Mast cell stabilizers for long-term control of asthma

Examples

Generic Name	Brand Name
cromolyn sodium	Intal
nedocromil sodium	Tilade

Both these medications are used with a metered-dose inhaler. A nebulizer can also be used with cromolyn. Inhalers may be used differently, depending on the medication used. Always consult the directions to be sure you are using the inhaler correctly.

How It Works

Mast cells are found throughout the body, including in the airways in the lungs. They can release substances that result in inflammation, causing the symptoms of asthma. Mast cell stabilizers prevent the mast cells from releasing the substances that cause inflammation. This may reduce asthma symptoms.

Why It Is Used

Cromolyn sodium and nedocromil sodium may be used to treat mild persistent asthma. They also can be used to prevent asthma symptoms during exercise and before exposure to a substance that may trigger an asthma attack. These medications formerly were the first choice to treat asthma symptoms in children. But they have not been found to be as effective as inhaled corticosteroids, which are now the recommended treatment.¹

Different types of medications are often used together in the treatment of asthma. For more information on the medications used in asthma, see:

• Asthma medications for adults, teens, and children older than age 5.
• Asthma medications for children age 5 and younger.

How Well It Works

Cromolyn and nedocromil reduce asthma symptoms, improve morning peak expiratory flow, and decrease the need for short-acting beta2-agonists.² But they are not as effective as inhaled corticosteroids.² In people who have mild allergic asthma, cromolyn works just as well as nedocromil. Nedocromil works better in people who have asthma but who do not have allergies and who are already using inhaled corticosteroids.²

Side Effects

Cromolyn has few side effects, making it a reasonable choice for long-term treatment. Throat irritation and coughing or skin rashes sometimes can occur with cromolyn treatment.

Some people taking nedocromil complain about the taste. Using a spacer decreases the unpleasant taste. Drinking juice after you take the medication may decrease the taste.

Sometimes people who use these medications complain of nausea, vomiting, fullness after eating, heartburn, or abdominal pain.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

• These medications usually do not relieve symptoms in people with moderate to severe persistent asthma.
• These medications are not used to treat asthma attacks.
• Nedocromil has not been approved for use in children younger than age 6.
• Cromolyn has been approved for use in children age 5 and older.
• These medications must be inhaled 3 or 4 times a day and may take more than 2 to 4 weeks to show their full effect.

Most health professionals recommend that everyone who uses a metered-dose inhaler (MDI) also use a spacer, which is attached to the MDI. A spacer may deliver the medication to your lungs better than an inhaler alone, and for many people it is easier to use than an MDI alone.

Try to avoid giving your child an inhaled medication when he or she is crying, because not as much medication is delivered to the lungs.

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Author:	Maria G. Essig, MS, ELS	Last Updated: May 15, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Harold S. Nelson, MD - Allergy and Immunology
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