CROMAL

Sodium Cromoglycate (NA)
Price: MDI: ₹150 - ₹250, Nasal Spray: ₹200 - ₹350
Mfr: Cipla Ltd. | Form: Metered Dose Inhaler (MDI), Nasal Spray

📋 Clinical Overview

Sodium Cromoglycate (also known as Cromolyn Sodium) is a mast cell stabilizer used primarily for the prophylactic management of allergic conditions. It is not a bronchodilator, antihistamine, or corticosteroid. It works by inhibiting the degranulation of sensitized mast cells that occurs after exposure to specific antigens, thereby preventing the release of histamine and other inflammatory mediators. It is considered a first-line prophylactic agent for mild to moderate asthma and allergic rhinitis, especially in children, due to its excellent safety profile.

💊 Dosage & Administration

Adult: Inhalation (MDI/Powder): 2-4 puffs (1-2 mg per puff) 4 times daily. Intranasal: 1 spray (5.2 mg/spray) in each nostril 3-4 times daily. Ophthalmic: 1-2 drops in each eye 4-6 times daily.

Note: INHALATION: Shake MDI well. Use spacer for better lung deposition and to reduce oropharyngeal side effects. Rinse mouth with water after inhalation to prevent throat irritation. NASAL: Clear nostrils before use. Tilt head slightly forward. Avoid sneezing or blowing nose immediately after. OPTHALMIC: Do not touch dropper tip to eye. Wait 5 minutes before instilling other eye drops.

⚠️ Contraindications

  • Hypersensitivity to Sodium Cromoglycate or any component of the formulation
  • Acute asthma attack or status asthmaticus (not for rescue)

🔬 Mechanism of Action

Sodium Cromoglycate inhibits the release of inflammatory mediators (e.g., histamine, leukotrienes, prostaglandins) from sensitized mast cells. It acts by blocking chloride channels, leading to membrane stabilization and inhibition of calcium influx, which is essential for mast cell degranulation. It may also inhibit the activation of eosinophils, neutrophils, and macrophages.

🤕 Side Effects

  • Inhalation: Throat irritation, cough, hoarseness, bad taste
  • Nasal: Transient nasal stinging/burning, sneezing
  • Ocular: Transient stinging/burning on instillation

🤰 Special Populations

Pregnancy: Category B (US FDA). Animal studies show no risk, but human data limited. Use only if clearly needed. Considered relatively safe due to minimal systemic absorption.

Driving: Unlikely to affect ability. Dizziness has been reported rarely.

🔄 Drug Interactions

Beta-2 Agonists (Salbutamol, Terbutaline)Sodium Cromoglycate may enhance bronchodilator effect. Often used concomitantly.Minor
Corticosteroids (Inhaled: Budesonide, Fluticasone)Additive prophylactic effect. No significant pharmacokinetic interaction.Minor
AmprenavirMay increase serum concentration of Sodium Cromoglycate (theoretical).Moderate

🔁 Alternatives to CROMAL

Same composition (Sodium Cromoglycate (NA)), different brands:

CROMATE INTAL CROMOCIP CROMOSTAT