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Understanding Asthma Medications (cont.)

Mast Cell Inhibitors for Asthma

Cromolyn sodium (Intal) and nedocromil (Tilade) are used to prevent allergic symptoms like runny nose, itchy eyes, and asthma. The response is not as potent as that of corticosteroid inhalers.

How mast cell inhibitors work

These drugs prevent the release of histamine and other chemicals from mast cells that cause asthma symptoms when you come into contact with an allergen (for example, pollen). The drug is not effective until four to seven days after you begin taking it.

Who should not use these medications

Individuals who are allergic to any components of the inhaled product should not take these drugs.


Frequent dosing is necessary, since the effects last only six to eight hours. Mast cell inhibitors are available as a liquid to be used with a nebulizer, a capsule that is placed in a device that releases the capsule powder to inhale, and handheld inhalers.

Drug or food interactions

Since these drugs have little or no effect beyond the area applied, they are unlikely to interact with other drugs. Mast cell inhibitors may cause a cough, irritation or unpleasant taste.

Side effects

These drugs are only effective for prevention and are not to be used to treat an acute asthma attack.

Monoclonal Antibodies for Asthma

Omalizumab (Xolair) is the newest asthma medication. It may be considered for individuals with persistent, moderate to severe asthma due to seasonal allergies that is not controlled by inhaled corticosteroids. The cost of omalizumab is estimated at $12,000-$15,000 per year.

How monoclonal antibodies work

Monoclonal antibodies bind to human immunoglobulin E (IgE) on the surface of mast cells and basophils (cells that release chemicals that cause allergic symptoms). By binding to IgE, omalizumab reduces the release of the allergy-inciting chemicals.

Who should not use these medications

Individuals who are allergic to omalizumab or its contents should not use it.


Adults and children older than 12 years of age are given an injection every two to four weeks. The dose depends on the body's IgE levels.

Drug or food interactions

Drug interactions have not been reported.

Side effects

Omalizumab is not effective in treating acute asthma attacks. Inhaled corticosteroids should not be suddenly stopped when initiating omalizumab. Swelling or pain at the area of injection may be experienced.

Medically reviewed by James E. Gerace, MD; American Board of Internal Medicine with subspecialty in Pulmonary Disease


"An overview of asthma management"

Medically Reviewed by a Doctor on 6/16/2016

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