sodium cromoglycate

Action and Spectrum

Actions and spectrum: 

Action: 

sodium cromoglycate is a mast cell stabilizer. It works by inhibiting the release of certain substances in the body that are involved in the allergic response, such as histamines and leukotrienes. By preventing the release of these inflammatory substances, sodium cromoglycate helps to reduce the symptoms of allergies and asthma. 

Spectrum: 

• Allergic Conjunctivitis: It can be used to relieve itching, swelling, and redness of the eyes caused by allergic conjunctivitis. 
• Asthma: sodium cromoglycate can help prevent asthma symptoms and asthma attacks in individuals with allergic asthma. It is not used to treat acute asthma attacks but is effective as a prophylactic (preventative) treatment. 
• Allergic Rhinitis: It may be used to relieve symptoms such as sneezing, runny, or itchy nose, and nasal congestion. 
• Exercise-Induced Bronchoconstriction: Some individuals, especially athletes, use sodium cromoglycate to prevent exercise-induced bronchoconstriction or exercise-induced asthma. 
• Food Allergies: In some cases, it may be used to prevent allergic reactions to certain foods. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Bad taste 

Wheeze 

Bronchospasm 

Nasal congestion 

Anaphylaxis 

Dizziness 

Urinary frequency 

Lacrimation 

Rash 

Urticaria 

Throat irritation 

Cough 

Nausea 

Laryngeal edema 

Pharyngeal irritation 

Angioedema 

Dysuria 

swelling and joint pain 

Headache 

Black Box Warning

Black Box Warning: 

there is no specific black box warning associated with sodium cromoglycate. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Allergy: Individuals who have a known allergy to sodium cromoglycate or any of its components should not use this medication. 
• Acute Asthma Attacks: sodium cromoglycate is not intended for the treatment of acute asthma attacks. It is a preventive medication and should not be used as a rescue medication during an acute attack. Patients with asthma should have a separate, fast-acting bronchodilator (such as albuterol) to address acute symptoms. 
• Age: The safety and effectiveness of sodium cromoglycate in children under 2 years old have not been established. It is typically used with caution in young children, and the decision to use it will depend on a healthcare provider’s assessment. 
• Pregnancy and Lactation: While sodium cromoglycate is considered safe during pregnancy and lactation, pregnant or nursing women should consult healthcare provider before using the medication.

Caution: 

• Not for Acute Relief: sodium cromoglycate is not intended for the immediate relief of acute asthma attacks or allergic reactions. It is a preventive medication and needs to be used consistently to be effective. Individuals with asthma should have a separate, fast-acting bronchodilator (e.g., albuterol) for acute symptom relief. 
• Regular Use: sodium cromoglycate is most effective when used regularly as prescribed. It may take several weeks of consistent use before its full preventive benefits are realized. 
• Pediatric Use: sodium cromoglycate can be used in children, but the appropriate dose and administration method should be determined by a healthcare provider. The safety and effectiveness in children under 2 years old have not been established.

Comorbidities: 

• Allergic Rhinitis: Many individuals with asthma also have allergic rhinitis (hay fever). sodium cromoglycate can be used to manage both conditions, as it helps control allergic reactions and inflammation in the airways. 
• Obesity: Obesity is associated with more severe asthma and may worsen asthma symptoms. It is a common comorbidity with asthma. 
• Asthma: Allergic reactions can trigger asthma symptoms. sodium cromoglycate may be prescribed to manage allergy-induced asthma. 
• Eczema: Eczema is a chronic skin condition often linked to allergies. sodium cromoglycate may help alleviate skin itching and inflammation in some cases. 
• Sinusitis: Chronic sinusitis is a common comorbidity of allergies, and sodium cromoglycate can help control sinus allergy symptoms. 
• Conjunctivitis: Allergic conjunctivitis, or eye allergies, often occurs with other allergies. sodium cromoglycate eye drops can be used to manage this condition. 
• Food Allergies: Individuals with food allergies may also have environmental allergies. sodium cromoglycate can help manage the latter. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category: not assigned 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

sodium cromoglycate, also known as cromolyn sodium, is a medication with anti-inflammatory and mast cell stabilizing properties. It acts by preventing histamine and leukotrienes release, from mast cells and basophils. These mediators play a key role in allergic and inflammatory responses.

By inhibiting their release, sodium cromoglycate helps to reduce inflammation, bronchoconstriction, and symptoms associated with conditions like asthma and allergies. It is primarily used as a preventive treatment and must be taken regularly to maintain its efficacy. This medication is available in various forms, including inhalers for asthma and nasal sprays for allergic rhinitis. sodium cromoglycate is well-tolerated and has a good safety profile when used as directed.  

Pharmacodynamics: 

• Mast Cell Stabilization: sodium cromoglycate is known for its mast cell stabilizing properties. Mast cells are immune cells that release inflammatory mediators, such as histamine and leukotrienes, when activated. sodium cromoglycate prevents the degranulation of mast cells, inhibiting the release of these mediators. This action helps reduce the allergic and inflammatory response, preventing symptoms like bronchoconstriction and airway inflammation in conditions such as asthma. 
• Inhibition of Allergic Reactions: By blocking the release of histamine and other allergic mediators, sodium cromoglycate can alleviate the symptoms of immediate hypersensitivity reactions, such as itching, swelling and redness associated with allergies, as well as asthma exacerbations triggered by allergens. 
• Anti-Inflammatory Effects: sodium cromoglycate also has anti-inflammatory properties. It helps reduce the infiltration of inflammatory cells, such as eosinophils, into the airways, which is a common feature of asthma. By minimizing inflammation in the airways, it contributes to the control of chronic respiratory conditions. 

Pharmacokinetics: 

Absorption: 

• Route of Administration: sodium cromoglycate is administered via inhalation (aerosolized form), nasal spray, and ophthalmic (eye drop) solutions. When used as an inhaler or nasal spray, it is delivered directly to the respiratory or nasal mucosa, respectively. 
• Absorption in the Lungs and Mucous Membranes: In the respiratory and nasal mucosa, sodium cromoglycate is minimally absorbed into the systemic circulation. This is an advantage for medications intended to have localized effects. 

Distribution: 

• Tissue Distribution: Cromolyn sodium remains primarily localized in the respiratory or nasal mucosa, where it exerts its anti-inflammatory and mast cell-stabilizing effects. It is not significantly distributed to other tissues or organs. 
• Plasma Protein Binding: Cromolyn sodium has low protein binding in the bloodstream, which contributes to its limited systemic distribution. 

Metabolism: 

• Hepatic Metabolism: Cromolyn sodium is not extensively metabolized in the liver, and it is primarily excreted unchanged in the urine. It is considered a drug with low hepatic metabolism. 

Excretion: 

• Renal Excretion: Cromolyn sodium is excreted primarily in the urine, where it is eliminated from the body without significant metabolism. It has a short half-life, which contributes to its rapid elimination. 

Adminstartion

Administration: 

• Inhalation: sodium cromoglycate is often administered as an inhalation solution using a nebulizer or an inhaler device. This route is primarily used for the management of asthma and other respiratory conditions. Patients inhale the medication directly into their lungs, where it exerts its anti-inflammatory and mast cell-stabilizing effects. 
• Nasal Spray: sodium cromoglycate is available as a nasal spray, which is used to manage allergic rhinitis. It is administered intranasally, and the medication is delivered directly to the nasal mucosa to control allergy symptoms like sneezing, runny nose, and nasal itching. 
• Ophthalmic (Eye Drops): Cromolyn sodium is also available in the form of ophthalmic solutions (eye drops). It is used to manage allergic conjunctivitis, a condition characterized by eye itching, redness, and tearing.

Patient Information Leaflet

Patient information leaflet 

Generic Name: sodium cromoglycate 

Pronounced: (so-dee-um kro-mog-li-kate)  

Why do we use sodium cromoglycate? 

sodium cromoglycate is used as a preventive treatment for asthma. It helps to reduce asthma attacks by stabilizing mast cells in the airways, which can become hyperresponsive in individuals with asthma. This medication is often used in combination with bronchodilators for better asthma control.

It is used to manage allergic rhinitis, also known as hay fever. sodium cromoglycate, when administered as a nasal spray, can help to relieve sneezing, runny or itchy nose, and nasal congestion associated with allergic reactions to pollen, dust mites, or other allergens. sodium cromoglycate is available in the form of ophthalmic (eye) drops to treat allergic conjunctivitis. It helps alleviate symptoms such as itchy, red, and watery eyes caused by allergies.