Cromoglycic acid preparations

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Cromoglicic acid: instructions, analogues and reviews

Cromoglicic acid belongs to a group of drugs that stabilize mast cell membranes.

Synonyms (analogues) of this substance are: “High-Krom”, “Ditek”, “Stadaglycin”, “Ifiral”, “Nalcrom”, “Cromohexal”, “Lecrolin”, “Cromogen”, “Kuzikrom”, “Cromoglin”, “Kropoz”, “Kromosol”, “Kromolyn”.

Table of contents:

Pharmacology

The drug has membrane-stabilizing and anti-allergic effects.

The product stabilizes the membrane of provoked mast cells, slows down the entry of calcium, as well as the degranulation and release of leukotrienes, bradykinin, prostaglandins, histamine and other biologically active substances. In addition, cromoglicic acid prevents inflammation, bronchospasms and allergies, and also inhibits eosinophilic chemotaxis.

The drug blocks receptors that are specific for inflammatory mediators. Cromoglicic acid (the instructions confirm this fact) with long-term use reduces the number of asthmatic attacks and weakens their course, reduces the need for corticosteroids and bronchodilators.

In patients suffering from mastocytosis, after 2-6 weeks of therapy, symptoms from the digestive system (vomiting, diarrhea, nausea, abdominal pain) and skin (itching, urticaria, hyperemia) decrease, which persist for three weeks after discontinuation of the drug.

The disappearance of manifestations of allergic eye pathologies occurs over several days or several weeks. In the case of allergic year-round rhinitis, the effectiveness of the drug reaches its maximum at 1-4 weeks of therapy.

Absorption of the drug after oral administration is no more than 1%, it is excreted in urine and feces throughout the day. With intraocular instillations, it is practically not absorbed into the general bloodstream, and traces of the drug are found in the aqueous humor of the eye and completely leave the body within 24 hours. When administered intranasally, absorption into the bloodstream (total) is less than 7%. In the case of inhalation administration, 90% of the drug is deposited in the bronchi and trachea. Absorption from the lungs is about 5-15% of the dose, a small proportion penetrates the gastrointestinal tract, and the remaining amount is exhaled. Absorption of the drug from the mucous membranes decreases if the amount of secretion increases.

Cromoglicic acid binds to plasma proteins by 75%. It is excreted in bile and urine within 24 hours. It enters mother's milk in small quantities. The duration of exposure to a single dose is 5 hours.

Indications

Cromoglycic acid preparations in various release forms are indicated for:

  • bronchial asthma, chronic bronchitis with bronchial obstruction - solution for inhalation;
  • food allergies (in the case of a proven antigen, as monotherapy or in combination with a diet), mastocytosis, UC, proctitis, coloproctitis - capsules;
  • allergic rhinitis (seasonal or year-round), hay fever - nasal spray;
  • allergic conjunctivitis (acute/chronic), allergic keratitis, keratoconjunctivitis, fatigue and eye strain, dry eyes, allergic irritation of the mucous membrane - eye drops.

Contraindications

Individual hypersensitivity, patient age up to 2 years (and for the aerosol form - up to 5), pregnancy (especially the 1st trimester), lactation (if the use of the drug is unavoidable, stop breastfeeding during therapy).

Restrictions on the use of the drug are imposed if there are nasal polyps (intranasal form).

Side effects

According to numerous reviews from doctors and patients, the drugs are well tolerated, but in rare cases, unwanted symptoms may occur.

When inhaled with cromoglycic acid, the following side effects are possible:

  • from the skin: dermatitis, exanthema, photodermatitis, urticaria, vascular edema;
  • from the nervous system: tinnitus, malaise, peripheral neuritis, dizziness, tremor, irritability, hallucinations, insomnia;
  • Gastrointestinal tract: constipation, nausea, diarrhea, gastroenteritis, abdominal pain, halitosis, flatulence, stomatitis, dyspepsia, glossitis, esophagospasm;
  • the genitourinary system may react with nephropathy and frequent urination;
  • respiratory system: pharyngitis, eosinophilic pneumonia, cough, laryngeal edema, vomiting, hemoptysis;
  • cardiovascular system: chest pain, hypotension, periarterial vasculitis, pericarditis, heart failure;
  • bones, joints: joint swelling, myositis, joint and muscle pain, polymyositis;
  • others: serum sickness.

When taken orally, side effects may include:

  • Gastrointestinal tract: diarrhea, nausea, abdominal discomfort, vomiting;
  • others: joint pain, skin rash.

For intranasal use:

  • Gastrointestinal tract: swelling of the tongue, unpleasant taste in the mouth;
  • respiratory system: increased secretion of nasal secretions, ulceration of the mucous membranes, suffocation, cough;
  • others: urticaria, headaches, exanthema, arthralgia, anaphylactic reactions.

Cromoglicic acid (eye drops) can cause the following adverse effects: stye, short-term burning sensation, dry eyelids, blurred vision, conjunctival edema, lacrimation, redness of the conjunctiva.

Interactions

Theophylline, beta-agonists, antihistamines and corticosteroids enhance the effect of drugs based on cromoglycic acid.

Joint inhalation of this substance with ambroxol and bromhexine is not recommended.

Possible administration: conjunctival, inhalation, intranasal, orally.

Admission rules

Inhalations with the contents of the capsules are carried out with spinhaler four times a day, every 3-6 hours. Aerosols and inhalation solutions are also used 4 times a day.

Nasal drops are prescribed to adult patients, 3 or 4 drops every 4 or 6 hours, and to children 6 years of age and older, 1-2 drops every 6 hours.

Once the therapeutic effect is achieved, the interval between doses increases. Nasal sprays are used 4-6 times a day, 1 dose. The course of therapy is 4 weeks.

The drugs should be discontinued gradually over about 7 days.

Eye drops are used four times a day, 1 or 2 drops. If necessary, increase the number of drops.

Precautionary measures

  • Drugs with cromoglycic acid are prescribed with particular caution in cases of liver and kidney dysfunction.
  • Drug therapy continues until the end of exposure to the allergenic factor.
  • The withdrawal of the drug is carried out gradually over 7 days.
  • A cough that appears as a result of inhalation is relieved with a glass of water inside. In case of repeated bronchospasm, preliminary inhalations with bronchodilators are performed. If the patient is already taking bronchodilators, they should be used immediately before inhalation.
  • If cromoglycic acid drops (instructions included) contain benzalkonium chloride, patients are not recommended to wear soft contact lenses during therapy. Rigid lenses must be removed 15 minutes before instillation. The patient should be warned about short-term visual impairment after instillation.

special instructions

Preparations based on cromoglicic acid are not used for the treatment of status asthmaticus and acute bronchial asthma. The patient should be warned about the need for constant use of the drug.

Inhalations are carried out using an ultrasonic, piezoelectric or compression inhaler using a mouthpiece or mask.

The aerosol can must be shaken before use, and when inhaled, it must be kept strictly vertical (the dosing valve is located at the bottom).

Inhalations with the contents of the capsules are carried out using a special pocket turbo inhaler (spinhaler), into which the capsule with the product is placed. When you press the lid, the capsule is pierced, and during active inhalation, the drug (in powder form) enters the respiratory system.

Cromoglicic acid, a prescription for which must be written by a doctor, is dispensed at the pharmacy only upon presentation of such a sheet.

Reviews

Feedback from patients indicates that after taking Cromohexal in the form of eye drops for allergic conjunctivitis, the symptoms go away very quickly.

They also speak well of a similar product - Intal capsules, prescribed for food allergies. In combination with a diet, the remedy is effective, and there is no trace of allergies left.

Source: http://www.syl.ru/article/328800/kromoglitsievaya-kislota-instruktsiya-analogi-i-otzyivyi

Cromoglicic acid

Description of the active component

pharmachologic effect

Antiallergic agent, mast cell membrane stabilizer. Inhibits the release of histamine, leukotrienes and other biologically active substances from mast cells. It is believed that the delay in the release of mediators occurs as a result of an indirect blockade of the penetration of calcium ions into cells. It has been established that cromoglycic acid suppresses the migration of neutrophils, eosinophils, and monocytes.

Prevents immediate and delayed asthmatic reactions after inhalation of allergens and non-antigenic irritants.

Indications

Bronchial asthma (atopic form, asthmatic triad, exercise asthma), chronic bronchitis with broncho-obstructive syndrome. Prevention and treatment of allergic conjunctivitis and keratoconjunctivitis. Prevention of seasonal and/or year-round rhinitis of allergic origin. Food allergy (with proven presence of antigen). As part of combination therapy for UC, proctitis or proctocolitis.

Dosage regimen

Individual. For inhalations - 1-10 mg (depending on the dosage form used) 4 times a day.

Orally for adults - 200 mg 4 times a day, for children aged 2 to 14 years - 100 mg 4 times a day.

When used in ophthalmology and ENT practice, the dose is set depending on the indications and the dosage form used.

Rectally applied in the form of microenemas.

Side effect

When administered by inhalation: possible irritation of the upper respiratory tract, cough, short-term bronchospasm; in some cases - severe bronchospasm with a decrease in external respiratory function.

With intranasal administration: at the beginning of treatment, irritation of the nasal mucosa is possible; in isolated cases - nosebleeds, allergic reactions.

When used topically in ophthalmology: there may be a temporary disturbance in the clarity of visual perception, a feeling of heat in the eye.

Allergic reactions: in isolated cases - skin rash, joint pain.

Other: in isolated cases - nausea.

Contraindications

I trimester of pregnancy, children up to 5 years of age (for inhalation use in the form of an aerosol), up to 2 years (in the form of capsules with powder for inhalation and solution for inhalation use); hypersensitivity to cromoglycic acid.

Pregnancy and lactation

Cromoglicic acid is contraindicated for use in the first trimester of pregnancy.

Use in the second and third trimesters of pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

Excreted in small quantities into breast milk. Use during lactation is possible only if the expected benefit to the mother outweighs the potential risk to the baby.

Use for liver dysfunction

Use with caution in case of concomitant liver diseases.

Use for renal impairment

Use with caution in case of concomitant kidney diseases.

Application for children

In children under 2 years of age, the dose of cromoglycic acid for inhalation use in the form of powder and solution has not been determined.

In children under 5 years of age, the dose of cromoglycic acid for inhalation use in aerosol form and for intranasal use has not been determined.

special instructions

Not used to relieve an acute attack of bronchial asthma.

Use with caution in case of concomitant diseases of the liver and kidneys.

In exceptional cases, when bronchospasm develops with inhalation of cromoglycic acid with a decrease in respiratory function, repeated use is not recommended.

In the treatment of UC, proctitis or proctocolitis, cromoglycic acid is the drug of choice in patients with hypersensitivity to sulfasalazine.

Bromhexine and ambroxol should not be used simultaneously in the inhalation solution of cromoglycic acid.

For food allergies, it should be used in combination with a diet that limits the intake of antigen.

In children under 2 years of age, the dose of cromoglycic acid for inhalation use in the form of powder and solution has not been determined.

In children under 5 years of age, the dose of cromoglycic acid for inhalation use in aerosol form and for intranasal use has not been determined.

Impact on the ability to drive vehicles and operate machinery

For some time after instillation into the eyes, you should refrain from performing work that requires increased attention.

Drug interactions

When using cromoglycic acid with oral and inhaled forms of beta-agonists, oral and inhaled forms of corticosteroids, theophylline and other methylxanthine derivatives, antihistamines, a potentiation effect is possible. The combined administration of cromoglycic acid and corticosteroids allows you to reduce the dose of the latter, and in some cases, completely cancel it. While reducing the dose of GCS, the patient should be under close medical supervision; the rate of dose reduction should not exceed 10% per week.

In inhalation solution, it is pharmaceutically incompatible with bromhexine or ambroxol. Bronchodilators must be taken (inhaled) before inhalation of cromoglycic acid.

When applied topically in ophthalmic practice, cromoglycic acid reduces the need for the use of ophthalmic drugs containing corticosteroids.

Medicinal reference book

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Source: http://www.rusmedserv.com/lekarstva/komponent/cromoglicic-acid.html

Cromoglicic acid

Antiallergic agent, mast cell membrane stabilizer. Inhibits the release of histamine, leukotrienes and other biologically active substances from mast cells. It is believed that the delay in the release of mediators occurs as a result of an indirect blockade of the penetration of calcium ions into cells. It has been established that cromoglycic acid suppresses the migration of neutrophils, eosinophils, and monocytes.

Prevents immediate and delayed asthmatic reactions after inhalation of allergens and non-antigenic irritants.

The degree of absorption of the active substance depends on the route of administration.

Plasma protein binding is 65%. Not metabolized. T1 /2 is about 1.5 hours. It is excreted unchanged in the urine and bile in approximately equal quantities.

Individual. For inhalations - 1-10 mg (depending on the dosage form used) 4 times a day.

Orally for adults - 200 mg 4 times a day, for children aged 2 to 14 years - 100 mg 4 times a day.

When used in ophthalmology and ENT practice, the dose is set depending on the indications and the dosage form used.

Rectally applied in the form of microenemas.

When administered by inhalation: possible irritation of the upper respiratory tract, cough, short-term bronchospasm; in some cases - severe bronchospasm with a decrease in external respiratory function.

With intranasal administration: at the beginning of treatment, irritation of the nasal mucosa is possible; in isolated cases - nosebleeds, allergic reactions.

When used topically in ophthalmology: there may be a temporary disturbance in the clarity of visual perception, a feeling of heat in the eye.

Allergic reactions: in isolated cases - skin rash, joint pain.

Other: in isolated cases - nausea.

Cromoglicic acid is contraindicated for use in the first trimester of pregnancy.

Use in the second and third trimesters of pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

Excreted in small quantities into breast milk. Use during lactation is possible only if the expected benefit to the mother outweighs the potential risk to the baby.

In children under 2 years of age, the dose of cromoglycic acid for inhalation use in the form of powder and solution has not been determined.

In children under 5 years of age, the dose of cromoglycic acid for inhalation use in aerosol form and for intranasal use has not been determined.

Not used to relieve an acute attack of bronchial asthma.

Use with caution in case of concomitant diseases of the liver and kidneys.

In exceptional cases, when bronchospasm develops with inhalation of cromoglycic acid with a decrease in respiratory function, repeated use is not recommended.

In the treatment of UC, proctitis or proctocolitis, cromoglycic acid is the drug of choice in patients with hypersensitivity to sulfasalazine.

Bromhexine and ambroxol should not be used simultaneously in the inhalation solution of cromoglycic acid.

For food allergies, it should be used in combination with a diet that limits the intake of antigen.

In children under 2 years of age, the dose of cromoglycic acid for inhalation use in the form of powder and solution has not been determined.

In children under 5 years of age, the dose of cromoglycic acid for inhalation use in aerosol form and for intranasal use has not been determined.

Impact on the ability to drive vehicles and operate machinery

For some time after instillation into the eyes, you should refrain from performing work that requires increased attention.

When using cromoglycic acid with oral and inhaled forms of beta-agonists, oral and inhaled forms of corticosteroids, theophylline and other methylxanthine derivatives, antihistamines, a potentiation effect is possible. The combined administration of cromoglycic acid and corticosteroids allows you to reduce the dose of the latter, and in some cases, completely cancel it. While reducing the dose of GCS, the patient should be under close medical supervision; the rate of dose reduction should not exceed 10% per week.

In inhalation solution, it is pharmaceutically incompatible with bromhexine or ambroxol. Bronchodilators must be taken (inhaled) before inhalation of cromoglycic acid.

When applied topically in ophthalmic practice, cromoglycic acid reduces the need for the use of ophthalmic drugs containing corticosteroids.

A description of the active substances of the drug is presented. The scientific information provided is general and cannot be used to make a decision about the possibility of using a particular drug.

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Cromoglicic acid

Content

Structural formula

Russian name

Latin name of the substance Cromoglycic acid

Chemical name

5,5′-[(2-Hydroxy-1,3-propanediyl)bis(oxy)]bis[4-oxo-4H-1-benzopyran-2-carboxylic acid (and as disodium salt)

Gross formula

Pharmacological group of the substance Cromoglycic acid

Nosological classification (ICD-10)

CAS code

Pharmacology

Stabilizes the membranes of sensitized mast cells, inhibits the entry of calcium ions, degranulation and the release of histamine, bradykinin, leukotrienes (including the slow-reacting substance of anaphylaxis), prostaglandins and other biologically active substances. Prevents the development of allergic and inflammatory reactions, bronchospasm, inhibits the chemotaxis of eosinophils. It has the ability to block receptors specific for inflammatory mediators. Long-term use reduces the frequency of bronchial asthma attacks and facilitates their course, reduces the need for bronchodilators and glucocorticoids. In patients with mastocytosis, after 2–6 weeks from the start of treatment, a decrease in symptoms from the gastrointestinal tract (diarrhea, abdominal pain, nausea, vomiting) and skin (hyperemia, urticaria, itching) is observed, which persists for 2–3 weeks after its discontinuation. Reduction of symptoms in allergic eye diseases manifests itself in a period of several days to several weeks. With year-round allergic rhinitis, the effect appears within 1 week and reaches a maximum after 1–4 weeks.

Long-term studies conducted on mice, hamsters, rabbits and rats did not reveal carcinogenic or teratogenic effects. When administered parenterally to mice, rats and rabbits at doses up to 338 times the human therapeutic dose, there is no effect on fertility. In higher doses, it has a toxic effect on the body of females, increases the frequency of fruit resorption and reduces their body weight.

After oral administration, no more than 1% is absorbed (0.45% is excreted in the urine within 24 hours), the rest is excreted in feces. When instilled into the eye, it is poorly absorbed into the systemic circulation (0.03%), trace amounts (less than 0.01%) penetrate into the aqueous humor and are completely eliminated within 1 day. After intranasal administration, less than 7% is absorbed into the systemic circulation. When administered by inhalation, up to 90% of the drug settles in the trachea and large bronchi. 5–15% of the dose is absorbed from the lungs (Cmax in the blood is created in 15–20 minutes), a small part enters the gastrointestinal tract, and the rest is exhaled. Absorption from the mucous membranes decreases as the amount of secretion increases. Binding to blood plasma proteins is 65–75%. It is not metabolized and is excreted from the body in equal quantities with urine and bile within 24 hours. T1 /2 is 1–1.5 hours. It passes into breast milk in small quantities. The effect of a single dose lasts up to 5 hours.

Application of the substance Cromoglycic acid

Inhalation forms: bronchial asthma, incl. atopic, physical exertion and asthmatic triad, chronic bronchitis with broncho-obstructive syndrome.

Capsules: food allergy (with proven presence of antigen, separately or in combination with a diet that limits the intake of allergen), as an aid: ulcerative colitis, proctitis, coloproctitis; mastocytosis.

Nasal spray: year-round and seasonal allergic rhinitis, hay fever.

Eye drops: acute and chronic allergic conjunctivitis, allergic keratitis, keratoconjunctivitis, dry eye syndrome, eye strain and fatigue, irritation of the mucous membrane of the eyes caused by allergic reactions (environmental factors, occupational hazards, household chemicals, cosmetics, ophthalmic drugs shapes, plants and pets).

Contraindications

Hypersensitivity (including to benzalkonium hydrochloride), pregnancy, breastfeeding, children under 2 years of age (for a dosed aerosol - up to 5 years).

Restrictions on use

Presence of polyps in the nasal cavity (for intranasal forms)

Use during pregnancy and breastfeeding

Contraindicated (especially in the first trimester of pregnancy). Breastfeeding should be stopped during treatment.

Side effects of the substance Cromoglycic acid

For inhalation use:

From the skin: exanthema, dermatitis; rarely - urticaria; in some cases - vascular edema, photodermatitis, exfoliative dermatitis.

From the nervous system and sensory organs: in some cases - malaise, dizziness, irritability, insomnia, hallucinations, tremor, peripheral neuritis, tinnitus.

From the gastrointestinal tract: nausea, gastroenteritis; in some cases - unpleasant taste in the mouth, stomatitis, glossitis, swelling of the parotid salivary gland, esophagospasm, dyspepsia, flatulence, abdominal pain, diarrhea, constipation, impaired liver function.

From the genitourinary system: frequent urination, nephropathy.

From the respiratory system: bronchial irritation during inhalation (cough, retching, short-term spasm; rarely - expressed with a decrease in external respiration, requiring discontinuation of the drug), pharyngitis; very rarely - hemoptysis, laryngeal edema, eosinophilic pneumonia.

From the cardiovascular system: in some cases - chest pain, periarterial vasculitis, heart failure, pericarditis, hypotension, cardiac arrhythmia.

From the musculoskeletal system: myositis, in some cases - muscle and joint pain, polymyositis, joint swelling.

Other: rarely - serum sickness.

When taken orally:

From the gastrointestinal tract: nausea, vomiting, abdominal discomfort, diarrhea.

Other: skin rash, joint pain.

For intranasal administration:

From the gastrointestinal tract: unpleasant taste in the mouth, swelling of the tongue.

From the respiratory system: short-term irritation of the mucous membrane and increased secretion from the nose; very rarely - nosebleeds, ulceration of the nasal mucosa, cough, suffocation.

Other: headache, arthralgia, anaphylactic reaction (cough, difficulty swallowing, itchy skin, swelling of the face, lips or eyelids, difficulty breathing), exanthema, urticaria.

For eye drops - short-term burning and blurred vision, conjunctival hyperemia, lacrimation, conjunctival swelling, sensation of a foreign body in the eye, dryness around the eyes, stye.

Interaction

Beta-agonists, glucocorticoids, antihistamines and theophylline potentiate the effect. You should not inhale bromhexine, ambroxol mixed with a solution of cromoglycic acid.

Routes of administration

Inhalation, orally, intranasally, conjunctivally.

Precautions for the substance Cromoglycic acid

Use with caution in patients with impaired liver or kidney function. Treatment is continued as long as the allergenic factor is active. Discontinuation of the drug must be carried out by gradually reducing the dose over 1 week. The cough that occurs after inhalation can be stopped by drinking a glass of water. If the use of the drug causes repeated bronchospasm, preliminary inhalation of bronchodilators is recommended. When concomitant therapy with bronchodilators is used, they are used before inhalation of cromoglycic acid.

If benzalkonium chloride (a preservative) is present in eye drops, you should not wear soft contact lenses during treatment. It is recommended to remove hard lenses 15 minutes before instillation. It should be taken into account that after instillation into the eye, a short-term visual impairment is observed (you should not immediately perform work that requires increased attention).

special instructions

Not intended for relief of acute attacks of bronchial asthma and status asthmaticus. The patient should be warned about the need for regular use of the drug. Inhalation of the solution should be carried out using a compression, ultrasonic or piezoelectric inhaler through a face mask or mouthpiece. The aerosol can must be shaken before use and kept in an upright position during inhalation (the dosing valve must be at the bottom). Inhalation of the contents of the capsule is carried out using a special pocket turbo inhaler (“Spinhaler”), into which a capsule with the drug is placed. By pressing the cap of the inhaler, the capsule is pierced and with the patient’s active respiratory effort during inhalation, the powder enters the respiratory tract.

Interactions with other active ingredients

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Cromoglicic acid

Content

Pharmacological properties of the drug Cromoglicic acid

Cromoglycic acid is an antiallergic agent, has a membrane-stabilizing effect, prevents the degranulation of mast cells and the release of histamine, leukotrienes (including SRSA, bradykinin), prostaglandins and other biologically active substances from them. When used by inhalation, it prevents the development of bronchospasm caused by the influence of various factors, but does not relieve developed bronchospasm in the husband. Long-term use reduces the frequency of asthma attacks and facilitates their course, reduces the need for bronchodilators and corticosteroids. A stable effect is achieved after 2–4 weeks of use; after a single administration, the effect lasts up to 5 hours.

Absorption from the respiratory tract into the systemic circulation when inhaled in powder form is 5–15%, after inhalation in the form of a solution - 8%. Absorption from the mucous membranes of the respiratory tract decreases with an increase in the amount of bronchial secretion. The maximum concentration in blood plasma is reached after 15 minutes. Not metabolized in the body. The half-life is 46–99 minutes (average about 80 minutes). It is excreted by the kidneys and through the intestines unchanged in approximately equal proportions; the rest is excreted through the lungs with exhaled air or settles on the walls of the oropharynx, then swallowed (absorption - less than 2%) and excreted through the intestines. When administered intranasally, less than 7% is absorbed into the systemic circulation. About 65% of cromoglycic acid binds to blood plasma proteins. The half-life is 1.5 hours. Part of the active substance is swallowed (about 1%), practically not absorbed, and is excreted in the feces.

Indications for use of the drug Cromoglycic acid

In the form of a dosed aerosol for inhalation, it is used for the prevention of asthma attacks, bronchospasm caused by allergens, irritants, cold or physical activity, and in chronic obstructive bronchitis.

Metered-dose nasal aerosol and nasal drops are used for the prevention and treatment of seasonal and year-round allergic rhinitis.

Eye drops are used for acute and chronic allergic conjunctivitis.

Use of the drug Cromoglycic acid

Inhalation of the inhalation powder contained in the capsule is carried out using a special device (spinhaler) - the contents of 1 capsule (20 mg) 4 times a day: at night, in the morning, 2 times during the day, with an interval of 3-6 hours. If necessary, dose increase to 120–160 mg/day.

Aerosol dosed for inhalation. Metered-dose aerosol for inhalation for adults and children aged 5 years and older is prescribed 2–10 mg 4 times a day. It is possible to increase the dose to 2 mg 6–8 times a day. Once the optimal therapeutic effect is achieved, you can switch to a maintenance dose. In severe cases, as well as with high concentrations of allergens, the dose can be increased to 15–20 mg 4 times a day. After achieving a therapeutic effect, you should not suddenly stop treatment; Cancellation is carried out gradually, over 1 week. During dose reduction, symptoms of the disease may recur. To prevent bronchospasm in asthma caused by physical activity or cold air, inhale a dose of 10 mg 10–15 minutes before exposure to the provoking factor.

Aerosol for intranasal use - 1 dose in each nasal passage 4-6 times a day. The course of treatment is 4 weeks. Cancel gradually, over 1 week.

Eye drops - adults and children, 1-2 drops into the conjunctival sac 4 times a day. Treatment must be continued until contact with the allergen that caused the disease ceases.

Contraindications to the use of the drug Cromoglycic acid

Hypersensitivity to cromoglycic acid, pregnancy (first trimester), age up to 5 years (for inhalation use in the form of an aerosol), up to 2 years (in the form of capsules with powder for inhalation).

Side effects of the drug Cromoglicic acid

During inhalation, irritation of the mucous membrane of the respiratory tract, dysphonia, and cough are possible; changes in taste, dry mouth; dizziness, headache; urinary retention, renal dysfunction; rarely - allergic reactions (skin rash, lacrimation, dysphagia, urticaria, itching, angioedema of the face, lips and eyelids, wheezing, decreased blood pressure).

When using a nasal spray, rarely - irritation of the mucous membrane of the nasal cavity and pharynx, reflex cough, feeling of dryness in the throat.

When using eye drops, a burning sensation, a foreign body, swelling and hyperemia of the conjunctiva may occur.

Special instructions for the use of the drug Cromoglycic acid

Use with caution in case of renal or liver failure, during pregnancy (II–III trimester) and breastfeeding.

If it is necessary to discontinue treatment, the dose is reduced gradually (over at least 1 week) to reduce the risk of exacerbation of the disease. Not used to relieve bronchospasm.

It is not recommended to use soft contact lenses during treatment with eye drops. If the patient uses hard contact lenses during treatment, before instilling eye drops, it is recommended to remove the contact lenses and put them back on no earlier than 15 minutes after instillation.

Drug interactions Cromoglycic acid

β-adrenergic agonists, corticosteroids, antihistamines and theophylline enhance the effect of cromoglycic acid. The combined administration of cromoglycic acid and corticosteroids allows you to reduce the dose of the latter, and in some cases, completely cancel them. While reducing the dose of GCS, the patient should be under close medical supervision; the rate of reduction should not exceed 10% per week. In inhalation solution, cromoglycic acid is pharmaceutically incompatible with bromhexine or ambroxol. Bronchodilators must be used before inhalation of cromoglycic acid.

List of pharmacies where you can buy Cromoglycic acid:

Source: http://www.minclinic.ru/drugs/K/kromoglitsievaya_kislota.html

Cromoglycic acid preparations

Part of the drug name:

Popular:

Medicines containing cromoglycic acid

Ditek

International name: Fenoterol+Cromoglicic acid

Pharmacological action: Ditek is a combination drug. Fenoterol stimulates beta2-adrenergic receptors of the bronchi, activates adenylate cyclase, increasing the formation of cAMP,.

Indications: Prevention and treatment: respiratory failure in chronic respiratory diseases (especially in children); bronchial asthma (more than .

Intal plus

International name: Salbutamol+Cromoglicic acid

Pharmacological action: Intal plus is a combination drug. Cromoglycic acid is a stabilizer of mast cell membranes; prevents bronchospasm, preventing degranulation.

Indications: Atopic bronchial asthma, “aspirin” asthma, exercise asthma, chronic asthmatic bronchitis.

Cromogen

International name: Cromoglicic acid

Dosage form: dosed inhalation aerosol, dosed nasal aerosol, dosed nasal aerosol, nasal drops, nasal spray, dosed nasal spray

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, blocks the entry of Ca2+ into mast cells, and prevents degranulation.

Indications: Hay fever, allergic rhinitis (including seasonal or year-round) - prevention and treatment.

Cromogen easy breathing

International name: Cromoglicic acid

Dosage form: dosed inhalation aerosol, dosed nasal aerosol, dosed nasal aerosol, nasal drops, nasal spray, dosed nasal spray

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, blocks the entry of Ca2+ into mast cells, and prevents degranulation.

Indications: Hay fever, allergic rhinitis (including seasonal or year-round) - prevention and treatment.

Cromoglycin-Ratiopharm

International name: Cromoglicic acid

Dosage form: dosed inhalation aerosol, dosed nasal aerosol, dosed nasal aerosol, nasal drops, nasal spray, dosed nasal spray

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, blocks the entry of Ca2+ into mast cells, and prevents degranulation.

Indications: Hay fever, allergic rhinitis (including seasonal or year-round) - prevention and treatment.

Kromosol

International name: Cromoglicic acid

Dosage form: dosed inhalation aerosol, dosed nasal aerosol, dosed nasal aerosol, nasal drops, nasal spray, dosed nasal spray

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, blocks the entry of Ca2+ into mast cells, and prevents degranulation.

Indications: Hay fever, allergic rhinitis (including seasonal or year-round) - prevention and treatment.

Kropoz

International name: Cromoglicic acid

Dosage form: dosed inhalation aerosol, dosed nasal aerosol, dosed nasal aerosol, nasal drops, nasal spray, dosed nasal spray

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, blocks the entry of Ca2+ into mast cells, and prevents degranulation.

Indications: Hay fever, allergic rhinitis (including seasonal or year-round) - prevention and treatment.

Kuzikrom

International name: Cromoglicic acid

Dosage form: eye drops

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, prevents the degranulation of mast cells and the release of histamine from them.

Indications: Allergic conjunctivitis, allergic keratitis, keratoconjunctivitis, dry eye syndrome; overstrain, excessive eye fatigue; irritation

Lecrolin

International name: Cromoglicic acid

Dosage form: eye drops

Pharmacological action: Antiallergic agent, has a membrane-stabilizing effect, prevents the degranulation of mast cells and the release of histamine from them.

Indications: Allergic conjunctivitis, allergic keratitis, keratoconjunctivitis, dry eye syndrome; overstrain, excessive eye fatigue; irritation

Source: http://pilulkin.com.ua/agent_of_drug/732/kromoglitsievaya_kislota/

Cromoglicic acid: instructions for use

ENT doctors very often encounter diseases of allergic origin. This pathology has mechanisms different from microbial damage, and therefore requires appropriate medications. And one of them is cromoglycic acid. What it is, what properties it has and how it is used - these aspects can be found in the instructions.

Characteristics

The disodium salt of cromoglycic acid is also called sodium cromoglycate. It is a white crystalline powder that is used as an active ingredient in various pharmacological forms:

  • Metered aerosols.
  • Nasal sprays.
  • Solutions and powders for inhalation.
  • Eye drops.
  • Capsules.

Based on this, some auxiliary ingredients may be included in the composition of medications. However, they are indifferent, i.e. they do not affect the body in any way.

Properties

Cromoglycic acid stabilizes the membranes of mast cells (basophils). It inhibits their degranulation and further release of various biological substances involved in allergic reactions: histamine, serotonin, bradykinin, prostaglandins and leukotrienes. In addition, the drug inhibits the migration of eosinophils and blocks receptors sensitive to inflammatory mediators.

All this provides cromoglycic acid with an important property - to prevent the development of allergic and associated inflammatory reactions. Preparations based on it effectively combat bronchospasm, rhinorrhea, lacrimation, urticaria, itching and other unpleasant manifestations in a sensitized body.

Pharmacokinetic properties

The bioavailability of a drug is determined by route of administration. When inhaled, most of the cromoglycate remains on the mucous membrane of the tracheobronchial tree. No more than 15% of the administered dose enters the bloodstream from the alveoli. When taken orally (orally), only 1% of the substance is subject to systemic absorption, and the acid introduced into the nasal cavity is absorbed in a volume of 7%. Once in the bloodstream, 2/3 of the drug binds to plasma proteins. It is not metabolized, but is excreted from the body by the kidneys and intestines. The half-life is no more than 90 minutes, and one dose is effective for 5 hours.

Cromoglicic acid is available in various dosage forms. Preparations based on it prevent mast cell degranulation and associated clinical and pathophysiological effects.

Indications

Given the properties of the drug, it is easy to guess when it is used. The medicinal substance is widely used in the treatment of diseases associated with the body's hypersensitivity to allergens:

  • Bronchial asthma.
  • Bronchitis with obstructive syndrome.
  • Rhinitis (seasonal and year-round).
  • Hay fever.
  • Conjunctivitis, keratitis.
  • Dry eye syndrome.
  • Food allergies.
  • Nonspecific ulcerative colitis.
  • Mastocytosis, etc.

Medicines with cromoglycic acid are used both in monotherapy of these diseases and in combination with other medicines. It should be remembered that the drug is intended to prevent allergic reactions, and is not suitable for relieving acute symptoms.

Application

Before taking the drug, you need to determine the cause of the disease. Determining the causative allergen is the most important component of adequate treatment. And this can only be done based on the results of diagnostics with the participation of a doctor. The dosage and duration of administration are also determined by a specialist.

Method of use

The route of administration of the drug must correspond to the diagnosis. Based on the duration of action, drugs are usually taken at intervals of 3-6 hours (unless otherwise indicated in the instructions). In inhalation form, cromoglycic acid is used in 1-2 puffs. As a prophylaxis for bronchospasm, the aerosol is used half an hour before the expected exercise or contact with the causative allergen.

The powder is inhaled using a special device - Spinhaler. When you press the cap of the inhaler, a capsule is pierced, the contents of which enter the respiratory tract as you inhale. One dose is administered to adults and children 4 times a day, but with intense allergenic exposure, the frequency of administration may increase. The solution is inhaled using inhalers or nebulizers - 1 ampoule. Once stable remission is achieved, the drug can be administered only as needed.

The solution for injection into the eyes is used 1-2 drops, and the nasal spray is used one injection into each nasal passage. Capsules are taken orally before meals by adults and children after 2 months in the appropriate dosage (table).

The capsules are swallowed whole, or their contents are first dissolved in hot water and then taken diluted with cold water. The drug should be used regularly and under the supervision of a physician, and if a lasting therapeutic effect is obtained, the dose may be reduced to a minimum. The course of treatment, as always, is determined by a specialist.

The drugs are prescribed by a doctor and taken in accordance with his recommendations. Each case requires an individual approach.

Side effects

Generally, cromoglycic acid is very well tolerated. However, in some cases, side effects may occur. Instructions for use mention the following:

  • Dyspeptic (unpleasant taste in the mouth, swelling of the tongue, nausea, abdominal discomfort, vomiting and diarrhea).
  • Respiratory (rhinorrhea, nosebleeds, irritation of the mucous membrane of the throat, pharyngitis, cough, reflex bronchospasm).
  • Skin (urticaria and other rashes, redness, dermatitis).
  • Neurological and sensory (dry eyes, short-term visual disturbances, dizziness, tinnitus, tremor, insomnia).
  • Cardiovascular (low blood pressure, arrhythmia, pain in the heart).
  • Other (dysuria, muscle and joint pain).

The nature of adverse reactions is determined by administering cromoglycic acid. Moreover, they are observed with varying frequency and do not necessarily occur in a particular patient. And with an overdose, the risk of adverse events increases many times over.

Restrictions

We must not forget that each drug has its own effect on the body. And in order for it to be within the therapeutic effects, it is important to take into account all limiting factors. Therefore, before prescribing treatment, the doctor takes into account the patient’s condition, concomitant diseases and concurrent use of other medications.

Contraindications

For cromoglycic acid, the instructions indicate only one absolute contraindication - individual hypersensitivity. Capsules for oral administration are not used in children under 2 months, and inhalation forms - up to 5 years. Nasal sprays are not recommended for use for nasal polyps. Patients with impaired renal and hepatic function take cromoglycate with extreme caution. And during the period of bearing a child and when breastfeeding, medicine is prescribed only after carefully weighing the potential risk.

Interaction

Preparations based on cromoglicic acid combine well with bronchodilators and glucocorticoids. They also enhance the effects of antihistamines and theophyllines. But it is better not to use such medications with ambroxol and bromhexine.

Cromoglycic acid has an antiallergic effect, preventing the degranulation of mast cells. It is produced in various dosage forms, which makes it possible to cover patients with pathologies not only of the respiratory tract. But each case requires an individual approach and medical supervision.

Source: http://elaxsir.ru/lekarstva/drugie-lekarstva/kislota-kromoglicievaya.html

Cromoglicic acid

Cromoglicic acid

Ditek (Germany), Intal (UK), Ifiral (India), Cromohexal (Germany), Cromogen (UK), Cromogen Easy Breathing (UK), Cromoglin (Germany), Cromolyn (Finland), Cromosol (Poland), Kropoz (Poland) ), Kusikrom (Spain), Lecrolin (Finland), Nalkrom (UK), Stadaglycin (Germany), Hi-Krom (UK)

Mast cell membrane stabilizers

Aerosol for inhalation doses 1 mg/dose; 5 mg/dose Aerosol naz. 2%; 20 mg/ml Eye drops. 10 mg; 2%; 20 mg/ml; 2%; 4% Capsules 100 mg

Capsules since. for inhalation 20 mg

Solution for inhalation 20 mg

Spray called 2%; 20 mg/ml; 300 mg

Stabilizes the membrane of mast cells and their granules due to blockade of Ca2+ entry into cells. Inhibits the release of allergy mediators (histamine, leukotrienes, PG2, etc.) from various cells located in the lumen of the bronchial tree and in the bronchial mucosa. Suppresses the migration of neutrophils and monocytes.

• Has a membrane-stabilizing effect. In the lungs, inhibition of the mediator response prevents the development of both the early and late stages of the asthmatic reaction (in response to immune and other stimuli).

• Most effective for the prevention of immediate allergic reactions in relatively young patients who have not yet developed chronic irreversible changes in the lungs. Does not eliminate developed bronchospasm.

• Long-term use reduces the frequency of bronchial asthma attacks and facilitates their course, reduces the need for bronchodilators and corticosteroids.

• A stable effect is achieved after 2-4 weeks of use. The effect after a single injection lasts up to 5 hours.

• A noticeable clinical effect in allergic eye diseases occurs within a few days or weeks.

Absorption from the respiratory tract into the systemic circulation - 10%; after inhalation of the powder - 5-15%, after inhalation of the solution - 8%. Absorption from the mucous membrane of the respiratory tract decreases as the amount of secretion increases. Cmax is reached after 15 minutes.

Not metabolized. T ½ 46-99 min (on average about 80 min). Excreted unchanged by the kidneys and through the intestines in approximately equal proportions; the rest is excreted through the lungs with exhaled air or settles on the walls of the oropharynx, then swallowed (without significant absorption - less than 2%) and excreted through the intestines.

When administered intranasally, less than 7% enters the systemic circulation. Binds to plasma proteins by 65%. Not metabolized, excreted unchanged by the kidneys and bile (in approximately equal amounts within 24 hours after use). T1/2

1.5 hours. Part of the active substance is swallowed (about 1%) and is excreted through the gastrointestinal tract without significant absorption.

Absorption through the mucous membrane of the eye is negligible. Systemic bioavailability is less than 0.03%. T1/2 - 5-10 min.

Indications for use.

• bronchial asthma, bronchospasm (including those caused by allergens, cold and/or dry air, environmental pollution), chronic bronchitis with broncho-obstructive syndrome.

For intranasal use:

• hay fever, allergic rhinitis (including seasonal or year-round) - prevention and treatment.

• allergic conjunctivitis, allergic keratitis, keratoconjunctivitis, dry eye syndrome, overstrain, eye fatigue, irritation of the mucous membrane of the eyes caused by allergic reactions (environmental factors, occupational hazards, household chemicals, cosmetics, ophthalmic dosage forms, plants and pets) .

Directions for use and doses

• Capsules with powder for inhalation. When swallowed as a capsule, cromoglycic acid is not effective in preventing asthma. Inhalation of the contents of the capsule (powder for inhalation) is carried out using a spinhaler - 1 capsule (20 mg) 4 times a day: at night, in the morning, 2 times during the day, with an interval of 3-6 hours. If necessary, the dose is increased to 120-160 mg/day days

• Metered aerosol for inhalation. In 1 dose - 1 mg: adults (including elderly people) and children over 5 years old, 2-10 mg 4 times a day. It is possible to increase the dose to 2 mg 6-8 times a day. In 1 dose - 5 mg: 5-10 mg (1-2 inhalations) 4 times / day. Once a stable therapeutic effect is achieved, you can switch to a maintenance dose that provides optimal disease control. In severe cases, as well as with a high concentration of allergens, the dose can be increased to 15-20 mg 4 times a day. After achieving a therapeutic effect, you should not suddenly stop treatment; discontinuation should be done gradually (within 1 week). During dose reduction, symptoms of the disease may recur. To prevent an attack of suffocation in bronchial asthma caused by physical stress or cold air, 10-15 minutes before the provoking factor, you need to take 10 mg.

• Solution for inhalation: 20 mg 4 times a day using an inhaler. The contents of the container are thoroughly shaken before use. During inhalation, it should be kept in an upright position, with the dosing valve at the bottom.

• Nasal drops. Adults are recommended to instill 3-4 drops of solution into each nasal passage every 4-6 hours, children over 6 years old - 1-2 drops every 6 hours. After achieving a therapeutic effect, it is possible to gradually lengthen the intervals between doses of the drug.

• Aerosol for intranasal use, nasal spray - 1 dose in each half of the nose 4-6 times a day. The course of treatment is 4 weeks. Cancellation should be carried out gradually over 1 week.

Instillation of eye drops (conjunctival). Treatment begins with instillation of 1-2 drops into each conjunctival sac 4 times a day with an interval of 4-6 hours. If necessary, the number of instillations can be increased to 6-8.

• Pregnancy (I trimester - for inhalations).

• Children's age (up to 5 years - for intranasal and inhalation use in the form of an aerosol, up to 2 years - in the form of capsules with powder for inhalation and solution for inhalation use).

• Breastfeeding (for intranasal administration).

Cautions, therapy monitoring

• Bronchodilators must be taken (inhaled) before inhalation of the drug.

• In addition to the side effects listed below, when using cromoglycic acid preparations, the following reactions are observed (a cause-and-effect relationship has not been proven) in 1 patient: Quincke's edema, dysuria, frequent urination, swelling and pain in the joints, swelling of the larynx, swelling of the parotid salivary glands . The following were observed in 1 patient: anemia, exfoliative dermatitis, hemoptysis, myalgia, nephropathy, periarteritis, pericarditis, peripheral neuritis, photodermatitis, polymyositis, pulmonary infiltrates with eosinophilia.

• While reducing the dose of GCS, the patient should be under close medical supervision; the rate of reduction should not exceed 10% per week.

• If it is necessary to discontinue treatment, the dose is reduced gradually (over at least 1 week) to reduce the risk of exacerbation of the disease.

• Not used to relieve bronchospasm.

• Treatment of patients with renal and/or liver failure should be carried out under the constant supervision of a physician (the advisability of dose reduction should be considered).

• Long-term experimental studies have not revealed carcinogenic or teratogenic effects. When administered parenterally to animals at a dose 338 times higher than the therapeutic dose for humans, it has no effect on fertility. In higher doses, it has a toxic effect on the body of females, increases the frequency of fruit resorption and reduces their body weight.

• When using drops in regular dropper bottles, you should avoid wearing soft contact lenses due to the preservative content; Hard contact lenses must be removed 15 minutes before instillation.

• Eye drops in dropper tubes for one-time use do not contain a preservative, so they can be used in patients intolerant to preservatives or who wear contact lenses.

• During the treatment period, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Prescribe with caution:

• in case of renal and/or liver failure;

• during pregnancy (II and III trimester - for inhalations);

• during lactation;

• with intranasal use - polyps of the nasal cavity.

From the respiratory system:

• irritation of the mucous membrane of the respiratory tract (hoarseness, cough (>10%), bronchospasm (>10%));

• with intranasal use - irritation or burning of the nasal mucosa, nasal congestion (1-10%), frequent sneezing (1-10%), cough, increased secretion from the nose;

• rarely - nosebleeds.

From the digestive system:

• unpleasant taste (>10% when using an aerosol);

• nausea, irritation and/or dry throat, dry mouth (1-10%).

From the nervous system:

From the urinary system:

• renal dysfunction. From the side of the organ of vision:

• impaired clarity of visual perception, burning in the eyes, swelling of the conjunctiva, foreign body sensation, dry eyes, lacrimation, stye; superficial damage to the corneal epithelium (if there is a preservative in the drops - benzalkonium chloride).

• with inhalations - anaphylaxis (difficulty swallowing, urticaria, itchy skin, swelling of the face, lips and eyelids, severe stridor or difficulty breathing, decreased blood pressure) is observed in less than 1 patient;

• with intranasal use - anaphylactic reactions (difficulty swallowing, urticaria, itching of the skin, swelling of the face, lips or eyelids, wheezing or difficulty breathing, skin rash).

Groups and drugs

Reduced need for

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Source: http://lekmed.ru/lekarstva/polost-nosa/kromoglicievaya-kislota.html