Symptomatic management of hayfever involves the use of antihistamine drugs alone or in combination with steroid nasal sprays and eye drops such as sodium cromoglicate eye drops. In this post, I will describe the use of sodium cromoglicate for the management of hayfever symptoms such as itchy and watery eyes. I will discuss:
- How sodium cromoglicate works
- Licensing restrictions (age restrictions)
- Availability of different brands of sodium cromoglicate eye drops
How sodium cromoglicate eye drop work?
Sodium cromoglicate reduces the release of histamine from the mast cell to stop allergic reactions due to allergens such as pollen, giving it a descriptive name of mast cell stabilizer.
Histamine is mainly stored in mast cells. During allergic reactions, histamine levels increase, causing the main symptoms of hayfever, such as itchiness (pruritus), sneezing (White, 1990). It is the histamine which contributes to symptoms of ocular (eye) allergic symptoms like redness and watering of the eyes.
The main indications for the use of eye drops containing sodium cromoglicate are the relief and treatment of seasonal and perennial (chronic) allergic conjunctivitis. Sodium cromoglicate help with:
- Soothing of the itchy eyes
- Prevention of symptoms associated with common allergens such as pollen or dust mites
- Relieving of itching, redness, and watering of eyes due to hayfever
Existing evidence from different clinical trials confirms that sodium cromoglicate is effective in the management of allergic conjunctivitis (Juniper et al, 1994).
Sodium cromoglicate eye drops: where to buy
Sodium cromoglicate eye drops are available as the general sale list item (GSL), meaning they can be purchased from any retail outlet or as pharmacy only medication (P), available only from pharmacies including online chemists.
There is no difference between sodium cromoglicate eye drops purchased from a supermarket and pharmacy. Both products contain the same active ingredient – sodium cromoglicate 2%.
Sodium cromoglicate eye drops: age restrictions
Over the counter, sodium cromoglicate drops are licensed for adults and children from 6 years of age. For children under 6 years of age, product information states that ‘there is no relevant indication’ to use sodium cromoglicate.
Drops containing sodium cromoglicate should not be used in children under two years of age.
Use of sodium cromoglicate eye drop in the pregnancy and lactation
The product information states that cautions should be taken (especially) during the first trimester of the pregnancy. Existing evidence with sodium cromoglicate indicates that there are no adverse effects on baby development in the pregnancy. Sodium cromoglicate should only be used in pregnancy when there is a definite need.
It is considered unlikely for sodium cromoglicate to be excreted in the breastmilk. No information exists, which suggests that sodium cromoglicate has adverse effects on the baby when breastfeeding.
How often should sodium cromoglicate be used?
For adults and children over six years of age, One or Two drops should be instilled into each eye four times a day.
What sodium cromoglicate eye drops can you buy?
There are several eye drop brands containing sodium cromoglicate. Common brands include:
- Opticrom Hayfever 2% (available in supermarkets and other retail outlets)
- Opticrom Allergy 2% (available as a pharmacy-only product, with no difference to the above drops)
- Opticrom Allergy single-dose eye drops. Sodium cromoglicate is supplied in single-dose containers. Opticrom Allergy single-dose eye drops are sterile and preservative-free.
- Optrex Hayfever Relief 2% Eye Drops (available in supermarkets and other retail outlets)
- Optrex Allergy 2% Eye Drops (pharmacy only product)
Additionally, larger pharmacies such as Boots and Lloyd Pharmacy sell their brands of sodium cromoglicate 2% eye drops.
Use of sodium cromoglicate by contact lens wearers
A patient who uses soft contact lenses should avoid contact with eye drops.
Contact lenses should be removed before application and put back at least 15 minutes after the application. The same advice applies to preservative-free, single-use eye drops.
Possible side effects with sodium cromoglicate eye drops
Some possible side effects associated with the use of sodium cromoglicate containing eye drops may include (frequency not known):
- Mild eye irritation
- Stinging or burning, which may happen straight after the application of the eye drops.
Other options in the management of seasonal hayfever
Seasonal hayfever can be managed with different drugs available in supermarkets and pharmacies. Antihistamine tablets and steroid nasal sprays reduce different symptoms associated with hayfever, including itchy and burning eyes. Some popular products used in the management of hayfever include:
- Antihistamine tablets such as loratadine and cetirizine
- Steroid nasal sprays including beclomethasone, fluticasone, budesonide. Learn more about the management of hayfever with steroid nasal sprays.
- Use of antihistamine eye drops such as Otrivine-Antistin which contain antihistamines, such as antazoline (with xylometazoline hydrochloride)
Elizabeth F. Juniper, Gordon H. Guyatt, Penelope J. Ferrie, Derek R. King. Sodium cromoglycate eye drops: Regular versus “as needed” use in the treatment of seasonal allergic conjunctivitis. Available at: https://doi.org/10.1016/0091-6749(94)90069-8 Accessed on 13/04/20 20
White MV. The role of histamine in allergic diseases. J Allergy Clin Immunol. 1990;86(4 Pt 2):599–605. doi:10.1016/s0091-6749(05)80223-4 Available at: https://doi.org/10.1016/s0091-6749(05)80223-4 Accessed on 11/04/2020