Medications and Drugs
GENERIC NAME: cromolyn
BRAND NAME: Nasalcrom, Intal; Opticrom
DRUG CLASS AND MECHANISM: Cromolyn is a synthetic
compound that
is used to prevent some allergic reactions. Many of the
symptoms and signs
of allergic reactions are caused by chemicals such as histamine
that are
released from mast cells, a type of cell that is found
throughout the body
as well as in the lungs, nose, and eyelids. Cromolyn works by
preventing
the release of these chemicals from the mast cells. Cromolyn is
inhaled to
prevent episodes of asthma due to allergy. It also is used as a
nasal
inhaler to treat seasonal allergic rhinitis (inflammation of
the lining of
the nose) and as an ophthalmic (eye) solution to treat allergic
conjunctivitis (inflammation of the lining of the eyelids).
Cromolyn was
approved by the FDA in 1973. In 1997, the FDA approved over-the-
counter
status for the nasal solution.
PRESCRIPTION: no (nasal solution). yes (other forms)
GENERIC AVAILABLE: yes
PREPARATIONS: Metered oral inhaler delivering 800 &
181 g of
cromolyn sodium per metered actuation in 8.1 and 14.2 g containers.
Nasal solution, 40 mg/ml cromolyn, in 13 or 26 ml metered
spray
containers. Each metered actuation delivers 5.2 mg cromolyn sodium.
Ophthalmic solution as a 4% solution of cromolyn in 10 ml
bottles.
STORAGE: Cromolyn should be kept at room temperature,
4-30°C
(39-86°F), and shaken well before each use.
PRESCRIBED FOR: Cromolyn oral inhaler controls
episodes of
asthma caused by foreign antigens such as pollens by preventing
spasm and
narrowing of the breathing tubes of the lungs. Cromolyn nasal
spray is
used for the control of the symptoms of allergic rhinitis, a
condition in
which the lining of the nose swells with fluid ("stuffy
nose")
and fluid is released into the nasal passages ("runny nose"). In
conjunctivitis, cromolyn eye solution controls swelling,
tearing, itching,
and redness of the eye.
DOSING: Doses vary from patient to patient.
Aerosol
inhalation: The canister should be shaken well before administering. After
breathing out completely, the mouthpiece is inserted between the open lips, and
the lips are closed firmly around the mouthpiece. The valve of the canister then
is pressed down one time while inhaling deeply and slowly. The canister then is
removed from the lips, and the breath is held for a count of 10 before exhaling
slowly. If more than one inhalation is being used, a minute should elapse between
inhalations. An extension tube (spacer) may be useful for persons who are unable
to coordinate inhaling and pressing down on the canister's valve. Following
administration, the mouth should be rinsed thoroughly with water or mouthwash
that is spit out. This will minimize dry mouth or throat, throat irritation,
and hoarseness.
The inhaler must be cleaned frequently. To clean, the canister
and cap
are removed from the inhaler. The inhaler is rinsed with
warm water
and dried thoroughly.
If a bronchodilator aerosol spray such as albuterol
(Proventil; Ventolin)
is used in addition to cromolyn, the bronchodilator should be
used first,
and 5 minutes should elapse before the cromolyn is used.
Intranasal spray: Adults and children 6 years of age and older
can use
one spray in each nostril three or four times daily. If
necessary,
physicians may increase the dose to 6 times daily.
Ophthalmic (eye) solution: Both hands should be washed before
each use
of cromolyn. The head is tilted back and
the lower
eyelid is pulled down with the index finger to form a pouch.
The bottle then
is
squeezed slightly to allow the prescribed number of drops into
the pouch,
and the eye is closed gently for one or two minutes without
blinking. The tip of
the dropper should not touch the eye or eyelid. The
usual dose in adults and children 4 years of age and older is
one or two
drops in each eye 4 to 6 times per day. Several weeks of
therapy may be
required before improvement is apparent.
DRUG INTERACTIONS: No drug interactions have been
described
with cromolyn.
PREGNANCY: Little cromolyn crosses the placenta, and
animal
studies have not shown adverse effects of cromolyn on the
fetus.
NURSING MOTHERS: Little cromolyn is secreted into breast
milk.
SIDE EFFECTS: In general, cromolyn is well- tolerated,
and side
effects usually are limited to the site of application.
Increased spasm of
the breathing tubes, throat irritation, and cough are the most
common side
effects from oral inhalation of cromolyn. Taking a
beta-adrenergic
bronchodilator prior to the cromolyn can prevent these side
effects.
Cromolyn intranasal spray can produce sneezing and nasal
irritation, but
these effects generally are short-lived following each
application.
Use of cromolyn eye drops can produce irritation of the eye.
This effect
also is generally short-lived.
Reference: FDA Prescribing Information
Last Editorial Review: 7/23/1998
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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