Your Patients Need Gastrocrom — Here's How to Help Them Find It

As a provider managing patients with systemic mastocytosis or mast cell activation syndrome, you've likely fielded calls from patients who can't find Gastrocrom (Cromolyn Sodium oral concentrate) at their pharmacy. The ongoing shortage has made this a routine challenge, and your patients are looking to you for help.

This guide offers a practical, step-by-step approach to helping patients locate Gastrocrom — and what to do when it simply can't be found.

Current Availability: What You Should Know

As of 2026, Gastrocrom remains in a state of chronic supply constraint. Key facts:

• Azurity Pharmaceuticals continues to manufacture Cromolyn Sodium oral concentrate, but supply is inconsistent
• Many retail pharmacy chains no longer routinely stock it
• Generic Cromolyn Sodium oral concentrate exists but faces similar availability challenges
• Regional variations in availability are significant — a pharmacy in one city may have stock while pharmacies 30 miles away are empty

The price without insurance ranges from $300 to $900+ per month, adding a financial barrier on top of the availability issue.

Why Your Patients Can't Find Gastrocrom

Understanding the root causes helps you set appropriate expectations with patients:

1. Single-source manufacturing: With essentially one manufacturer (Azurity), any production disruption affects the entire market
2. Low commercial priority: The small patient population makes Gastrocrom a low-revenue product that doesn't attract additional manufacturers
3. Retail pharmacy stocking decisions: Chain pharmacies stock based on demand algorithms. Low-volume medications get dropped from routine inventory
4. Wholesaler limitations: Even pharmacies willing to order may find their wholesaler has no stock to allocate
5. Insurance barriers: Prior authorization and step therapy requirements delay access even when stock exists

5 Steps You Can Take to Help Patients

Step 1: Use Real-Time Availability Tools

Medfinder for Providers allows you to check pharmacy-level stock for Gastrocrom in real time. You can:

• Search by patient's zip code to find nearby pharmacies with current stock
• Direct patients to specific pharmacies rather than having them call around blindly
• Integrate stock checking into your workflow when writing prescriptions for hard-to-find medications

Even a 30-second search before the patient leaves your office can save them hours of frustration.

Step 2: Build Specialty Pharmacy Relationships

Establish ongoing relationships with 1-2 specialty pharmacies that reliably handle rare disease medications. These pharmacies often:

• Have dedicated supply chain contacts at manufacturers
• Maintain buffer stock for medications with known shortage histories
• Offer patient coordination services (insurance help, delivery, refill reminders)

When you identify a reliable specialty pharmacy source for Gastrocrom, share that information with your entire care team so all patients benefit.

Step 3: Prescribe for Maximum Flexibility

Small prescribing decisions can meaningfully impact your patient's ability to fill:

• Allow generic substitution (DAW 0) — don't lock the prescription to brand-name Gastrocrom unless clinically necessary
• Use the generic name "Cromolyn Sodium oral concentrate" to give pharmacies the widest sourcing options
• Prescribe 90-day supplies when insurance allows — this reduces the number of times patients must navigate the shortage
• Send prescriptions electronically to the specific pharmacy you've confirmed has stock, rather than a default pharmacy

Step 4: Have a Compounding Backup Plan

Identify at least one compounding pharmacy in your area (or nationally, for mail-order compounding) that can prepare oral Cromolyn Sodium from bulk powder. Key steps:

• Verify they can compound Cromolyn Sodium oral solution at appropriate concentrations
• Confirm pricing with the pharmacy — compounded versions may range from $100-$400/month depending on the pharmacy
• Pre-build a prescription template for compounded Cromolyn Sodium so you can pivot quickly when manufactured products are unavailable

Step 5: Streamline Prior Authorization

Prepare your PA documentation in advance so it doesn't become a bottleneck:

• Keep a template letter with standard clinical rationale for Gastrocrom (diagnosis codes D47.02, D89.40-D89.49)
• Document step-therapy failures clearly — many insurers require documentation that antihistamines alone are insufficient
• Include severity documentation: frequency of symptoms, impact on daily function, lab values if applicable
• When possible, file PAs before the patient's current supply runs out

When Gastrocrom Can't Be Found: Alternative Approaches

If Gastrocrom and generic Cromolyn Sodium are both unavailable, consider these clinical alternatives:

• Compounded oral Cromolyn Sodium — Same active ingredient, prepared from bulk. Most direct substitution.
• Compounded oral Ketotifen (1-2 mg BID) — Mast cell stabilizer + H1 antihistamine. Closest pharmacologic alternative. Side effects: sedation, weight gain.
• H1 + H2 combination therapy — Cetirizine or Hydroxyzine (H1) plus Famotidine (H2). Broad histamine blockade without mast cell stabilization.
• Montelukast (10 mg daily) — Leukotriene antagonist, helpful for some patients. Note FDA boxed warning for neuropsychiatric effects.

For a patient-oriented discussion of alternatives, direct patients to: Alternatives to Gastrocrom.

Workflow Tips for Your Practice

Integrate shortage management into your routine clinical workflow:

• Flag Gastrocrom patients in your EHR — Set alerts so you know at each visit to check on their medication access
• Discuss backup plans proactively — Don't wait for a patient to call in crisis. At each visit, confirm they have adequate supply and review contingency options
• Designate a staff member as your pharmacy liaison for shortage medications. Having one person who knows the specialty and compounding pharmacy contacts saves time for the whole team
• Share the Medfinder for Providers link with your nursing and support staff so they can help patients locate stock between visits

Final Thoughts

The Gastrocrom shortage is a persistent challenge, but proactive management can prevent it from becoming a clinical crisis for your patients. By building pharmacy relationships, prescribing flexibly, maintaining compounding options, and leveraging real-time tools like Medfinder for Providers, you can keep your patients on effective therapy even during supply disruptions.

Your patients trust you to help them navigate this — and with the right systems in place, you can deliver.

Related resources for your patients:

• How to Find Gastrocrom in Stock Near You
• How to Save Money on Gastrocrom
• Gastrocrom Side Effects: What to Expect