A Comprehensive Monograph on Fluocinolone Acetonide (DB00591): From Topical Dermatoses to Intravitreal Implants

Overview and Key Findings

Fluocinolone acetonide is a synthetic, fluorinated corticosteroid that has been a cornerstone of anti-inflammatory therapy for over six decades. Identified by DrugBank ID DB00591 and CAS Number 67-73-2, this small molecule has demonstrated remarkable versatility, attributable to its potent intrinsic activity and its adaptability to a wide range of pharmaceutical formulations.[1] This report provides an exhaustive analysis of fluocinolone acetonide, synthesizing data from chemical databases, regulatory filings, clinical trials, and professional pharmacotherapy resources to create a definitive monograph for clinicians and researchers.

The primary mechanism of action for fluocinolone acetonide is its function as a high-affinity agonist of the intracellular glucocorticoid receptor.[1] This interaction initiates a cascade of genomic effects, leading to the upregulation of anti-inflammatory proteins like annexin-1 and the subsequent suppression of key inflammatory mediators, including prostaglandins and leukotrienes.[2] This fundamental activity translates into potent anti-inflammatory, antipruritic, and vasoconstrictive effects, which form the basis of its therapeutic utility.[4]

A defining characteristic of fluocinolone acetonide is the critical role that pharmaceutical formulation plays in dictating its clinical application and safety profile. The same active pharmaceutical ingredient is engineered into a spectrum of products, from low-potency topical creams, oils, and shampoos for the management of dermatological conditions such as atopic dermatitis and psoriasis, to sophisticated, long-acting intravitreal implants for chronic, sight-threatening ocular diseases like diabetic macular edema (DME) and non-infectious posterior uveitis.[2]