Your Patients Need Cromolyn — Here's How to Help Them Get It

The Cromolyn Sodium oral solution shortage has entered its third year, and for many providers managing patients with mastocytosis and MCAS, it has become a recurring clinical headache. Patients call in distress because their pharmacy can't fill their prescription, and the burden of locating the medication often falls on the care team.

This guide offers a practical, step-by-step approach to helping your patients find and maintain access to Cromolyn during the ongoing shortage. For background on the shortage itself, see our provider briefing on the Cromolyn shortage.

Current Availability Overview

As of early 2026, Cromolyn Sodium oral solution (100 mg/5 mL ampules) is still being produced by several manufacturers, but availability remains inconsistent:

• Viatris/Meda (Gastrocrom): Sporadically available
• Micro Labs: Active but constrained by API supply issues
• Rising Pharmaceuticals: Limited availability with periodic restocking
• Omnivium Pharmaceuticals: Available under new NDC 81665-0104-96 (old NDC may show as discontinued)
• Woodward Pharma: Discontinued

The nasal spray (NasalCrom) and ophthalmic formulations are generally unaffected.

Why Patients Can't Find Cromolyn

Understanding the barriers helps you troubleshoot for your patients:

1. Pharmacy ordering systems may flag Cromolyn as unavailable or discontinued due to NDC changes or allocations
2. Chain pharmacies often have lower priority for shortage drugs compared to high-volume medications
3. Patients may not know to check independent pharmacies, compounding pharmacies, or to ask for specific NDC numbers
4. Insurance denials add a second barrier when patients do find stock but can't afford the cash price

What Providers Can Do: 5 Steps

Step 1: Direct Patients to Medfinder

Medfinder is a free tool that tracks real-time pharmacy availability for shortage medications. You can search for Cromolyn and identify stocked pharmacies by location — either during the patient visit or by sharing the link for patients to check on their own.

Consider adding Medfinder to your patient handouts or discharge instructions for patients on shortage medications.

Step 2: Provide the Updated NDC

One of the most common reasons pharmacies report Cromolyn as "unavailable" is the NDC change by Omnivium Pharmaceuticals. The new NDC is:

Cromolyn Sodium Oral Solution 100 mg/5 mL — NDC 81665-0104-96

Include this on the prescription or in a note to the dispensing pharmacy. Advise pharmacists to search this NDC or contact their wholesaler directly with it.

Step 3: Write Compounding-Friendly Prescriptions

When the commercial solution is unavailable, compounding pharmacies can prepare Cromolyn Sodium in capsule form (100 mg or 200 mg). To enable this option:

• Add "compounding acceptable" to the prescription
• Specify the desired dose (e.g., Cromolyn Sodium 200 mg capsules, #120, take 1 capsule QID 30 minutes before meals and at bedtime)
• Provide the patient with names of local compounding pharmacies or national ones that ship

Compounded Cromolyn typically costs $200–$250 for a 60–90 day supply.

Step 4: Have an Alternative Protocol Ready

Not every patient will be able to access Cromolyn consistently. Document a backup protocol in the patient's chart so transitions are seamless when shortages hit. Common alternatives include:

• Ketotifen (compounded oral, 1–2 mg BID): Dual mast cell stabilizer and H1 antihistamine. Must be compounded in the U.S. Cost: $50–$150/month.
• H1 + H2 antihistamine optimization: Maximize Cetirizine or Fexofenadine + Famotidine dosing.
• Hydroxyzine (25–50 mg TID): Helpful for histamine-related pruritus, anxiety, and flushing.

For a patient-friendly comparison you can share: Alternatives to Cromolyn If You Can't Fill Your Prescription.

Step 5: Support Prior Authorization and Appeals

Some patients can find Cromolyn but can't afford it without insurance coverage. If a PA is required:

• Document the medical necessity (diagnosis of mastocytosis or MCAS, failed alternatives if applicable)
• Note the shortage — some insurers have been more flexible with PA requirements during documented shortages
• If denied, file an appeal citing FDA shortage status and lack of therapeutic alternatives

For patients paying cash, direct them to discount programs: GoodRx coupons (starting ~$134 for 96 ampules), SingleCare, or Prescription Hope ($70/month). More details: How to Help Patients Save Money on Cromolyn.

Alternative Medications at a Glance

When Cromolyn is unavailable, here are evidence-based alternatives to discuss with patients:

• Ketotifen — Mast cell stabilizer + H1 antihistamine. Compounded oral form, 1–2 mg twice daily. Most directly comparable to Cromolyn's mechanism.
• Cetirizine (Zyrtec) — H1 antihistamine, 10 mg daily, OTC. Helps with histamine-mediated symptoms.
• Famotidine (Pepcid) — H2 antihistamine, 20–40 mg twice daily, OTC. Addresses GI and systemic histamine symptoms.
• Hydroxyzine — H1 antihistamine, 25–50 mg up to TID, Rx. Useful for pruritus and anxiety.

None of these are identical to Cromolyn's mechanism of preventing mast cell degranulation, but they can help manage symptoms during gaps in Cromolyn access.

Workflow Tips for Your Practice

• Flag Cromolyn patients in your EHR so you're proactively aware when refill issues arise
• Build a pharmacy list of local independent and compounding pharmacies that reliably stock or can prepare Cromolyn
• Use Medfinder during the visit to show patients where stock is available — this takes 30 seconds and can prevent days of phone calls
• Share patient education: Our posts on finding Cromolyn in stock and saving money on Cromolyn are written at a patient-friendly level and can be shared directly.
• Connect patients with TMS — The Mast Cell Disease Society (tmsforacure.org) provides shortage updates and peer support.

Final Thoughts

The Cromolyn Sodium shortage is a structural problem without a quick fix. But with the right tools and a proactive approach, you can significantly reduce the burden on your patients — and your practice. Use Medfinder, prescribe with compounding flexibility, and maintain an alternative protocol that's ready to activate when supply dips.

For the clinical background on this shortage, see our Cromolyn Shortage: What Providers and Prescribers Need to Know in 2026.