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cromolyn [disodium chromate] (Intal, Gastrocrom, Nasalcrom, Crolom)
Tradename: Intal, Crolom. (cromolyn sodium).
Indications:
1) prophlaxis for bronchospasm
a) prophylaxis for allergen-induced asthma
b) prophylaxis for exercise-induced asthma
- inhaler 15-20 minutes before exercise
2) ocular inflammation [7]
- keratitis, vernal conjunctivitis, allergic conjunctivitis
3) allergic rhinitis [7]
4) systemic mastocytosis [7]
5) inflammatory bowel disease [7]
6) food allergy [7]
Dosage:
- 20 mg (2 inhalations) inhaled QID.
- 200 mg PO QID. Pediatrics: 2-12 yo: 100 mg PO BID.
- nasal: 1 spray (5.2 mg) TID/QID
a) prophylactic dosing
b) variable response
- Ophthalmic: 1 drop 4-6 times/day (4%)
Tabs: 100 mg.
Nebulizer: 10 mg/mL. 2 mL/ampule. Inhaler:
Nasal spray: Tradename: Nasalcrom, 5.2 mg/spray
Ophthalmic: (Crolom) (4%)
Pharmacokinetics: duration of action 4-6 hours
Adverse effects:
1) common (> 10%)
- coughing (bronchospasm)
- hoarseness
- unpleasant taste (inhalation aerosol)
2) less common (1-10%)
- dry mouth, sneezing, stuffy nose, angioedema, dizziness, dysuria, nausea/vomiting
3) uncommon (< 1%)
- eosinophilic pneumonia, anaphylactic reaction, headache, rash, urticaria, diarrhea, nasal burning, joint pain, ocular stinging, lacrimation, wheezing, throat irritation, pulmonary infiltrates
Mechanism of action:
1) inhibits mast cell response to IgE
- 4 to 10 times less potent than nedocromil
2) inhibits activation of macrophages
3) inhibits activation of T helper cells
4) decreases bronchial hyper-responsiveness
5) inhibits antigen-induced bronchospasm & release of histamine from sensitized mast cells.
General
antiasthmatic agent
chromate
mast cell stabilizer
ocular decongestant
Properties
MISC-INFO: elimination route LIVER
KIDNEY
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 85
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 742, 763
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Deprecated Reference