Allergospasmin

Allergospasmin is a combination inhaler that, like Aarane, contains the active ingredients cromoglicic acid and reproterol. It is used for the preventive and symptomatic treatment of allergic bronchial asthma.

Cromoglicic acid acts as a mast cell stabilizer to prevent allergic reactions, while reproterol, a beta-2 agonist, dilates the bronchi. Allergospasmin is available as a metered-dose inhaler.

Like Aarane, Allergospasmin is used less often today, because inhaled corticosteroids are more effective in asthma therapy. However, it remains an option for mild allergic asthma.

Allergospasmin works through two mechanisms:

Cromoglicic acid:

• Stabilizes mast cell membranes
• Prevents the release of histamine and leukotrienes
• Has a preventive effect against allergic reactions
• Requires regular use for its full effect

Reproterol:

• Short-acting beta-2 agonist
• Rapid bronchodilation (3-5 minutes)
• Duration of action: 4-6 hours
• Symptomatic relief

Time course:

• Reproterol: immediate effect (minutes)
• Cromoglicic acid: preventive effect after days to weeks of regular use

Allergospasmin is suitable for:

• Mild allergic asthma
• Prevention of allergen-induced asthma
• Prophylaxis of exercise-induced asthma
• Patients with concerns about corticosteroids (mild asthma)

Not suitable:

• Moderate to severe asthma
• As the sole therapy for uncontrolled asthma
• As a replacement for inhaled corticosteroids in most patients

Allergospasmin metered-dose inhaler:

• 1 mg sodium cromoglicate + 0.5 mg reproterol hydrochloride per puff
• Starting dose: 2 puffs 4 times daily (after getting up, at midday, in the early evening and before going to bed), at least 3 hours apart
• Once the effect has been achieved, the daily dose can be reduced gradually under medical supervision
• For sudden shortness of breath, 1 additional puff, and one more puff if there is no improvement after 5 minutes. If a severe attack still does not improve, seek medical help immediately
• No more than 16 puffs per day, as a higher dose is generally not expected to provide any additional benefit but increases the risk of side effects, including serious ones
• Before allergen exposure: 2 puffs 10-15 min beforehand

Metered-dose inhaler: 1. Remove the protective cap, shake 2. Breathe out deeply 3. Close your lips around the mouthpiece 4. Breathe in slowly while releasing a puff 5. Hold your breath for 10 seconds

Important:

• Use regularly (preventive effect)
• Be patient – cromoglicic acid needs time
• Do not stop abruptly

Do not use in case of:

• Hypersensitivity to the active ingredients

Use with caution in:

• Severe heart disease
• Hyperthyroidism
• Pheochromocytoma

Pregnancy: Only if clearly indicated.

Breastfeeding: Benefit-risk assessment.

Uncommon:

• Tremor
• Palpitations
• Headache

Very rare:

• Cough after inhalation
• Irritation of the throat and windpipe
• Nausea
• Paradoxical bronchospasm
• Severe allergic reaction with bronchospasm

Frequency not known:

• Allergic reactions (e.g. itching, hives, skin rash)

Interactions:

• Beta blockers – can cancel out the effect of reproterol
• MAO inhibitors – increased effects on the heart

Useful combination with:

• Antihistamines in allergic asthma