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Cromolyn sodium is generally well-tolerated, but certain risks and precautions should be considered:

Hypersensitivity Reactions: Severe allergic responses, including anaphylaxis, have been reported, though they are rare. Symptoms may include difficulty breathing, swelling of the face or throat, and hives. Immediate medical attention is necessary if such reactions occur.

Acute Bronchospasm: Cromolyn is not a bronchodilator and should not be used to relieve sudden asthma attacks or acute bronchospasm. Inhalation of cromolyn can, in rare cases, induce bronchospasm or cough, which may require discontinuation of the medication.

Eosinophilic Pneumonia: There have been rare instances of eosinophilic pneumonia associated with cromolyn use. If symptoms such as fever, cough, or difficulty breathing develop, discontinuation of the drug and medical evaluation are advised.

Concomitant Corticosteroid Therapy: In patients dependent on corticosteroids, introducing cromolyn may allow for a gradual reduction of corticosteroid dosage. However, this should be done cautiously and under close medical supervision to prevent exacerbation of asthma symptoms.

Cardiac Considerations: Certain formulations of cromolyn inhalers contain propellants that may not be suitable for individuals with coronary artery disease or a history of cardiac arrhythmias. Consultation with a healthcare provider is recommended for these patients.

Use in Specific Populations:

• Pregnancy: Classified as Category B, indicating no evidence of harm in animal studies, but human data are limited. Cromolyn should be used during pregnancy only if clearly needed.

• Breastfeeding: It is unknown whether cromolyn passes into breast milk. Caution is advised when administering to nursing mothers.

• Pediatric Use: Safety and efficacy have not been established in children under 2 years of age. Use in this population should be considered only if the potential benefits outweigh the risks.

• Geriatric Use: Due to potential age-related decreases in liver, kidney, or heart function, older adults should use cromolyn with caution, starting at the lower end of the dosing range.

Renal and Hepatic Impairment: Patients with kidney or liver impairments should use cromolyn cautiously, as these conditions may affect drug metabolism and excretion. Dose adjustments may be necessary.

Patients should always consult their healthcare provider to determine if cromolyn is appropriate for their specific health conditions and to discuss any potential risks.

Common side effects:

• coughing
• stuffy nose
• sneezing
• headache
• nausea
• tearing
• temporary stinging or burning in the eyes

Less common but important to monitor:

• watery or itchy eyes
• dryness around the eye
• puffy eyes
• general eye irritation

Serious side effects:

• dizziness
• painful or frequent urination
• joint swelling or pain
• swollen glands around the cheek (parotid gland)
• muscle weakness
• heartburn
• very serious allergic reaction (trouble breathing, swelling of the face, tongue, or throat, severe dizziness, and rashes)

Cromolyn sodium is generally considered to have a low risk of drug interactions due to its localized action in the lungs or nasal passages, rather than being absorbed into the bloodstream. However, there are a few potential interactions that patients should be aware of:

Bronchodilators

If you are using a bronchodilator, such as Albuterol, it is recommended to use it first. Bronchodilators help open the airways, allowing cromolyn sodium to work more effectively in managing asthma symptoms or allergies.

Other Inhaled Medications

Using cromolyn sodium alongside other inhaled medications may increase the risk of throat irritation or coughing. To minimize this, follow your healthcare provider’s guidance on how to space out these medications appropriately.

Systemic Corticosteroids

If you are transitioning from systemic corticosteroids to cromolyn sodium, your doctor will likely reduce the corticosteroid dose gradually. This tapering process helps prevent withdrawal symptoms and ensures a smoother transition to cromolyn sodium as part of your asthma maintenance therapy.

It is essential to inform your healthcare provider about all medications, supplements, and herbal products you are currently taking to avoid potential interactions. If you have any concerns, consider scheduling a telemedicine appointment with one of our providers for personalized advice on the safe use of cromolyn sodium.