Synonyms: (1R,3'R,4R,6R,7R,11Z)-7-Hydroxy-3',6,7,14-tetramethyl-8H,17H-spiro[2,9-dioxa-14-azabicyclo[9.5.1]heptadec-11-ene-4,2'-oxirane]-3,8,17-trione;spiro[2,9-dioxa-14-azabicyclo[9.5.1]heptadec-11-ene-4,2'-oxirane]-3,8,17-trione, 7-hydroxy-3',6,7,14-tetramethyl-, (1R,3'R,4R,6R,7R,11Z)-