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Cromolyn (Nasal)

Pronunciation

Pronunciation

(KROE moe lin)

Index Terms

  • Cromoglicate
  • Cromoglycic Acid
  • Cromolyn Sodium
  • Disodium Cromoglycate
  • DSCG
  • Sodium Cromoglicate
  • Sodium Cromoglycate

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Aerosol Solution, Nasal, as sodium:

NasalCrom: 5.2 mg/actuation (13 mL, 26 mL) [contains benzalkonium chloride, edetate disodium]

Generic: 5.2 mg/actuation (26 mL)

Brand Names: U.S.

  • NasalCrom [OTC]

Pharmacologic Category

  • Mast Cell Stabilizer

Pharmacology

Acts locally to reduce calcium influx which decreases histamine degranulation from mast cells (Melvin 2011).

Onset of Action

Response to treatment: May occur at 1 to 2 weeks

Use: Labeled Indications

Allergic rhinitis: Prevent and relieve nasal symptoms of hay fever and other nasal allergies (eg, runny/itchy nose, sneezing, allergic stuffy nose).

Contraindications

OTC labeling: When used for self-medication, do not use if hypersensitive to cromolyn or any component of the formulation.

Dosing: Adult

Allergic rhinitis (treatment and prophylaxis): Intranasal: Instill 1 spray (5.2 mg) in each nostril 3 to 4 times daily; may be increased up to 6 times daily. For prophylaxis initiate prior to exposure to allergen; symptomatic relief may require 1 to 2 weeks.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Allergic rhinitis: Children ≥2 years and Adolescents: Intranasal: Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Administration

Clear nasal passages by blowing nose prior to use. For prophylaxis, initiate prior to exposure to allergen.

Storage

Store between 20°C to 25°C (68°F to 77°F). Protect from light.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined.

>10%:

Dermatologic: Burning sensation of the nose

Respiratory: Nasal mucosa irritation, sneezing, stinging sensation of the nose

1% to 10%:

Central nervous system: Headache

Gastrointestinal: Unpleasant taste

Respiratory: Cough, hoarseness, post-nasal drip

<1% (Limited to important or life-threatening): Epistaxis

Warnings/Precautions

Other warnings/precautions:

• Local nasal effects: Brief nasal stinging and/or sneezing may occur after use.

• Self-medication (OTC use): Consult a health care provider before use if you have fever, discolored nasal discharge, sinus pain, or wheezing. Discontinue use and consult a health care provider if shortness of breath, wheezing, chest tightness, hives, or swelling of the mouth or throat occurs; if you have new symptoms, symptoms worsen, or your symptoms do not improve within 2 weeks, or need to use for >12 weeks. Do not use to treat sinus infection, asthma, or cold symptoms.

Pregnancy Considerations

Based on available studies, cromolyn may be used for the treatment of allergic rhinitis in pregnant women (Gilbert 2005; Mazzotta 1999; Namazy 2016; Scadding 2008).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience sneezing, burning, or stinging. Have patient report immediately to prescriber severe nasal irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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