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Cromones
They are generally less effective than antihistamines and topical corticosteroids. Furthermore, regular use (ie four times daily) is essential and this increases non-compliance.
Disodium cromoglicate is available in topical form for use in the eyes, nose, and bronchi. It is most useful as a prophylactic treatment or when antihistamines are not tolerated. Sodium nedocromil is available in an ophthalmological solution for treating eye symptoms.
Mode of Action
Cromones appear to act on the cell wall of mast cells and/or the intracellular events that follow allergen binding to IgE. Their mechanism of action is largely undetermined, but may include blockage of calcium channels on mast cell membranes, phosphodiesterase inhibition, or blockage of oxidative phosphorylation.
Drug Information
The following table lists some major cromones available in the UK, Canada, and US for the treatment of allergic rhinitis. Only brand name drugs are listed, but generic versions may also be available.
| Active ingredients | Brand names and country where licensed |
| Nasal solutions | |
| Sodium cromoglicate, cromolyn | Children’s Nasalcrom, Nasalcrom (US) Apo-Cromolyn, Cromolyn Nasal Solution, Gen-Cromoglycate (Canada) |
| Eye solutions | |
| Nedocromil sodium | Alocril (US) |
References
van Cauwenberge P, Bachert C, Passalacqua G, et al. Consensus statement on the treatment of allergic rhinitis. European Academy of Allergology and Clinical Immunology. Allergy 2000;55:116–134.
Dykewicz MS, Fineman S, Skoner DP, et al. Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol 1998;81:478–518.
Scadding GK. Corticosteroids in the treatment of pediatric allergic rhinitis. J Allergy Clin Immunol 2001;108:S59–S64.
Corren J. Allergic rhinitis: treating the adult. J Allergy Clin Immunol 2000;105:S610–S615.