Sodium cromoglycate inhaler (Intal)

[runcyclexcski]

Can anyone share their experience getting Intal inhaler since it has been delisted in the UK? Or, do you now take it via a nebulizer instead? If yes, can you share the name of the nebulizer device and the manufacturer of the cromolyn/chromoglycate solution?

Pubmed indicates it's less effective than albuterol/ventolin/sabultamol in clinical studies. This probably gave the NHS the excuse to delist it. However, clinical studies are for the average population. If the average population findings worked equally well for everyone, we all would be happy running around using just one steroid inhaler, and not posting desperately here :).

I used to take Intal 15+ years ago in the USA, before I got on a biologic, and I found it more effective than the "blue inhaler" in helping me exercise. Once I got on the biologic and desensitization shots, I did not need Intal. I am now back to square one, b.c. the biologic is no longer effective, and I am struggling to get desensitization shots approved.

[fayeber]

Hi, ChromoneLover commented on sodium cromoglycate in reply to xxxedusaxxx. This was 8 days ago.Hope this helps.

[Patk1]

I'd be asking to try another biologic- I'm in process of being assessed for another.my son as a child was on intal b4 changing to bricanyl and pulmicort,at that time,which worked for him

[ChromoneLover]

I was prescribed inhaled Sodium Cromoglicate in 1977, when it was a relatively new prophylactic treatment for hayfever (and, in my case, asthma) because nothing else had worked, and (at 21 years old) I was rapidly heading towards COPD by the age of 30. Initially, it was inhaled via a nasal 'insufflator' (manual 'puffer') from 10-20mg capsules, but later was replaced by Intal (oral) and Rynacrom (nasal) inhalers. It worked so well, for me, that I rarely needed Becotide or Salbutamol (preventer/reliever inhalers), but, 45 years on (2022), I discovered that Sanofi had ceased manufacturing Intal - apparently it was due to the halogenated propellant gas, and it was also deemed 'not an anti-asthma treatment'.

I had very little Intal left, and needed it for the hayfever season, which was due to start (for me) in March 2022, so I looked at what formulations were still available in other countries: the nasal spray was available as Nasalcrom (equivalent to Rynacrom nasal spray), from Amazon, USA, although delivery charges were very high. I knew I couldn't inhale that spray deeply enough to treat my lungs, so I bought a small, portable, rechargeable, 'mesh nebuliser' (from Amazon, UK) with which to inhale a 2-spray dose through the mask supplied. If I breathe the vapour in through my nose, it works really well for my hayfever, in combination with the 'hayfever relief' eyedrops (2% w/v sodium cromoglicate) from Boots chemist, and I have not had asthma since, except when I have missed one or more doses.

[runcyclexcski]

This is very useful information, many thanks! I was considering to do the exact thing you describe -- get 2% chromoglycate over the counter and use mesh nebulizer. Thus, knowing that it works for you is very helpful. The doses described in papers going back to the 1970-80s are about 20 mg (of course it's not known what fraction of that reaches the lungs). It is very disappointing that we depend on some corporate decision to discontinue a drug. CFC is not the only method of drug delivery. Maybe the chemical is not cheap to manufacture, and the fact that it's generic makes it not worth it.

Do you still get Nasalcrom via Amazon? I think the eyedrops should be available anwhere -- are these as efficient as Nasalcrom in your experience? They are all 2% cromo, but I wonder what's different about the eyedrop composition.

I also have found that there is an ongoing trial based on another dry fomulation of cromolyn, but it's not clear where that stands. They claim they used am "eFlow" nebulizer to deliver it.

ncbi.nlm.nih.gov/pmc/articl...

[ChromoneLover in reply to runcyclexcski]

The eyedrops are 2%(w/v), but the Nasalcrom is 4% (w/v) - same as Rynacrom used to be. Both contain Benzalkonium chloride, so I buy Nasalcrom, rather than doubling the volume of the eyedrops, to avoid inhaling more preservative than necessary.

[runcyclexcski in reply to ChromoneLover]

Makes sense. Do you know if Benzalkonium chloride is a common preservative in inhalers? This paper indicates that it causes bronchoconstriction at doses they studied (8mg of cromolyn alleviated that), and apparently in the 90s they've stopped using that preservative in some inhalers.

pubmed.ncbi.nlm.nih.gov/214...

Do you measure 1 ml of the stuff and apply that to the nebulizer and take it like Intal, 4x a day, and how long does each treatmnet take? Sorry for asking, I have no experience with nebulizers except at AE.

Just found that Amazon does not ship nasalcrom to the EU from the US. Also found that it's called "Lomudal" in Scandinavia and Europe (20 EUR for 20 ml), some seem to ship. Mostly offerred as an eye drop solution, but a 4% solution exists as a nasal spray.

[ChromoneLover]

Yes, Benzalkonium Chloride is a commonly-used preservative in eyedrops and nasal sprays. You need to order the nasal spray version, and squirt the number of (metered dose) sprays into the nebuliser reservoir, then inhale via the mask.