Flumetasone, also known as flumethasone,[1] is a corticosteroid for topical use. It has anti-inflammatory, antipruritic, and vasoconstrictive properties, and it is approved for human and animal use for a variety of medical conditions.[2][3]

Flumetasone
Clinical data
Trade namesFlucort
Other namesFlumethasone (USAN)
AHFS/Drugs.comMicromedex Detailed Consumer Information
Routes of
administration
Topical
ATC code
Legal status
Legal status
Pharmacokinetic data
MetabolismLiver, CYP3A4-mediated
Identifiers
  • (1R,2S,8S,10S,11S,13R,14R,15S,17S)-1,8-difluoro-14,17-dihydroxy-14-(2-hydroxyacetyl)-2,13,15-trimethyltetracyclo[8.7.0.02,7.011,15]heptadeca-3,6-dien-5-one
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.016.701 Edit this at Wikidata
Chemical and physical data
FormulaC22H28F2O5
Molar mass410.458 g·mol−1
3D model (JSmol)
  • C[C@@H]1C[C@H]2[C@@H]3C[C@@H](C4=CC(=O)C=C[C@@]4([C@]3([C@H](C[C@@]2([C@]1(C(=O)CO)O)C)O)F)C)F
  • InChI=1S/C22H28F2O5/c1-11-6-13-14-8-16(23)15-7-12(26)4-5-19(15,2)21(14,24)17(27)9-20(13,3)22(11,29)18(28)10-25/h4-5,7,11,13-14,16-17,25,27,29H,6,8-10H2,1-3H3/t11-,13+,14+,16+,17+,19+,20+,21+,22+/m1/s1 ☒N
  • Key:WXURHACBFYSXBI-GQKYHHCASA-N ☒N
 ☒NcheckY (what is this?)  (verify)

It was patented in 1951 and approved for medical use in 1964.[4]

Chemistry and mechanism of action

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Flumetasone is classified as a moderately potent corticosteroid and a glucocorticoid receptor agonist. Like other corticosteroids, it functions as an immunosuppressant by decreasing function of the lymphatic system, reducing immunoglobulin and complement concentrations, lowering lymphocyte concentrations, and preventing antigen-antibody binding.[2] Flumethasone is 420 times as potent as cortisone in an animal model for anti-inflammatory activity.[citation needed]

Society and culture

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Names

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Trade names include Locacorten, Locorten, and Orsalin.[5] It is available in combination with clioquinol, under the brand name Locacorten-Vioform (in some countries Locorten-Vioform[6]), for the treatment of otitis externa and otomycosis.[7] It is usually formulated as the pivalic acid ester prodrug called flumetasone pivalate.[2]

Veterinary uses

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In April 2023, the US Food and Drug Administration approved the first generic version of flumethasone (Bimasone), for certain diseases that cause inflammation in horses, dogs, and cats.[3] Flumetasone is recommended for the various rheumatic, allergic, dermatologic and other disease states that are known to be responsive to anti-inflammatory drugs (i.e., corticoids) in these species.[3]

In horses, flumetasone is approved for use for musculoskeletal conditions due to inflammation, such as bursitis (a painful condition that affects the fluid-filled sacs that cushion the bones, tendons and muscles near a horse's joints, often in the hip or shoulder), carpitis (inflammation of the connective tissues near the horse's carpus, which is comparable to the human wrist), osselets (arthritis in the fetlock joint of a horse, often in the front legs), and myositis (rapid muscle wasting, often in the horse's hindquarters).[3]

In dogs, Bimasone is approved for use for musculoskeletal conditions due to inflammation of muscles or joints, such as arthritis, osteoarthritis, intervertebral disc disease, and myositis.[3] The drug has proven useful in treating canine ear infections (otitis externa) when used with topical medication for similar reasons.[3] It is also approved for certain acute and chronic skin conditions (dermatoses) from various causes to help control the itchy skin (pruritus), irritation, and inflammation associated with these conditions, and for use in treating allergic reactions, such as hives, urticaria (raised itchy rash on skin), and insect bites.[3] Flumetasone is also approved for treating shock in dogs, when administered intravenously.[3]

In cats, flumetasone is approved for certain acute and chronic skin conditions (dermatoses) from various causes to help control the itchy skin (pruritus), irritation, and inflammation associated with these conditions.[3]

References

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  1. ^ Morton IK, Hall JM (1999). Concise Dictionary of Pharmacological Agents Properties and Synonyms. Dordrecht: Springer Netherlands. p. 122. ISBN 9789401144391.
  2. ^ a b c "Flumethasone". National Center for Advancing Translational Sciences.
  3. ^ a b c d e f g h i "FDA Approves Generic Flumethasone for Diseases in Cats, Dogs and Horse". U.S. Food and Drug Administration (FDA). 5 April 2023. Archived from the original on 7 April 2023. Retrieved 7 April 2023.   This article incorporates text from this source, which is in the public domain.
  4. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 484. ISBN 9783527607495. Archived from the original on 10 January 2023. Retrieved 7 April 2023.
  5. ^ "Flumetasone Overview - Active Ingredient - RxReasoner". www.rxreasoner.com. Retrieved 7 February 2024.
  6. ^ "Flumetasone/Clioquinol 0.02% w/v / 1% w/v Ear Drops solution - Summary of Product Characteristics (SmPC) - (emc)". www.medicines.org.uk. Retrieved 7 February 2024.
  7. ^ "Locacorten Vioform Eardrops - Uses, Side Effects, Interactions - MedBroadcast.com". www.medbroadcast.com. Retrieved 7 February 2024.