Can sodium cromoglycate eye drops be used as nasal drops?

Pediatricians often prescribe sodium cromoglycate eye drops to children with allergic rhinitis, and its usage is to drop into the nose. Many parents will ask: "Isn't sodium cromoglycate eye drops? Can it be used to drop into the nose?"

Cromolyn sodium eye drops are an over-the-counter antiallergic drug for the otolaryngology department. They are a clear, colorless or almost colorless liquid. Each milliliter of this product contains 20 mg of sodium cromoglycate and is used to prevent spring allergic conjunctivitis. For external use, 1-2 drops are used 4 times a day; for severe cases, the amount can be increased to 6 times a day. Use 2-3 weeks in advance during the high-incidence season. Adverse reactions include occasional tingling and allergic reactions. This product is contraindicated for people who are allergic to it, women who are pregnant for less than three months, and patients with severe liver and kidney dysfunction. The bottle cap should be closed after use to avoid contamination of the bottle mouth; the nasal cavity should be cleaned before use; if an overdose or serious adverse reactions occur, seek medical attention immediately. [1]

From the perspective of pharmacological effects, sodium cromoglycate eye drops can stabilize the cell membrane of mast cells and prevent mast cell degranulation, thereby inhibiting the release of allergic reaction mediators such as histamine, leukotrienes, 5-hydroxytryptamine, bradykinin and slow-reacting substances, thereby inhibiting the adverse effects of allergic reaction mediators on tissues and effectively treating allergic conjunctivitis. [2]

Allergic rhinitis (AR) in children is a non-infectious inflammatory disease of the nasal mucosa that occurs after the body is exposed to allergens and is mainly mediated by immunoglobulin E (IgE). It is one of the common allergic diseases. Cromolyn sodium, as a mast cell membrane stabilizer, is a commonly used second-line treatment for AR in children in clinical practice. It has a certain effect on relieving the symptoms of sneezing, runny nose and nasal itching in AR in children, and can inhibit allergic reactions to a certain extent. It is used to treat allergic rhinitis. [3]

The instructions for sodium cromoglycate eye drops do not confirm or deny that it is effective for nasal diseases, but it has a certain effect on rhinitis caused by allergic factors. Literature research shows that sodium cromoglycate eye drops are effective in treating variant rhinitis. [4] However, sodium cromoglycate eye drops can only temporarily relieve symptoms. To completely treat allergic rhinitis, it is best to avoid contact with allergens. Mild intermittent AR in children is treated with antihistamines, and moderate to severe intermittent and persistent AR in children is treated with nasal glucocorticoids, antihistamines, or (and) leukotriene receptor antagonists. [3]

References

[1] Instructions for use of sodium cromoglycate eye drops. Instructions revised on December 1, 2015.

[2] Mei Dan et al., New progress in the pharmacology and application of sodium cromoglycate[J]. Chinese Pharmacy, 1998, 9(3):135.

[3]Xu Zhengmin et al., Diagnosis and treatment of allergic rhinitis in children - clinical practice guidelines[J]. Chinese Journal of Practical Pediatrics, 2019, 34 (3): 169.

[4] Wei Fuyi, 52 cases of allergic rhinitis treated with sodium cromoglycate eye drops [J]. New Medicine, 2002, 33 (2): 68.