II. Indications

III. Mechanism

  1. Cromolyn (Cromoglycate)
    1. Synthetic Mast Cell Stabilizer with anti-inflammatory activity used to prevent type 1 Allergic Reactions
    2. Blocks Antigen-mediated Calcium influx into Mast Cells (and other inflammatory cells)
    3. Prevents degranulation, the release of inflammatory mediators (e.g. Histamine, Leukotriene) from Mast Cells
      1. Also prevents degranulation from other inflammatory cells (e.g. Macrophages, PMNs, Eosinophils)
      2. Also inhibits Eosinophil chemotaxis
  2. Cromolyn Sodium (Sodium Cromoglycate)
    1. Sodium salt form of cromlyn typically used in inhaled and Topical Medications

IV. Medications

  1. Inhaled (Exercise-Induced Asthma)
    1. Cromolyn Sodium Inhaler (MDI)
    2. Nebulized Cromolyn Sodium Solution
  2. Oral Solution (Mastocytosis)
    1. Cromolyn Sodium Oral Solution
  3. Ocular Mast Cell Stabilizer (Crolom, for Allergic Conjunctivitis)
    1. See Cromolyn Sodium Ophthalmic
  4. Intranasal Mast Cell Stabilizer (Allergic Rhinitis)
    1. See Intranasal Cromolyn

V. Dosing: Asthma

  1. Exercise-Induced Asthma
    1. Approved for age 5 years and older
    2. Use two puffs via MDI (or 20 mg/2ml nebulized) 10 to 15 minutes before Exercise
  2. Chronic Asthma
    1. Not recommended in modern Asthma guidelines
    2. FDA approved MDI for use in age >=5 years, and nebulizer for use age >=2 years
    3. Use two puffs via MDI (or 20 mg/2ml nebulized) four times daily
      1. Adults may use up to 4 puffs at one time

VI. Dosing: Mastocytosis

  1. Dissolve oral concentrate (100 mg/5 ml) in water, strir and drink
  2. Take 30 minutes before meals and at bedtime
  3. Ages 2 to 12 years: 100 mg orally taken four times daily
  4. Age >12 years and Adults: 200 mg orally taken four times daily

VII. Dosing: Topical Cromolyn

  1. Ocular Mast Cell Stabilizer (Allergic Conjunctivitis)
    1. See Cromolyn Sodium Ophthalmic
    2. Cromolyn Sodium (Crolom) 1 drop in each eye every 4 to 6 hours (or 4 to 6 times daily)
  2. Intranasal Mast Cell Stabilizer (Allergic Rhinitis, age >=2 years)
    1. See Intranasal Cromolyn
    2. Intranasal Cromolyn (NasalCrom) use 1 puff every 6 to 8 hours (or 3 to 4 times daily)

VIII. Efficacy: Inhaler in Asthma

  1. Not recommended in modern Asthma guidelines due to low efficacy
  2. NOT effective in acute bronchospasm (e.g. rescue Inhaler)

IX. Adverse Effects: Asthma Inhaler

X. Safety

  1. Pregnancy Category B
  2. Unknown safety in Lactation

XI. Pharmacokinetics

  1. Slow onset of action
  2. Effects may be delayed for weeks after starting and using regularly

XIII. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. (2022) Comparison of Asthma Medications, Presc Lett, #381217

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Related Studies

Cost: Medications

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

Ontology: Cromolyn Sodium (C0012694)

Definition (NCI) The sodium salt form of cromolyn, a mast cell stabilizer with anti-inflammatory activity. Cromolyn sodium probably interferes with the antigen-stimulated calcium transport across the mast cell membrane, thereby inhibiting mast cell release of histamine, leukotrienes, and other substances that cause hypersensitivity reactions. Cromolyn sodium also inhibits eosinophil chemotaxis.
Definition (MSH) A chromone complex that acts by inhibiting the release of chemical mediators from sensitized mast cells. It is used in the prophylactic treatment of both allergic and exercise-induced asthma, but does not affect an established asthmatic attack.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D004205
SnomedCT 40652001, 331036007, 320637004, 317419006, 330496008, 387221005
English Cromoglycate, Disodium, Cromoglycate, Sodium, Disodium Cromoglycate, Sodium Cromoglycate, Sodium cromoglycate [asthma], Sodium cromoglycate [eye], Sodium cromoglycate [gi], Sodium cromoglycate [nose], 5,5'-[(2-Hydroxy-1,3-propanediyl)bis(oxy)]bis[4-oxo-4H-1-benzopyran-2-carboxylic Acid], Disodium Salt, Cromolyn Sodium, cromolyn sodium, Cromoglicic acid sodium, Sodium cromoglycate [gastro-intestinal use], cromolyn sodium (medication), CROMOLYN SODIUM, Cromolyn Sodium [Chemical/Ingredient], cromoglycate sodium, dscg, sodium cromoglicate, scg, sodium cromoglycate, disodium cromoglycate, 4H-1-Benzopyran-2-carboxylic acid, 5,5'-((2-hydroxy-1,3-propanediyl)bis(oxy))bis(4-oxo-, disodium salt), Sodium cromoglicate [nose], Sodium cromoglicate [asthma], Sodium cromoglycate [asthma] (product), Sodium cromoglicate [gastro-intestinal use], Sodium cromoglicate [eye], Sodium cromoglycate [gastro-intestinal use] (product), Sodium cromoglycate [nose] (product), Sodium cromoglycate [eye] (product), DSCG, Disodium cromoglycate, Sodium cromoglycate, Cromolyn sodium, SCG, Sodium cromoglicate, Cromolyn sodium (product), Cromolyn sodium (substance), Sodium cromoglycate [asthma] (substance), Sodium cromoglycate [eye] (substance), Sodium cromoglycate [gastro-intestinal use] (substance), Sodium cromoglycate [nose] (substance)
Swedish Natriumkromoglikat
Czech kromoglykany, kromoglykát dvojsodný, Cromolyn, Intal
Finnish Kromoglikaatti
Russian KROMOLIN-NATRII, DINATRIIA KROMOGLIKAT, INTAL, NATRIIA KROMOGLIKAT, KROMOGLIKAT-NATRII, ДИНАТРИЯ КРОМОГЛИКАТ, ИНТАЛ, КРОМОГЛИКАТ-НАТРИЙ, КРОМОЛИН-НАТРИЙ, НАТРИЯ КРОМОГЛИКАТ
Japanese インタール, クールウェイ, クモロール, ノスラン, クロモグリク酸ナトリウム, ドルーミン, クロモリーク, ミタヤク, メインター, クロモリンナトリウム, アレルナート, クロモフェロン, ソジウムクロモグリケート, オフタルギー, シズレミン, トーワタール, リノジェット, ルゲオン, クロモグリク酸二ナトリウム, クロモグリク酸, アルギノン
Italian Cromoglicato disodico, Sodio cromoglicato, Cromolina sodica
Spanish cromoglicato sódico (producto), cromoglicato sódico, ácido cromoglícico sódico (producto), ácido cromoglícico sódico, cromoglicato de sodio (uso gastrointestinal) (producto), cromoglicato de sodio (uso gastrointestinal), cromoglicato de sodio [uso oftálmico], cromoglicato de sodio (uso nasal) (producto), cromoglicato de sodio (uso nasal), cromoglicato de sodio [uso oftálmico] (producto), cromoglicato de sodio [antiasmático], cromoglicato de sodio [antiasmático] (producto), cromoglicato de sodio (nasal) (producto), cromoglicato de sodio (nasal), cromoglicato de sodio [asma] (producto), cromoglicato de sodio [asma], cromoglicato de sodio [oftálmico] (producto), cromoglicato de sodio [oftálmico], cromoglicato disódico, cromolina sódica (producto), cromolina sódica (sustancia), cromolina sódica, Cromoglicato Disódico, Cromoglicato Sódico, Cromolin Sódico
Croatian NATRIJEV KROMOGLIKAT
Polish Sól dwusodowa kromoglikatu, Intal, Kromoglikan disodowy, Kromoglikonian dwusodowy
French Cromoglycate disodium
German Cromolynnatrium, Dinatriumcromoglicinat, Dinatriumcromoglycat, Natriumcromoglycat, Cromogilicinsäure, Dinatriumsalz
Portuguese Cromoglicato de Sódio, Cromoglicato Dissódico, Cromolina Sódica

Ontology: Cromolyn (C0086073)

Definition (NCI) A synthetic mast cell stabilizer with anti-inflammatory activity. Cromolyn probably interferes with the antigen-mediated calcium ion influx into mast cells. This prevents mast cell degranulation, resulting in mast cell stabilization and inhibition of the release of inflammatory mediators, such as histamine and leukotrienes, which are involved in type I allergic reactions. Cromolyn also prevents inflammatory mediator release from eosinophils.
Definition (CSP) chromone complex which blocks mast cell degeneration; primarily used as an antiasthmatic; also an orphan drug for the treatment of mastocytosis and vernal keratoconjunctivitis.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D004205
SnomedCT 21701005, 372672009, 40652001
English Cromoglycic Acid, Cromoglicic Acid, cromolyn, cromoglycic acid, Cromolyn [Chemical/Ingredient], 1,3-Bis(2-carboxychromon-5-yloxy)-2-hydroxypropane, 1,3-Di(2-carboxy-4-oxochromen-5-yloxy)propan-2-ol, Cromolyn, cromoglicic acid, 4H-1-Benzopyran-2-carboxylic acid, 5,5'-((2-hydroxy-1,3-propanediyl)bis(oxy))bis(4-oxo)-, CROMOLYN, Cromoglycic acid, Cromoglicic acid, Cromolyn (product), Cromolyn (substance)
Spanish cromoglicato, ácido cromoglícico (sustancia), ácido cromoglícico, cromolina (producto), cromolina (sustancia), cromolina

Ontology: Inhaled sodium cromoglycate (C0360199)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
SnomedCT 349969005
English Inhaled sodium cromoglycate, Inhaled sodium cromoglycate (product), Inhaled sodium cromoglycate (substance)
Spanish cromoglicato de sodio inhalatorio (producto), cromoglicato de sodio inhalatorio

Ontology: Mast cell stabilizer (C1268905)

Concepts Pharmacologic Substance (T121)
SnomedCT 108860003, 372553000
English mast cell stabilizer, cell mast stabilizers, Mast cell stabilizer, Mast cell stabiliser, Mast cell stabilizer (product), Mast cell stabilizer (substance), Mast Cell Stabilizer, Mast Cell Stabilizers
Spanish estabilizador de mastocitos (producto), estabilizador de mastocitos (sustancia), estabilizador de mastocitos