The MastAttack 107: The Layperson’s Guide to Understanding Mast Cell Diseases, Part 82

95. How do you take oral cromolyn?

  • Cromolyn is a mast cell stabilizer. Most mast cell patients are on cromolyn. Currently, it is taken orally for use in the GI tract, or it is taken nebulized for use in the lungs.
  • Cromolyn is an incredibly finicky substance. It sticks to everything. Your body barely uses it: only 2% of cromolyn is actually absorbed in the GI tract and only 5% in the lungs. The cromolyn that is absorbed is actually not the cromolyn that helps stabilize mast cells. The rest basically just sits on top of cells in the GI tract or lungs and stabilizes mast cells that way.
  • In order to maximize benefit from cromolyn, it is important that it not be taken when there is food or medications that cromolyn could stick to. This is mostly an issue for oral cromolyn used in the GI tract. You do not want to take other medications too close to taking cromolyn because the cromolyn may stick to the other med and not be available to stabilize mast cells. You do not want to eat too close to taking cromolyn because the food could stick to cromolyn, making it unavailable to stabilize mast cells, or the food could block the cromolyn from getting to the surface of the mast cells, preventing it from stabilizing them.
  • Oral cromolyn is usually taken 30 minutes before meals and at bedtime for a total of four times daily. Cromolyn should not be taken until two hours or more after eating the previous meal as this is about how long it takes for food to move out of the stomach. It is worth noting that many mast cell patients have gastroparesis or impaired GI motility which can cause food to stay in the stomach longer. There is no particular recommendation on what to do in this instance.
  • Ampules of cromolyn need to be stored at room temperature and protected from light. The ampules should not be taken out of the foil packs until you are using them. They should not be mixed ahead of time.
  • The intended dose for oral cromolyn in mast cell patients is usually 200 mg (two ampules) four times a day. Patients usually do better when they gradually increase the amount of cromolyn they are taking rather than starting at that dose. How slowly they increase varies widely. Patients should speak with their providers about an appropriate dosing schedule. There is lots of information about this in patient groups and forums.