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Inhaled Cromolyn Sodium

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Inhaled Cromolyn Sodium, Inhaled Sodium Cromoglycate, Cromolyn Sodium Inhaler, Cromolyn Sodium, Cromolyn, Cromoglycate, Mast Cell Stabilizer, Intal

  • See Also
  1. Cromolyn Sodium Ophthalmic
  2. Intranasal Cromolyn
  • Indications
  1. Exercise Induced Asthma
  2. Mastocytosis
  • 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
  • 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
  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
  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
  • 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)
  1. Not recommended in modern Asthma guidelines due to low efficacy
  2. NOT effective in acute bronchospasm (e.g. rescue Inhaler)
  1. Pharyngitis
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Pharmacokinetics
  1. Slow onset of action
  2. Effects may be delayed for weeks after starting and using regularly
  • Resources
  1. Cromolyn Sodium Oral Concentrate
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=93f80edb-3b38-423e-8cd6-5b5cb4393ec2
  2. Cromolyn Sodium Nebulizer Solution
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=8fe37a7a-edd6-4733-bb7e-e01c1906aeba
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. (2022) Comparison of Asthma Medications, Presc Lett, #381217