Nasal Mast Cell Stabilizers
Place in Therapy
Place in Therapy
Overall, the evidence shows that sodium cromoglycate is a good agent to use in the treatment of allergic rhinitis. However, it wouldn’t be considered a first line agent as the evidence shows that there is less benefit compared to 1st and 2nd generation antihistamines. Guidelines recommend that intranasal glucocorticoids should be used as a first line agent for seasonal allergic rhinitis. Studies confirm that mometasone furoate nasal spray is the first choice compared to sodium cromoglycate. Furthermore, studies show that azelastine eye drops is as effective as sodium cromoglycate. In one study, cromolyn sodium 4% nasal solution was found to be well tolerated and effective, suggesting that it is suitable for OTC use in the treatment of seasonal allergic rhinitis. It is safe in pregnancy and lactation. The common side effects can be dryness and irritation. The duration of use should be about a week. In totality, there is no harm in using sodium cromoglycate but the preference should be given to 1st and 2nd generation antihistamines due to its greater efficacy.
References
1. Lange B, Lukat KF, Rettig K, Holtappels G, Bachert C. Efficay, cost-effectiveness, and tolerability of mometasone furoate, levocabastine, and disodium cromoglycate nasal sprays in the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. February 2005; 95(3): 272-82.
2. James IG, Campbell LM, Harrison JM, Fell PJ, Ellers-Lenz B, Petzold U. Comparison of the efficacy and tolerability of topically administered azelastine, sodium cromoglycate and placebo in the treatment of seasonal allergic conjunctivitis and rhino-conjunctivitis. Curr Med Res Opin. 2003; 19(4): 313-20.
3. Meltzer EO. Efficacy and patient satisfaction with cromolyn sodium nasal solution in the treatment of seasonal allergic rhinitis: a placebo-controlled study. Clin Ther. Jun 2002; 24(6): 942-52.
4. Owen CG, Shah A, Smeeth L, Sheikh L. Topical treatments for seasonal allergic conjunctivitis: systemic review and meta-analysis of efficacy and effectiveness. BJG. June 2004; 54(503): 451-56.
5. Van Cauwenberge P, Bachert C, Passalacqua G, Canonica GW, Durham SR, Fokkens WJ, et al. Consensus statement on the treatment of allergic rhinitis. J Allergy Clin Immunol. February 2000; 55(2): 116-34.
6. C-health. Drug Factsheets: PMS-Sodium Cromoglycate. MediResource. Updated on 2014. Accessed on June 28, 2014. http://chealth.canoe.ca/drug_info_details.asp?channel_id=0&brand_name_id=2430&page_no=2#AdverseEffects
Overall, the evidence shows that sodium cromoglycate is a good agent to use in the treatment of allergic rhinitis. However, it wouldn’t be considered a first line agent as the evidence shows that there is less benefit compared to 1st and 2nd generation antihistamines. Guidelines recommend that intranasal glucocorticoids should be used as a first line agent for seasonal allergic rhinitis. Studies confirm that mometasone furoate nasal spray is the first choice compared to sodium cromoglycate. Furthermore, studies show that azelastine eye drops is as effective as sodium cromoglycate. In one study, cromolyn sodium 4% nasal solution was found to be well tolerated and effective, suggesting that it is suitable for OTC use in the treatment of seasonal allergic rhinitis. It is safe in pregnancy and lactation. The common side effects can be dryness and irritation. The duration of use should be about a week. In totality, there is no harm in using sodium cromoglycate but the preference should be given to 1st and 2nd generation antihistamines due to its greater efficacy.
References
1. Lange B, Lukat KF, Rettig K, Holtappels G, Bachert C. Efficay, cost-effectiveness, and tolerability of mometasone furoate, levocabastine, and disodium cromoglycate nasal sprays in the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. February 2005; 95(3): 272-82.
2. James IG, Campbell LM, Harrison JM, Fell PJ, Ellers-Lenz B, Petzold U. Comparison of the efficacy and tolerability of topically administered azelastine, sodium cromoglycate and placebo in the treatment of seasonal allergic conjunctivitis and rhino-conjunctivitis. Curr Med Res Opin. 2003; 19(4): 313-20.
3. Meltzer EO. Efficacy and patient satisfaction with cromolyn sodium nasal solution in the treatment of seasonal allergic rhinitis: a placebo-controlled study. Clin Ther. Jun 2002; 24(6): 942-52.
4. Owen CG, Shah A, Smeeth L, Sheikh L. Topical treatments for seasonal allergic conjunctivitis: systemic review and meta-analysis of efficacy and effectiveness. BJG. June 2004; 54(503): 451-56.
5. Van Cauwenberge P, Bachert C, Passalacqua G, Canonica GW, Durham SR, Fokkens WJ, et al. Consensus statement on the treatment of allergic rhinitis. J Allergy Clin Immunol. February 2000; 55(2): 116-34.
6. C-health. Drug Factsheets: PMS-Sodium Cromoglycate. MediResource. Updated on 2014. Accessed on June 28, 2014. http://chealth.canoe.ca/drug_info_details.asp?channel_id=0&brand_name_id=2430&page_no=2#AdverseEffects