Cromoglicic acid
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AHFS/Drugs.com | International Drug Names |
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Routes of administration | topical: oral, nasal spray, inhaled, eye drops |
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Pharmacokinetic data | |
Bioavailability | 1% |
Elimination half-life | 1.3 hours |
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Cromoglicic acid (
It is considered a breakthrough drug in management of asthma, as the patients can be freed from steroids in many cases; however, it is mainly effective as a prophylaxis for allergic and exercise-induced asthma, not as a treatment for acute asthma attacks.[citation needed]
Cromoglicic acid has been the non-
History
Cromolyn was discovered in 1965 by
Preparations
Cromoglicic acid is available in multiple forms:
- as a over-the-counter form, US), Prevalin (non-direct version, NL)) to treat allergic rhinitis.
- in a nebulizer solution for aerosol administration to treat asthma.
- as an inhaler (Intal, Fisons Pharmaceuticals, UK) for preventive management of asthma.[2] The maker of Intal, King Pharmaceuticals, has discontinued manufacturing the inhaled form, cromolyn sodium inhalation aerosol, due to issues involving CFC-free propellant.[3] As stocks are depleted, this inhaler preparation will no longer be available to patients.[4] In the EU it is manufactured without CFCs by Sanofi, although it must be imported from Canada or Mexico for USA residents.
- as eye drops (Opticrom and Optrex Allergy (UK), Crolom, Cromolyn (Canada)) for allergic conjunctivitis[5]
- in an oral form (Gastrocrom, Nalcrom) to treat mastocytosis,[6] mast cell activation syndrome, dermatographic urticaria and ulcerative colitis. Another oral product, Intercron (sodium cromoglicate in distilled water, from Zambon France), is used for food allergies.
Mechanism of action
"Cromolyn works because it prevents the release of mediators that would normally attract inflammatory cells and because it stabilizes the inflammatory cells. MCT mast cells found in the mucosa are stabilised."[7] Nedocromil is another mast cell stabilizer that also works in controlling asthma. The underlying
It is known to somewhat inhibit
- exaggerated neuronal reflexes triggered by stimulation of irritant receptors on sensory nerve endings (e.g. exercise-induced asthma)
- release of preformed eosinophils) in allergen-induced asthma
Note: Another chemical (NPPB: 5-nitro-2(3-phenyl) propylamino-benzoic acid) was shown, in the same study, to be a more effective chloride channel blocker.
Finally it may act by inhibiting calcium influx.
Cromoglicate is classified as a chromone.
Cromolyn is also being tested as a drug to treat insulin-induced lipoatrophy[11][12] and Alzheimer's disease in combination with Ibuprofen.[13] Cromolyn is also known to bind S100P protein and disrupt the interaction with RAGE.[14][15]
Synthesis
See also
References
- PMID 19264689. Review.
- PMID 8635375. Archived from the originalon 2013-04-14.
- ^ Carter E (July 31, 2009). "King Pharmaceuticals: Dear Healthcare Professionals" (PDF). Food and Drug Administration. King Pharmaceuticals. Retrieved May 28, 2012.
- ^ "Intal Inhaler discontinued - MPR". Empr.com. 4 August 2009. Retrieved 2012-05-28.
- PMID 26028608.
- PMID 2110198.
- ^ Werner's Pathophysiology page 224
- ^ ISBN 978-0-443-07145-4.
- ISBN 978-3-642-75857-7.
- PMID 8564197.
- PMID 24265375.
- ^ Yasgur BS (18 December 2013). "A Surprising Option for Managing Insulin-Induced Lipoatrophy".
- ^ "Alzt-Op1". Alzforum.
- PMID 25084534.
- PMID 25450399.