Mast Cell Stabilizer Availability and Usage

Ophthalmic and Inhaled Formulations

• The American Academy of Ophthalmology recommends mast cell stabilizers, such as cromolyn sodium, for frequently recurrent or persistent allergic conjunctivitis, but these must be obtained by prescription, as ophthalmic cromolyn sodium is not available over-the-counter 1, 2
• Cromolyn sodium inhalation solution for exercise-induced bronchoconstriction and asthma management is prescription-only, and nedocromil sodium is currently not available in the United States as a metered-dose inhaler or dry powder inhaler 3

Safety and Efficacy

• Chronic vasoconstrictor use should be avoided, as it can cause rebound vasodilation if used beyond 10 days, and cromolyn sodium does not have this limitation and can be used long-term safely 2, 4
• Oral cromolyn sodium for gastrointestinal mast cell disorders, such as mast cell activation syndrome and systemic mastocytosis, requires a prescription and is effective at a dose of 200 mg four times daily, but the OTC nasal spray is not appropriate for systemic mast cell disorders 5