Cromoglicic acid is an active ingredient mainly used for prophylaxis against allergic diseases. The active ingredient is generally applied in the form of inhalation sprays, capsules for inhalation, eye and nose drops, and nasal sprays.
What is cromoglicic acid?
Cromoglicic acid is mainly used for prophylaxis against allergic diseases. It is applied in the form of inhalation sprays, capsules for inhalation, eye and nose drops, and nasal sprays. Cromoglicic acid belongs to the group of active substances known as cromones. In addition to cromoglicic acid, known derivatives of chromone include flavones (yellow plant pigments) and also certain heart-active glycosides, such as khellinin. These derivatives are isolated from umbelliferous plants, while cromoglicic acid is produced synthetically. Because of its better water solubility, the disodium salt of cromoglicic acid is used in medicines. Undissolved, cromoglicic acid and its salt exist as a white crystalline solid. The active substance is always applied in solution to prevent allergic reactions only locally in the form of drops, sprays or by inhalation. Enteral absorption (via the intestine) is not possible. The reason for this is the low lipophilicity (fat solubility) of cromoglicic acid or its salt. Cromoglicic acid acts directly on mast cells and prevents the formation of inflammatory mediators, such as histamine. Because cromoglicic acid has a very short half-life, it must be used at least four times a day to prevent allergic reactions.
Pharmacological action
Cromoglicic acid prevents the release of inflammatory mediators by inhibiting the chloride channels of activated mast cells. Mast cells store certain messenger substances, such as histamine or heparin, which are responsible for the body’s defense. Histamine in particular causes inflammatory reactions during the defense response. In the case of an allergic reaction, these messenger substances are released at an increased rate to combat normally harmless substances. Cromoglicic acid has an inhibitory effect on the release of the inflammatory mediators, although not immediately, but after several weeks of use. Therefore, the sole application of cromoglicic acid is unsuitable in the case of an existing acute allergic reaction. This allergy can only be successfully controlled by long-term treatment with cromoglicic acid. However, the active substance is suitable for the prevention of allergy. However, the development of the effect can take 2-4 weeks. Therefore, treatment should begin several weeks before an expected allergy season.
Medical use and application
Cromoglicic acid is a long-term anti-allergic agent. Typical conditions treated with cromoglicic acid include bronchial asthma, allergic rhinitis (hay fever), allergic conjunctivitis (conjunctivitis), and allergic reactions of the digestive organs. As already mentioned, the treatment is mostly used for prophylaxis, because the effect occurs with a considerable time delay. Systemically, cromoglicic acid has hardly any effect because less than 10 percent of it is absorbed by the body. Therefore, the drug can usually only be applied locally to the affected areas. However, for the prevention and treatment of asthmatic diseases, there is also a combinatorial use of cromoglicic acid with reproterol. Reproterol has a bronchodilator effect and can initially relieve the acute dyspnea that occurs in bronchial asthma. Long-term use of the combined drug in existing asthma leads to good treatment success in the long term, as the anti-inflammatory effect and rapid relief of breathlessness are combined in one drug here. Due to the poor absorption and short half-life of cromoglicic acid, the drug must be applied several times a day for weeks. For the treatment of food allergies, cromoglicic acid can also be taken orally in the form of capsules. Here, too, the active ingredient exerts its influence locally on the intestinal mucosa after the capsules dissolve in the intestine.
Risks and side effects
Cromoglicic acid is very well tolerated. Even with long-term use, side effects have rarely been observed. However, it should be borne in mind that any active ingredient can lead to hypersensitivity reactions in a corresponding physical constitution. The side effects mentioned below can thus be regarded as a basic risk.In rare cases, the use of eye drops may cause burning of the eyes, a feeling of foreign bodies or swelling of the conjunctiva. Nasal sprays with cromoglicic acid may cause headaches or disturbances of the sense of taste. Hypersensitivity reactions, such as skin rash, hives, gastrointestinal problems or respiratory spasms, also occur in isolated cases with inhalation or oral use. Although the active substance prevents allergic diseases, allergic shock also occurs in very rare cases. Adverse interactions with other medications have not been reported.
