NEDOCROMIL SODIUM

NEDOCROMIL SODIUM (ned'o-cro-mil) Tilade, Alocril Classifications: antiinflammatory; mast cell stabilizer; antiasthmatic; Therapeutic: antiasthmatic; mast cell stabilizer Prototype: Cromolyn sodium Pregnancy Category: B

Availability

1.75 mg aerosol; 2% ophthalmic solution

Action

Inhibits activation of and mediators released from inflammatory cell types associated with asthma (e.g., neutrophils, mast cells, monocytes).

Therapeutic Effect

Inhibits release of inflammatory mediators including histamine and prostaglandin D₂.

Uses

Maintenance therapy for patients with mild to moderate asthma. Ocular use for allergic conjunctivitis (see Appendix A-1).

Contraindications

Hypersensitivity to nedocromil; acute bronchospasm, particularly status asthmaticus; children <6 y.

Cautious Use

Pregnancy (category B), lactation.

Route & Dosage

Asthma Adult: Inhalation 2 inhalations q.i.d. at regular intervals, NOT for acute asthma attacks Child (≥6 y): Inhalation 2 inhalations q.i.d.

Administration

Inhalation

• Use correct administration technique to ensure maximum drug efficacy. Review instruction leaflet supplied by manufacturer.
• Reduce dosage in stages, with each lower dose maintained for several weeks of good control prior to further decreasing dose.

Adverse Effects (≥1%)

GI: Abnormal bitter taste, nausea, vomiting. CNS: Headache, dizziness. Respiratory: Sore throat irritation, cough.

Interactions

Drug: No clinically significant interactions established.

Pharmacokinetics

Absorption: 90% of dose is deposited in throat and swallowed. Less than 7% is absorbed systemically in patients with asthma. Onset: 1 wk for therapeutic effect. Peak: 10–20 min. Metabolism: Does not appear to be metabolized. Elimination: 6% in urine in 72 h. Half-Life: 2.3 h.

Nursing Implications

Assessment & Drug Effects

• Assess for coughing and bronchospasms induced by nedocromil. These are indications for discontinuation of drug and should be promptly reported.
• Monitor patients for whom systemic or inhaled steroid therapy has been reduced, as nedocromil may not fully substitute for the decrease in dose of steroid.

Patient & Family Education

• Learn to administer the drug properly. Review patient instruction leaflet.
• Do not use it to treat acute bronchospasms because nedocromil is not a bronchodilator.
• Continue regular nedocromil therapy even during symptom-free periods.

---

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug