Details of Drug

Drug General Information (ID: D0684)
Drug Name	Fluticasone (nasal)
Drug Type	Small molecule
Drug Synonymous	Fluticaps; Fluticaps (TN); Fluticasone (INN); S-(fluoromethyl) (6S,8S,9R,10S,11S,13S,14S,16R,17R)-6,9-difluoro-11,17-dihydroxy-10,13,16-trimethyl-3-oxo-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthrene-17-carbothioate Click to Show/Hide
Disease Class	CA08: Vasomotor/allergic rhinitis
Therapeutic Class	Antiinflammatory Agents
Structure
Structure	3D Structure		2D Structure
Formula	C22H27F3O4S
InChI	1S/C22H27F3O4S/c1-11-6-13-14-8-16(24)15-7-12(26)4-5-19(15,2)21(14,25)17(27)9-20(13,3)22(11,29)18(28)30-10-23/h4-5,7,11,13-14,16-17,27,29H,6,8-10H2,1-3H3/t11-,13+,14+,16+,17+,19+,20+,21+,22+/m1/s1
InChIKey	MGNNYOODZCAHBA-GQKYHHCASA-N
Canonical SMILES	CC1CC2C3CC(C4=CC(=O)C=CC4(C3(C(CC2(C1(C(=O)SCF)O)C)O)F)C)F
External Link
	Pubchem ID	5311101
	CAS Number	90566-53-3
	CHEBI ID	5134
	TTD ID	D0LC6K

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM004 Affected intra/extra-hepatic metabolism BM017 CYP450 enzyme inhibition BM022 CYP450 enzyme induction
Relation Graph

Full list of drugs interacting with Fluticasone (nasal)
Affected intra/extra-hepatic metabolism
	CYP450 enzyme inhibition					Drug Num: 47
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0080		Amprenavir	C25H35N3O6S	65016	Major		Inter Info	[1], [2], [3]
D0116		Atazanavir	C38H52N6O7	148192	Major		Inter Info	[1], [2], [3]
D0192		Boceprevir	C27H45N5O5	10324367	Major		Inter Info	[1], [2], [3]
D0302		Ceritinib	C28H36ClN5O3S	57379345	Major		Inter Info	[1], [2], [3]
D0349		Clarithromycin	C38H69NO13	84029	Major		Inter Info	[1], [2], [3]
D0375		Cobicistat	C40H53N7O5S2	25151504	Major		Inter Info	[1], [2], [3]
D0386		Conivaptan	C32H26N4O2	151171	Major		Inter Info	[1], [2], [3]
D0439		Delavirdine	C22H28N6O3S	5625	Major		Inter Info	[1], [2], [3]
D0692		Fosamprenavir	C25H36N3O9PS	131536	Major		Inter Info	[1], [2], [3]
D0789		Idelalisib	C22H18FN7O	11625818	Major		Inter Info	[1], [2], [3]
D0799		Indinavir	C36H47N5O4	5362440	Major		Inter Info	[1], [2], [3]
D0867		Itraconazole	C35H38Cl2N8O4	55283	Major		Inter Info	[1], [2], [3]
D0880		Ketoconazole	C26H28Cl2N4O4	456201	Major		Inter Info	[1], [2], [3]
D0946		Lonafarnib	C27H31Br2ClN4O2	148195	Major		Inter Info	[1], [2], [3]
D1117		Nefazodone	C25H32ClN5O2	4449	Major		Inter Info	[1], [2], [3]
D1119		Nelfinavir	C32H45N3O4S	64143	Major		Inter Info	[1], [2], [3]
D1315		Posaconazole	C37H42F2N8O4	468595	Major		Inter Info	[1], [2], [3]
D1415		Ritonavir	C37H48N6O5S2	392622	Major		Inter Info	[4], [5], [6]
D1444		Saquinavir	C38H50N6O5	441243	Major		Inter Info	[1], [2], [3]
D1541		Telaprevir	C36H53N7O6	3010818	Major		Inter Info	[1], [2], [3]
D1544		Telithromycin	C43H65N5O10	3002190	Major		Inter Info	[1], [2], [3]
D1653		Troleandomycin	C41H67NO15	202225	Major		Inter Info	[1], [2], [3]
D1660		Tucatinib	C26H24N8O2	51039094	Major		Inter Info	[1], [2], [3]
D1706		Voriconazole	C16H14F3N5O	71616	Major		Inter Info	[1], [2], [3]
D0100		Aprepitant	C23H21F7N4O3	135413536	Moderate		Inter Info	[7], [8], [9]
D0313		Chloramphenicol	C11H12Cl2N2O5	5959	Moderate		Inter Info	[7], [8], [9]
D0341		Ciprofloxacin	C17H18FN3O3	2764	Moderate		Inter Info	[7], [8], [9]
D0393		Crizotinib	C21H22Cl2FN5O	11626560	Moderate		Inter Info	[7], [8], [9]
D0413		Dalfopristin	C34H50N4O9S	6323289	Moderate		Inter Info	[7], [8], [9]
D0426		Darunavir	C27H37N3O7S	213039	Moderate		Inter Info	[7], [8], [9]
D0497		Diltiazem	C22H26N2O4S	39186	Moderate		Inter Info	[7], [8], [9]
D0534		Dronedarone	C31H44N2O5S	208898	Moderate		Inter Info	[7], [8], [9]
D0543		Duvelisib	C22H17ClN6O	50905713	Moderate		Inter Info	[7], [8], [9]
D0638		Fedratinib	C27H36N6O3S	16722836	Moderate		Inter Info	[7], [8], [9]
D0667		Fluconazole	C13H12F2N6O	3365	Moderate		Inter Info	[7], [8], [9]
D0171		Berotralstat	C30H26F4N6O	137528262	Moderate		Inter Info	[7], [8], [9]
D0696		Fosnetupitant	C31H35F6N4O5P	71544786	Moderate		Inter Info	[7], [8], [9]
D1709		Voxelotor	C19H19N3O3	71602803	Moderate		Inter Info	[7], [8], [9]
D0693		Fosaprepitant	C23H22F7N4O6P	135413538	Moderate		Inter Info	[7], [8], [9]
D0793		Imatinib	C29H31N7O	5291	Moderate		Inter Info	[7], [8], [9]
D0852		Isavuconazonium	C35H35F2N8O5S+	6918606	Moderate		Inter Info	[7], [8], [9]
D0906		Letermovir	C29H28F4N4O4	45138674	Moderate		Inter Info	[7], [8], [9]
D1127		Netupitant	C30H32F6N4O	6451149	Moderate		Inter Info	[7], [8], [9]
D1398		Ribociclib	C23H30N8O	44631912	Moderate		Inter Info	[7], [8], [9]
D1505		Stiripentol	C14H18O3	5311454	Moderate		Inter Info	[7], [8], [9]
D1690		Verapamil	C27H38N2O4	2520	Moderate		Inter Info	[7], [8], [9]
D0597		Erythromycin	C37H67NO13	12560	Minor		Inter Info	[11], [5], [2]
	CYP450 enzyme induction					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0545		Echinacea	NA	NA	Moderate		Inter Info	[7], [10]

References
1	Product Information. Norvir (ritonavir). Abbott Pharmaceutical, Abbott Park, IL.
2	Product Information. Veramyst (fluticasone nasal). GlaxoSmithKline, Research Triangle Park, NC.
3	Valin N, De Castro N, Garrait V, Bergeron A, Bouche C, Molina JM "Iatrogenic Cushing's syndrome in HIV-infected patients receiving ritonavir and inhaled fluticasone: description of 4 new cases and review of the literature." J Int Assoc Physicians AIDS Care 8 (2009): 113-21. [PMID: 19270151]
4	Fardon TC, Lee DK, Haggart K, McFarlane LC, Lipworth BJ "Adrenal suppression with dry powder formulations of fluticasone propionate and mometasone furoate." Am J Respir Crit Care Med 170 (2004): 960-6. [PMID: 15184207]
5	Product Information. Flovent (fluticasone). Glaxo Wellcome, Research Triangle Park, NC.
6	Rouanet I, Peyriere H, Mauboussin JM, Vincent D "Cushing's syndrome in a patient treated by ritonavir/lopinavir and inhaled fluticasone." HIV Med 4 (2003): 149-50. [PMID: 12702137]
7	Cerner Multum, Inc. "Australian Product Information.".
8	Product Information. Imbruvica (ibrutinib). Pharmacyclics Inc, Sunnyvale, CA.
9	St Clair K, Maguire JD "Role of fluconazole in a case of rapid onset ritonavir and inhaled fluticasone-associated secondary adrenal insufficiency." Int J STD AIDS 23 (2012): 371-2. [PMID: 22648897]
10	Gorski JC, Huang SM, Pinto A, et al. "The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo." Clin Pharmacol Ther 75 (2004): 89-100. [PMID: 14749695]
11	Cerner Multum, Inc. "UK Summary of Product Characteristics.".

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