II. Indications
- Exercise Induced Asthma
- Mastocytosis
III. Mechanism
- Cromolyn (Cromoglycate)
- Synthetic Mast Cell Stabilizer with anti-inflammatory activity used to prevent type 1 Allergic Reactions
- Blocks Antigen-mediated Calcium influx into Mast Cells (and other inflammatory cells)
- Prevents degranulation, the release of inflammatory mediators (e.g. Histamine, Leukotriene) from Mast Cells
- Also prevents degranulation from other inflammatory cells (e.g. Macrophages, PMNs, Eosinophils)
- Also inhibits Eosinophil chemotaxis
- Cromolyn Sodium (Sodium Cromoglycate)
- Sodium salt form of cromlyn typically used in inhaled and Topical Medications
IV. Medications
- Inhaled (Exercise-Induced Asthma)
- Cromolyn Sodium Inhaler (MDI)
- Nebulized Cromolyn Sodium Solution
- Oral Solution (Mastocytosis)
- Cromolyn Sodium Oral Solution
- Ocular Mast Cell Stabilizer (Crolom, for Allergic Conjunctivitis)
- Intranasal Mast Cell Stabilizer (Allergic Rhinitis)
V. Dosing: Asthma
-
Exercise-Induced Asthma
- Approved for age 5 years and older
- Use two puffs via MDI (or 20 mg/2ml nebulized) 10 to 15 minutes before Exercise
- Chronic Asthma
- Not recommended in modern Asthma guidelines
- FDA approved MDI for use in age >=5 years, and nebulizer for use age >=2 years
- Use two puffs via MDI (or 20 mg/2ml nebulized) four times daily
- Adults may use up to 4 puffs at one time
VI. Dosing: Mastocytosis
- Dissolve oral concentrate (100 mg/5 ml) in water, strir and drink
- Take 30 minutes before meals and at bedtime
- Ages 2 to 12 years: 100 mg orally taken four times daily
- Age >12 years and Adults: 200 mg orally taken four times daily
VII. Dosing: Topical Cromolyn
-
Ocular Mast Cell Stabilizer (Allergic Conjunctivitis)
- See Cromolyn Sodium Ophthalmic
- Cromolyn Sodium (Crolom) 1 drop in each eye every 4 to 6 hours (or 4 to 6 times daily)
-
Intranasal Mast Cell Stabilizer (Allergic Rhinitis, age >=2 years)
- See Intranasal Cromolyn
- Intranasal Cromolyn (NasalCrom) use 1 puff every 6 to 8 hours (or 3 to 4 times daily)
VIII. Efficacy: Inhaler in Asthma
IX. Adverse Effects: Asthma Inhaler
X. Safety
- Pregnancy Category B
- Unknown safety in Lactation
XI. Pharmacokinetics
- Slow onset of action
- Effects may be delayed for weeks after starting and using regularly
XII. Resources
- Cromolyn Sodium Oral Concentrate
- Cromolyn Sodium Nebulizer Solution
XIII. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- (2022) Comparison of Asthma Medications, Presc Lett, #381217
Images: Related links to external sites (from Bing)
Related Studies
| cromolyn sodium (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CROMOLYN SODIUM NASAL SPRAY | Generic OTC | $0.26 per ml |
| cromolyn (on 6/21/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CROMOLYN 100 MG/5 ML ORAL CONC | Generic | $0.27 per ml |
| CROMOLYN 20 MG/2 ML NEB SOLN | Generic | $1.50 per ml |
| CROMOLYN 4% EYE DROPS | Generic | $0.59 per ml |