Cromolyn Sodium and Nedocromil for Asthma

Pediatrician showing girl inhaler in examination room
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In This Article

Intal (cromolyn sodium) and Tilade (nedocromil) are used as add-on controller medications and alternative treatment options for the treatment of asthma. In some instances, they can be used as an alternative to inhaled steroids, which are considered the treatment of choice. However, some parents and providers are drawn to this class of medication due to a low incidence of side effects.

Both medications work by blocking part of the asthma immune response.

Cromolyn sodium or nedocromil can be used as alternative treatments for mild persistent asthma, or before exposure to allergens that cause asthma symptoms, such as:

Because these drugs are not as effective as inhaled steroids in controlling asthma symptoms, they remain an alternative, but not preferred, treatment for most asthma patients.

How They Work

Cromolyn sodium and nedocromil prevent inflammation by stopping mast cells from releasing histamine. Cromolyn sodium and nedocromil also act directly on eosinophils to decrease inflammation. In this way, some patients use these drugs if exposure to an allergen is anticipated in advance. As mentioned above, others use it as a long-term maintenance treatment when they are unable to tolerate or do not want to take inhaled steroids for some reason.

The end result of decreased inflammation is a decrease in wheezing, chest tightness, shortness of breath, and coughing. Unlike your quick-relief medications, such as a short-acting beta agonist, cromolyn sodium and nedocromil need to be taken several times a day to be effective.

Prescriptions and Dosages

Cromolyn sodium and nedocromil are prescribed as aerosols in metered dose inhalers (MDIs). Generally, you'll need to take either drug four times a day, but nedocromil has also been effective in a twice-per-day dose. To improve your symptoms, both cromolyn sodium and nedocromil need to be taken daily no matter how well you feel or how well your asthma symptoms are controlled.

If you feel your asthma is under good control, you can talk to your doctor about changing your asthma care plan.

Both drugs have a similar mechanism of action, but nedocromil is able to be prescribed once daily, which may increase compliance. Cromolyn is available as nebulized treatment and generally has a better taste than nedocromil making it more likely to be taken by a child.

Nedocromil is not currently available in the United States.

Possible Risks and Side Effects

While using cromolyn sodium and nedocromil is generally safe, there is some risk of side effects, like most other medications. While most side effects will decrease as you continue to use the drug, make sure to tell your doctor if they continue or bother you significantly. Side effects include:

  • Bad taste in the mouth
  • Cough
  • Itching or a sore throat
  • Headache
  • Sneezing or stuffy nose

Make sure to tell your doctor immediately if you experience:

  • Shortness of breath
  • Wheezing

Proper Usage

The most important factor in using cromolyn sodium and nedocromil to improve your asthma symptoms is to take the drugs correctly. For example, we know that only 70% of asthmatics take their inhaled steroids as directed by their physicians, and you will generally have to take cromolyn sodium and nedocromil more times per day.

In addition, be aware that using cromolyn sodium or nedocromil when you are currently experiencing asthma symptoms may make your asthma worse.

Using cromolyn sodium and nedocromil with a spacer not only can increase the amount of medication that gets into your lungs but also helps decrease the side effects. If you do not want to use a spacer, it is very important to learn how to use an MDI appropriately.​

When to Call Your Doctor

Call your doctor about your asthma if:

  • Your asthma gets worse after taking cromolyn sodium or nedocromil
  • Your rescue inhaler is no longer relieving your asthma symptoms
  • You are consistently using your rescue asthma inhaler more than twice per week
  • Your peak flows are worsening
  • You use your entire rescue inhaler in 2 months or less
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Article Sources
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  • Medline Encyclopedia.
  • Medline Encyclopedia. Cromolyn Sodium
  • National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma