hyponatremia
BM092  Antagonize the effect of corticosteroids
  Relation Graph
 Full list of drugs interacting with Flunisolide
      Affected gastrointestinal absorption
   Altered absorption (Unspecific) Drug Num:  1
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D0814
 
Insulin human (inhalation, rapid acting)
 
C257H383N65O77S6
 
118984375 
Moderate    Inter Info   
[41], [42], [43]
      Affected organization distribution
   Interference of cell/tissue uptake Drug Num:  1
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D1817
 
Indium In-111 oxyquinoline
 
C27H18InN3O3
 
16685037 
Moderate    Inter Info   
[39]
      Affected intra/extra-hepatic metabolism
   CYP450 enzyme inhibition Drug Num:  28
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D0080
 
Amprenavir
 
C25H35N3O6S
 
65016 
Moderate    Inter Info   
[10], [11], [12]
D0116
 
Atazanavir
 
C38H52N6O7
 
148192 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0192
 
Boceprevir
 
C27H45N5O5
 
10324367 
Moderate    Inter Info   
[10], [11], [12]
D0302
 
Ceritinib
 
C28H36ClN5O3S
 
57379345 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0349
 
Clarithromycin
 
C38H69NO13
 
84029 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0375
 
Cobicistat
 
C40H53N7O5S2
 
25151504 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0386
 
Conivaptan
 
C32H26N4O2
 
151171 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0426
 
Darunavir
 
C27H37N3O7S
 
213039 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0439
 
Delavirdine
 
C22H28N6O3S
 
5625 
Moderate    Inter Info   
[10], [11], [12]
D0597
 
Erythromycin
 
C37H67NO13
 
12560 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0638
 
Fedratinib
 
C27H36N6O3S
 
16722836 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0692
 
Fosamprenavir
 
C25H36N3O9PS
 
131536 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0789
 
Idelalisib
 
C22H18FN7O
 
11625818 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0799
 
Indinavir
 
C36H47N5O4
 
5362440 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0867
 
Itraconazole
 
C35H38Cl2N8O4
 
55283 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0880
 
Ketoconazole
 
C26H28Cl2N4O4
 
456201 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D0946
 
Lonafarnib
 
C27H31Br2ClN4O2
 
148195 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1117
 
Nefazodone
 
C25H32ClN5O2
 
4449 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1119
 
Nelfinavir
 
C32H45N3O4S
 
64143 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1315
 
Posaconazole
 
C37H42F2N8O4
 
468595 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1415
 
Ritonavir
 
C37H48N6O5S2
 
392622 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1444
 
Saquinavir
 
C38H50N6O5
 
441243 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1541
 
Telaprevir
 
C36H53N7O6
 
3010818 
Moderate    Inter Info   
[10], [11], [12]
D1544
 
Telithromycin
 
C43H65N5O10
 
3002190 
Moderate    Inter Info   
[10], [11], [12]
D1653
 
Troleandomycin
 
C41H67NO15
 
202225 
Moderate    Inter Info   
[10], [11], [12]
D1660
 
Tucatinib
 
C26H24N8O2
 
51039094 
Moderate    Inter Info   
[10], [11], [12]
D1706
 
Voriconazole
 
C16H14F3N5O
 
71616 
Moderate    Inter Info   
[13], [14], [15], [16], [17], [10], [18], [11], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [12], [32], [33], [34], [35], [36], [37], [38]
D1709
 
Voxelotor
 
C19H19N3O3
 
71602803 
Moderate    Inter Info   
[10], [11], [12]
      Pharmacodynamic additive effects
   Additive immunosuppressive effects Drug Num:  4
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D0203
 
Brexucabtagene autoleucel
 
NA
 
NA
Major    Inter Info   
[2]
D0348
 
Cladribine
 
C10H12ClN5O3
 
20279 
Major    Inter Info   
[2], [7]
D0501
 
Dinutuximab
 
NA
 
NA
Major    Inter Info   
[2]
D1174
 
Omacetaxine mepesuccinate
 
C29H39NO9
 
285033 
Moderate    Inter Info   
[40]
   Increased risk of hypokalemia Drug Num:  14
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D0103
 
Arformoterol
 
C19H24N2O4
 
3083544 
Minor    Inter Info   
[13], [6], [2], [44]
D0691
 
Formoterol
 
C19H24N2O4
 
3410 
Minor    Inter Info   
[13], [6], [2], [44]
D0797
 
Indacaterol
 
C24H28N2O3
 
6918554 
Minor    Inter Info   
[13], [6], [2], [44]
D0854
 
Isoetharine
 
C13H21NO3
 
3762 
Minor    Inter Info   
[6], [2], [44]
D0859
 
Isoprenaline
 
C11H17NO3
 
3779 
Minor    Inter Info   
[6], [2], [44]
D0924
 
Levosalbutamol
 
C13H21NO3
 
123600 
Minor    Inter Info   
[6], [2], [44]
D1185
 
Orciprenaline
 
C11H17NO3
 
4086 
Minor    Inter Info   
[6], [2], [44]
D1298
 
Pirbuterol
 
C12H20N2O3
 
4845 
Minor    Inter Info   
[6], [2], [44]
D1374
 
Racepinephrine
 
C9H13NO3
 
838 
Minor    Inter Info   
[13], [6], [2], [44]
D1414
 
Ritodrine
 
C17H21NO3
 
33572 
Minor    Inter Info   
[6], [2], [44]
D1438
 
Salbutamol
 
C13H21NO3
 
2083 
Minor    Inter Info   
[6], [2], [44]
D1440
 
Salmeterol
 
C25H37NO4
 
5152 
Minor    Inter Info   
[13], [6], [2], [44]
D1554
 
Terbutaline
 
C12H19NO3
 
5403 
Minor    Inter Info   
[13], [6], [2], [44]
D1695
 
Vilanterol
 
C24H33Cl2NO5
 
10184665 
Minor    Inter Info   
[6], [2], [44]
   Increased risk of hyponatremia Drug Num:  1
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D0449
 
Desmopressin
 
C46H64N14O12S2
 
5311065 
Major    Inter Info   
[1], [2], [3], [4], [5], [6]
      Pharmacodynamic antagonistic effects
   Antagonize the effect of corticosteroids Drug Num:  1
Drug ID
 
Drug Name
Formula Pubchem ID Severity Level Interaction Detail REF
D1063
 
Mifepristone
 
C29H35NO2
 
55245 
Major    Inter Info   
[8], [9]
References
1 Product Information. Stimate (desmopressin). Forest Pharmaceuticals, St. Louis, MO.
2 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3 Product Information. Nocdurna (desmopressin). Ferring Inc, North York, ON.
4 Product Information. Noctiva (desmopressin). Avadel Pharmaceuticals, Chesterfield, MO.
5 Product Information. DDAVP (desmopressin). Rhone-Poulenc Rorer, Collegeville, PA.
6 Cerner Multum, Inc. "Australian Product Information.".
7 Product Information. Leustatin (cladribine). Ortho Biotech Inc, Raritan, NJ.
8 Product Information. Korlym (mifepristone). Corcept Therapeutics Incorporated, Menlo Park, CA.
9 Product Information. Mifeprex (mifepristone) Danco Laboratories, New York, NY.
10 Edsbacker S, Andersson T "Pharmacokinetics of budesonide (Entocort EC) capsules for Crohn's disease." Clin Pharmacokinet 43 (2004): 803-21. [PMID: 15355126]
11 Finkenbine RD, Frye MD "Case of psychosis due to prednisone-clarithromycin interaction." Gen Hosp Psychiat 20 (1998): 325-6. [PMID: 9788033]
12 Soldatos G, Sztal-Mazer S, Woolley I, Stockigt J "Exogenous glucocorticoid excess as a result of ritonavir-fluticasone interaction." Intern Med J 35 (2005): 67-8. [PMID: 15667475]
13 Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
14 Bhumbra NA, Sahloff EG, Oehrtman SJ, Horner JM "Exogenous Cushing syndrome with inhaled fluticasone in a child receiving lopinavir/ritonavir." Ann Pharmacother 41 (2007): 1306-9. [PMID: 17535841]
15 Bolland MJ, Bagg W, Thomas MG, Lucas JA, Ticehurst R, Black PN "Cushing's syndrome due to interaction between inhaled corticosteroids and itraconazole." Ann Pharmacother 38 (2004): 46-9. [PMID: 14742792]
16 Busse KH, Formentini E, Alfaro RM, Kovacs JA, Penzak SR "Influence of antiretroviral drugs on the pharmacokinetics of prednisolone in HIV-infected individuals." J Acquir Immune Defic Syndr 48 (2008): 561-6. [PMID: 18645517]
17 Couturier J, Steele M, Hussey L, Pawliuk G "Steroid-induced mania in an adolescent: risk factors and management." Can J Clin Pharmacol 8 (2001): 109-12. [PMID: 11493940]
18 EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
19 Garey KW, Rubinstein I, Gotfried MH, Khan IJ, Varma S, Danziger LH "Long-term clarithromycin decreases prednisone requirements in elderly patients with prednisone-dependent asthma." Chest 118 (2000): 1826-7. [PMID: 11115481]
20 Glynn AM, Slaughter RL, Brass C, et al "Effects of ketoconazole on methylprednisolone pharmacokinetics and cortisol secretion." Clin Pharmacol Ther 39 (1986): 654-9. [PMID: 3709030]
21 Gupta SK, Dube MP "Exogenous Cushing syndrome mimicking human immunodeficiency virus lipodystrophy." Clin Infect Dis 35 (2002): E69-71. [PMID: 12203188]
22 Hillebrand-Haverkort ME, Prummel MF, ten Veen JH "Ritonavir-induced Cushing's syndrome in a patient treated with nasal fluticasone." AIDS 13 (1999): 1803. [PMID: 10509596]
23 Itkin IH, Menzel ML "The use of macrolide antibiotic substances in the treatment of asthma." J Allergy Clin Immunol 45 (1970): 146-62. [PMID: 5309312]
24 Kandrotas RJ, Slaughter RL, Brass C, Jusko WJ "Ketoconazole effects on methylprednisolone disposition and their joint suppression of endogenous cortisol." Clin Pharmacol Ther 42 (1987): 465-70. [PMID: 3311551]
25 Kotlyar M, Brewer ER, Golding M, Carson SW "Nefazodone inhibits methylprednisolone disposition and enhances its adrenal-suppressant effect." J Clin Psychopharmacol 23 (2003): 652-6. [PMID: 14624194]
26 LaForce CF, Szefler SJ, Miller MF, Ebling W, Brenner M "Inhibition of methylprednisolone elimination in the presence of erythromycin therapy." J Allergy Clin Immunol 72 (1983): 34-9. [PMID: 6602160]
27 Lebrun-Vignes B, Archer VC, Diquest B, et al. "Effect of itraconazole on the pharmacokinetics of prednisolone and methylprednisolone and cortisol secretion in healthy subjects." Br J Clin Pharmacol 51 (2001): 443-50. [PMID: 11422002]
28 Main KM, Skov M, Sillesen IB, et al. "Cushing's syndrome due to pharmacological interaction in a cystic fibrosis patient." Acta Paediatr 91 (2002): 1008-11. [PMID: 12412882]
29 Penzak SR, Formentini E, Alfaro RM, Long M, Natarajan V, Kovacs J "Prednisolone pharmacokinetics in the presence and absence of ritonavir after oral prednisone administration to healthy volunteers." J Acquir Immune Defic Syndr 40 (2005): 573-80. [PMID: 16284534]
30 Raaska K, Niemi M, Neuvonen M, Neuvonen PJ, Kivisto KT "Plasma concentrations of inhaled budesonide and its effects on plasma cortisol are increased by the cytochrome P4503A4 inhibitor itraconazole." Clin Pharmacol Ther 72 (2002): 362-369. [PMID: 12386638]
31 Skov M, Main KM, Sillesen IB, Muller J, Koch C, Lanng S "Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide." Eur Respir J 20 (2002): 127-33. [PMID: 12166560]
32 Ulrich B, Frey FJ, Speck RF, Frey BM "Pharmacokinetics/pharmacodynamics of ketoconazole-prednisolone interaction." J Pharmacol Exp Ther 260 (1992): 487-90. [PMID: 1738098]
33 Varis T, Backman JT, Kivisto KT, Neuvonen PJ "Diltiazem and mibefradil increase the plasma concentrations and greatly enhance the adrenal-suppressant effect of oral methylprednisolone." Clin Pharmacol Ther 67 (2000): 215-21. [PMID: 10741623]
34 Varis T, Kaukonen KM, Kivisto KT, Neuvonen PJ "Plasma concentrations and effects of oral methylprednisolone are considerably increased by itraconazole." Clin Pharmacol Ther 64 (1998): 363-8. [PMID: 9797792]
35 Varis T, Kivisto KT, Neuvonen PJ "The effect of itraconazole on the pharmacokinetics and pharmacodynamics of oral prednisolone." Eur J Clin Pharmacol 56 (2000): 57-60. [PMID: 10853878]
36 Yamashita SK, Ludwig EA, Middleton E Jr, Jusko WJ "Lack of pharmacokinetic and pharmacodynamic interactions between ketoconazole and prednisolone." Clin Pharmacol Ther 49 (1991): 558-70. [PMID: 1827622]
37 Zurcher RM, Frey BM, Frey FJ "Impact of ketoconazole on the metabolism of prednisolone." Clin Pharmacol Ther 45 (1989): 366-72. [PMID: 2639662]
38 Samaras K, Pett S, Gowers A, McMurchie M, Cooper DA "Iatrogenic Cushing's syndrome with osteoporosis and secondary adrenal failure in HIV-infected patients receiving inhaled corticosteroids and ritonavir-boosted protease inhibitors: six cases." J Clin Endocrinol Metab 90 (2005): 4394-8. [PMID: 15755851]
39 Product Information. Indium Oxyquinoline In-111 (indium oxyquinoline In-111). GE Healthcare, Princeton, NJ.
40 Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
41 Black DM, Filak AT "Hyperglycemia with non-insulin-dependent diabetes following intraarticular steroid injection." J Fam Pract 28 (1989): 462-3. [PMID: 2703816]
42 Greenstone MA, Shaw AB "Alternate day corticosteroid causes alternate day hyperglycaemia." Postgrad Med J 63 (1987): 761-4. [PMID: 3444801]
43 Product Information. EXUBERA (insulin inhalation, rapid acting). Pfizer U.S. Pharmaceuticals Group, New York, NY.
44 Product Information. Foradil (formoterol) Novartis Pharmaceuticals, East Hanover, NJ.