How cromoglicic acid works
Allergic reactions are excessive defense reactions of the immune system to actually harmless stimuli (allergens) such as pollen, house dust mites, certain foods or pets. Contact of the allergen with the skin, mucous membrane or conjunctiva of the eyes causes unpleasant symptoms such as redness, swelling and itching.
Mast cell stabilizers such as cromoglicic acid can be used to suppress these allergic reactions. They stabilize the mast cells so that they no longer react so sensitively to allergens by releasing inflammatory messengers. This prevents allergy symptoms.
Absorption, breakdown and excretion of cromoglicic acid
As cromoglicic acid only acts locally and is not absorbed into the body when taken orally, only dosage forms such as eye drops, nasal sprays or inhalation preparations are suitable for the active ingredient. Cromoglicic acid is also only absorbed to a very limited extent via the mucous membranes and is excreted unchanged in the urine and stool.
When is cromoglicic acid used?
Cromoglicic acid is approved for the treatment of:
Treatment is always preventative, as cromoglicic acid is not suitable for acute treatment. The therapy can be used seasonally (e.g. for grass or tree pollen allergies) or permanently.
How cromoglicic acid is used
When using it, it should be noted that cromoglicic acid only has a relevant effect after around two to three days. Until then, acutely effective anti-allergic agents should be used in parallel with the mast cell stabilizer.
Nasal spray
Eye drops
To treat watery, irritated eyes, one drop of cromoglicic acid eye drops (two percent sodium cromoglicate solution) is instilled into the conjunctival sac of both eyes four times a day. If necessary, the dose can be increased to two drops eight times a day.
Inhalation solution
Cromoglicic acid inhalation solutions as well as aerosols and powder inhalers are available to treat asthmatic symptoms. Aerosol sprays and powder inhalers should be reserved for adult patients, as their use requires a certain degree of coordination. Inhalation solutions that are nebulized via an inhaler and inhaled through a mask are suitable for children.
What are the side effects of cromoglicic acid?
In some patients, the active ingredient cromoglicic acid causes irritation of the mucous membranes in the nose and mouth, nosebleeds, sneezing, coughing, hoarseness, loss of taste and swelling of the tongue. The eye drops can lead to burning eyes, a foreign body sensation and reddened eyes.
Other possible side effects include headaches, nausea and, rarely, hypersensitivity reactions (itching, shortness of breath, asthma attacks and swelling of the mucous membranes).
What should be considered when using cromoglicic acid?
Direct interactions between cromoglicic acid and other active substances are not known to date.
If necessary, the nose should be blown before using the nasal spray.
When using cromoglicic acid for asthma, the respiratory burst force, which is measured using a peak flow meter, should always be monitored so that any deterioration in breathing can be noticed in good time. To discontinue treatment with cromoglicic acid, the dosage should be reduced gradually. Abrupt discontinuation could trigger an asthma attack.
During pregnancy and breastfeeding, the doctor will carefully weigh up the benefits and risks of using the mast cell stabilizer.
How to obtain medication with cromoglicic acid
Combination preparations that also contain a prescription-only active ingredient (e.g. for asthma patients) require a prescription.
How long has cromoglicic acid been known?
The mast cell stabilizer cromoglicic acid was discovered through self-experiments by the scientist R. Altounyan in 1965. He examined various plants for their asthma-improving effect and discovered the substance khellin in bishop’s weed. Its chemical derivative, cromoglicic acid, proved to be effective and had comparatively few side effects. Today, there are numerous approved preparations containing the active ingredient cromoglicic acid.
