Indication Type	Indication	Combined Product Details	Approval Level
Treatment of	Dermatoses		••••••••••••
Used in combination to treat	Inflammation	Combination Product in combination with: Neomycin (DB00994), Nystatin (DB00646), Gramicidin D (DB00027)	••••••••••••
Used in combination to treat	Pruritus	Combination Product in combination with: Neomycin (DB00994), Nystatin (DB00646), Gramicidin D (DB00027)	••••••••••••

Contraindications & Blackbox Warnings

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Pharmacodynamics

Fluocinonide is a potent glucocorticoid steroid used topically as anti-inflammatory agent for the treatment of skin disorders such as eczema. It mediates its effects to relieve itching, redness, dryness, crusting, scaling, inflammation, and discomfort associated with inflammatory skin conditions.

Mechanism of action

Fluocinonide is a potent glucocorticoid steroid used topically as anti-inflammatory agent for the treatment of skin disorders such as eczema. Fluocinonide 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.

Target	Actions	Organism
AGlucocorticoid receptor	agonist	Humans
USmoothened homolog	agonist	Humans

Absorption

The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings. In general, percutaneous absorption is minimal.

Volume of distribution

Not Available

Protein binding

Not Available

Metabolism

Not Available

Route of elimination

Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys.

Half-life

Not Available

Clearance

Not Available

Adverse Effects

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Toxicity

Side effects may include acne-like eruptions, burning, dryness, excessive hair growth, infection of the skin, irritation, itching, lack of skin colour, prickly heat, skin inflammation, skin loss or softening, stretch marks.

Pathways

Not Available

Pharmacogenomic Effects/ADRs Browse all" title="About SNP Mediated Effects/ADRs" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">

Not Available

Interactions

Drug Interactions Learn More" title="About Drug Interactions" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">

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.

Drug	Interaction
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Abametapir	The serum concentration of Fluocinonide can be increased when it is combined with Abametapir.
Abatacept	The risk or severity of adverse effects can be increased when Fluocinonide is combined with Abatacept.
Abemaciclib	The metabolism of Abemaciclib can be increased when combined with Fluocinonide.
Acalabrutinib	The metabolism of Acalabrutinib can be increased when combined with Fluocinonide.
Acarbose	The risk or severity of hyperglycemia can be increased when Fluocinonide is combined with Acarbose.

Food Interactions

No interactions found.

Products

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International/Other Brands

Fluonex / Lonide / Lyderm (Taro) / Metosyn (Bioglan) / Topsymin / Topsyn (Syntex)

Brand Name Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Fluocinol Pak	Cream; Kit	1 mg/1g	Topical	PureTek Corporation	2020-07-02	Not applicable
Fluocinonide	Solution	0.5 mg/1mL	Topical	County Line Pharmaceuticals, LLC	2014-02-28	2019-10-01
Fluocinonide	Cream	0.5 mg/1g	Topical	A S Medication Solutions	1984-06-26	Not applicable
Fluocinonide	Ointment	0.5 mg/1g	Topical	Nucare Pharmaceuticals,inc.	2017-10-02	Not applicable
Fluocinonide	Cream	0.5 mg/1g	Topical	Lake Erie Medical DBA Quality Care Products LLC	1984-06-26	2018-02-08

Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Fluocinonide	Cream	0.5 mg/1g	Topical	A-S Medication Solutions	1990-09-30	Not applicable
Fluocinonide	Ointment	0.5 mg/1g	Topical	Nucare Pharmaceuticals,inc.	1992-05-01	Not applicable
Fluocinonide	Cream	1 mg/1g	Topical	bryant ranch prepack	2020-04-30	Not applicable
Fluocinonide	Ointment	0.5 mg/1g	Topical	Physicians Total Care, Inc.	1994-11-22	Not applicable
Fluocinonide	Ointment	0.5 mg/1g	Topical	Teva Pharmaceuticals USA, Inc.	1992-05-01	Not applicable

Mixture Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End
Flumethovix	Fluocinonide (1 mg/1g) + Dimethicone (1.8 g/100g) + Zinc oxide (2 g/100g)	Kit	Topical	Primary Pharmaceuticals, Inc.	2021-02-19	2024-01-31
Hexicinide	Fluocinonide (1 mg/1g) + Chlorhexidine gluconate (4 g/100mL)	Kit	Topical	PureTek Corporation	2014-01-14	Not applicable
Lidecomb Cream	Fluocinonide (0.5 mg / g) + Gramicidin D (0.25 mg / g) + Neomycin sulfate (5 mg / g) + Nystatin (100000 unit / g)	Cream	Topical	Medicis Pharmaceutical Corporation	1980-12-31	1998-09-25

Unapproved/Other Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End
Fluocinol Pak	Fluocinonide (1 mg/1g)	Cream; Kit	Topical	PureTek Corporation	2020-07-02	Not applicable
Fluocinonide 0.05% / Hyaluronic Acid Sodium Salt 0.5% / Niacinamide 4%	Fluocinonide (0.05 g/100g) + Sodium hyaluronate (0.5 g/100g)	Cream	Topical	Sincerus Florida, LLC	2019-05-22	Not applicable
Fluopar	Fluocinonide (1 mg/1g) + Dimethicone (50 mg/1mL)	Cream; Kit	Topical	PureTek Corporation	2014-01-14	Not applicable

Chemical Identifiers

UNII: 2W4A77YPAN
CAS number: 356-12-7
InChI Key: WJOHZNCJWYWUJD-IUGZLZTKSA-N
InChI: InChI=1S/C26H32F2O7/c1-13(29)33-12-20(32)26-21(34-22(2,3)35-26)10-15-16-9-18(27)17-8-14(30)6-7-23(17,4)25(16,28)19(31)11-24(15,26)5/h6-8,15-16,18-19,21,31H,9-12H2,1-5H3/t15-,16-,18-,19-,21+,23-,24-,25-,26+/m0/s1
IUPAC Name: 2-[(1S,2S,4R,8S,9S,11S,12R,13S,19S)-12,19-difluoro-11-hydroxy-6,6,9,13-tetramethyl-16-oxo-5,7-dioxapentacyclo[10.8.0.0^{2,9}.0^{4,8}.0^{13,18}]icosa-14,17-dien-8-yl]-2-oxoethyl acetate
SMILES: [H][C@@]12C[C@@]3([H])[C@]4([H])C[C@H](F)C5=CC(=O)C=C[C@]5(C)[C@@]4(F)[C@@H](O)C[C@]3(C)[C@@]1(OC(C)(C)O2)C(=O)COC(C)=O

References

Synthesis Reference

US. Patent 3,197,469.

General References

Not Available

External Links

Human Metabolome Database: HMDB0015181
KEGG Drug: D00325
PubChem Compound: 9642
PubChem Substance: 46504523
ChemSpider: 9265
RxNav: 4462
ChEBI: 5109
ChEMBL: CHEMBL1501
ZINC: ZINC000003977978
Therapeutic Targets Database: DAP000421
PharmGKB: PA449664
RxList: RxList Drug Page
Drugs.com: Drugs.com Drug Page
PDRhealth: PDRhealth Drug Page
Wikipedia: Fluocinonide

FDA label

Download (818 KB)

MSDS

Download (75.1 KB)

Clinical Trials

Clinical Trials Learn More" title="About Clinical Trials" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">

Phase	Status	Purpose	Conditions	Count
4	Completed	Treatment	Atopic Dermatitis	2
4	Recruiting	Treatment	Central Centrifugal Cicatricial Alopecia (CCCA)	1
2	Completed	Supportive Care	Breast Carcinoma	1
2	Completed	Treatment	Atopic Dermatitis	1
2	Terminated	Treatment	Hand and Foot Skin Reaction / Rash	1

Pharmacoeconomics

Manufacturers

Not Available

Packagers

Actavis Group
Advanced Pharmaceutical Services Inc.
A-S Medication Solutions LLC
Contract Pharm
Dispensing Solutions
Diversified Healthcare Services Inc.
E. Fougera and Co.
Gallipot
Innoviant Pharmacy Inc.
Major Pharmaceuticals
Mason Distributors
Medicis Pharmaceutical Co.
Nycomed Inc.
Palmetto Pharmaceuticals Inc.
Patheon Inc.
Pharmedix
Physicians Total Care Inc.
Preferred Pharmaceuticals Inc.
Qualitest
Quality Care
Rebel Distributors Corp.
Stat Rx Usa
Taro Pharmaceuticals USA
Teva Pharmaceutical Industries Ltd.
United Research Laboratories Inc.

Dosage Forms

Form	Route	Strength
Cream; kit	Topical	1 mg/1g
Cream	Topical	0.5 mg/1g
Gel	Topical	0.5 mg/1g
Ointment	Topical	0.05 mg/1g
Ointment	Topical	0.5 mg/1g
Solution	Topical	0.5 mg/1mL
Cream	Topical
Powder	Not applicable	1 g/1g
Cream; kit	Topical
Kit	Topical	1 mg/1g
Kit	Topical
Cream	Topical	0.05 % w/w
Cream; emulsion	Topical	.05 %
Gel	Topical	0.05 % w/w
Ointment	Topical	0.05 % w/w
Cream	Topical	0.01 %
Ointment	Topical	0.01 %
Ointment	Topical	.05 %
Gel	Topical	0.05 %
Ointment	Topical	0.05 %
Cream	Topical	.05 %
Cream	Topical	0.05 %
Solution	Nasal; Respiratory (inhalation)	0.05 g
Solution	Oral	0.05 %
Cream	Topical	15 MG/30G
Gel	Cutaneous	50.000 mg
Gel	Topical	15 MG/30G
Ointment	Topical	0.05 g/100g
Solution	Cutaneous	15 MG/30G
Jelly	Topical	.5 mg / g
Gel	Topical
Cream	Topical	1 mg/1g

Prices

Unit description	Cost	Unit
Vanos 0.1% Cream 60 gm Tube	275.75USD	tube
Fluocinonide powder	176.0USD	g
Vanos 0.1% Cream 30 gm Tube	155.34USD	tube
Fluocinonide 0.05% Ointment 60 gm Tube	50.96USD	tube
Fluocinonide 0.05% Gel 60 gm Tube	50.78USD	tube
Fluocinonide-E 0.05% Cream 60 gm Tube	47.84USD	tube
Fluocinonide 0.05% Gel 30 gm Tube	30.1USD	tube
Fluocinonide 0.05% Ointment 30 gm Tube	28.61USD	tube
Fluocinonide-E 0.05% Cream 30 gm Tube	28.6USD	tube
Fluocinonide 0.05% Solution 60ml Bottle	27.23USD	bottle
Fluocinonide 0.05% Cream 60 gm Tube	22.71USD	tube
Fluocinonide 0.05% Solution 20ml Bottle	21.99USD	bottle
Fluocinonide 0.05% Ointment 15 gm Tube	21.88USD	tube
Fluocinonide 0.05% Gel 15 gm Tube	21.85USD	tube
Fluocinonide-E 0.05% Cream 15 gm Tube	20.18USD	tube
Fluocinonide 0.05% Cream 30 gm Tube	13.54USD	tube
Fluocinonide 0.05% Cream 15 gm Tube	11.99USD	tube
Vanos 0.1% cream	4.13USD	g
Lidex 0.05% cream	3.57USD	g
Fluocinonide-e 0.05% cream	1.33USD	g
Fluocinonide 0.05% cream	0.6USD	g
Fluocinonide-emol 0.05% cream	0.4USD	g
Lyderm 0.05 % Gel	0.38USD	g
Lyderm 0.05 % Ointment	0.37USD	g
Lyderm 0.05 % Cream	0.29USD	g
Tiamol 0.05 % Emollient Cream	0.27USD	g

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)
US7220424	No	2007-05-22	2023-01-07
US7794738	No	2010-09-14	2022-09-11
US8232264	No	2012-07-31	2023-03-09
US6765001	No	2004-07-20	2021-12-21

Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	309 °C	PhysProp
water solubility	4.74 mg/L	Not Available
logP	3.19	HANSCH,C ET AL. (1995)

Predicted Properties

Property	Value	Source
Water Solubility	0.0168 mg/mL	ALOGPS
logP	2.93	ALOGPS
logP	2.05	Chemaxon
logS	-4.5	ALOGPS
pKa (Strongest Acidic)	13.6	Chemaxon
pKa (Strongest Basic)	-3.4	Chemaxon
Physiological Charge	0	Chemaxon
Hydrogen Acceptor Count	6	Chemaxon
Hydrogen Donor Count	1	Chemaxon
Polar Surface Area	99.13 Å²	Chemaxon
Rotatable Bond Count	4	Chemaxon
Refractivity	120.56 m³·mol^-1	Chemaxon
Polarizability	48.97 Å³	Chemaxon
Number of Rings	5	Chemaxon
Bioavailability	1	Chemaxon
Rule of Five	Yes	Chemaxon
Ghose Filter	No	Chemaxon
Veber's Rule	No	Chemaxon
MDDR-like Rule	No	Chemaxon

Predicted ADMET Features

Property	Value	Probability
Human Intestinal Absorption	+	0.9823
Blood Brain Barrier	+	0.981
Caco-2 permeable	-	0.5804
P-glycoprotein substrate	Substrate	0.7813
P-glycoprotein inhibitor I	Inhibitor	0.8103
P-glycoprotein inhibitor II	Non-inhibitor	0.5782
Renal organic cation transporter	Non-inhibitor	0.8178
CYP450 2C9 substrate	Non-substrate	0.8667
CYP450 2D6 substrate	Non-substrate	0.8951
CYP450 3A4 substrate	Substrate	0.7219
CYP450 1A2 substrate	Non-inhibitor	0.9045
CYP450 2C9 inhibitor	Non-inhibitor	0.9071
CYP450 2D6 inhibitor	Non-inhibitor	0.9482
CYP450 2C19 inhibitor	Non-inhibitor	0.9025
CYP450 3A4 inhibitor	Non-inhibitor	0.8309
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.8455
Ames test	Non AMES toxic	0.7768
Carcinogenicity	Non-carcinogens	0.9166
Biodegradation	Not ready biodegradable	1.0
Rat acute toxicity	3.1492 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9835
hERG inhibition (predictor II)	Non-inhibitor	0.6907

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	splash10-0005-2970300000-b28abd90df71a08d5830
LC-MS/MS Spectrum - LC-ESI-qTof , Positive	LC-MS/MS	splash10-05p9-0489400000-cb64b15c0db3ac6d9647
MS/MS Spectrum - , positive	LC-MS/MS	splash10-05p9-0489400000-cb64b15c0db3ac6d9647
Predicted MS/MS Spectrum - 10V, Positive (Annotated)	Predicted LC-MS/MS	splash10-004j-0003900000-01b056b48a5ee67e1083
Predicted MS/MS Spectrum - 10V, Negative (Annotated)	Predicted LC-MS/MS	splash10-0006-1000900000-12f663e512060d8df28c
Predicted MS/MS Spectrum - 20V, Negative (Annotated)	Predicted LC-MS/MS	splash10-053r-8000900000-6de714eb8dce2c96b0ef
Predicted MS/MS Spectrum - 20V, Positive (Annotated)	Predicted LC-MS/MS	splash10-00ke-1002900000-70cc2a78c884a447a289
Predicted MS/MS Spectrum - 40V, Negative (Annotated)	Predicted LC-MS/MS	splash10-0a4l-8500900000-912d93636e50ba506b6f
Predicted MS/MS Spectrum - 40V, Positive (Annotated)	Predicted LC-MS/MS	splash10-0api-4383900000-d09e6a27c91a10dbf512
Predicted 1H NMR Spectrum	1D NMR	Not Applicable
Predicted 13C NMR Spectrum	1D NMR	Not Applicable

Chromatographic Properties

Collision Cross Sections (CCS)

Adduct	CCS Value (Å²)	Source type	Source
[M-H]-	216.898939	predicted	DarkChem Lite v0.1.0
[M-H]-	208.06499	predicted	DeepCCS 1.0 (2019)
[M+H]+	216.475839	predicted	DarkChem Lite v0.1.0
[M+H]+	210.14445	predicted	DeepCCS 1.0 (2019)
[M+Na]+	217.046239	predicted	DarkChem Lite v0.1.0
[M+Na]+	216.1546	predicted	DeepCCS 1.0 (2019)

Targets

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insights and accelerate drug research.

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Details1. Glucocorticoid receptor

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

Jessop S, Whitelaw D, Jordaan F: Drugs for discoid lupus erythematosus. Cochrane Database Syst Rev. 2001;(1):CD002954. [Article]

Details2. Smoothened homolog

Kind: Protein
Organism: Humans
Pharmacological action: Unknown
Actions: Agonist

General Function: Wnt-protein binding
Specific Function: G protein-coupled receptor that probably associates with the patched protein (PTCH) to transduce the hedgehog's proteins signal. Binding of sonic hedgehog (SHH) to its receptor patched is thought t...
Gene Name: SMO
Uniprot ID: Q99835
Uniprot Name: Smoothened homolog
Molecular Weight: 86395.95 Da

References

Wang J, Lu J, Bond MC, Chen M, Ren XR, Lyerly HK, Barak LS, Chen W: Identification of select glucocorticoids as Smoothened agonists: potential utility for regenerative medicine. Proc Natl Acad Sci U S A. 2010 May 18;107(20):9323-8. doi: 10.1073/pnas.0910712107. Epub 2010 May 3. [Article]

Enzymes

Details1. Cytochrome P450 3A4

Kind: Protein
Organism: Humans
Pharmacological action: No
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

Moore CD, Roberts JK, Orton CR, Murai T, Fidler TP, Reilly CA, Ward RM, Yost GS: Metabolic pathways of inhaled glucocorticoids by the CYP3A enzymes. Drug Metab Dispos. 2013 Feb;41(2):379-89. doi: 10.1124/dmd.112.046318. Epub 2012 Nov 9. [Article]
Dvorak Z, Pavek P: Regulation of drug-metabolizing cytochrome P450 enzymes by glucocorticoids. Drug Metab Rev. 2010 Nov;42(4):621-35. doi: 10.3109/03602532.2010.484462. [Article]

Details2. Cytochrome P450 3A5

Kind: Protein
Organism: Humans
Pharmacological action: Unknown
Actions: Inducer

General Function: Oxygen binding
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 oxidizes a variety of structurally un...
Gene Name: CYP3A5
Uniprot ID: P20815
Uniprot Name: Cytochrome P450 3A5
Molecular Weight: 57108.065 Da

References

Dvorak Z, Pavek P: Regulation of drug-metabolizing cytochrome P450 enzymes by glucocorticoids. Drug Metab Rev. 2010 Nov;42(4):621-35. doi: 10.3109/03602532.2010.484462. [Article]

Carriers

Details1. Corticosteroid-binding globulin

Kind: Protein
Organism: Humans
Pharmacological action: Unknown
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

Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [Article]
Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [Article]
Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [Article]

Drug created at June 13, 2005 13:24 / Updated at February 20, 2024 23:55

Fluocinonide

Identification

Structure for Fluocinonide (DB01047)

Pharmacology

Interactions

Products

Categories

Chemical Identifiers

References

Clinical Trials

Pharmacoeconomics

Properties

Spectra

Collision Cross Sections (CCS)

Targets

References

References

Enzymes

References

References

Carriers

References