Mast Cell Stabilizers: Uses, most common brand names, and safety information

Medically reviewed by  Jamie Winn, PharmD

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An allergy develops when your immune system reacts to a foreign substance, called an allergen. This can be something you touch, eat, breathe in, or inject into your body. Allergies are the 6th leading cause of chronic illness in the United States. More than 50 million Americans experience numerous types of allergies each year. Almost half of these cases are due to seasonal allergic rhinitis. Mast cell stabilizers can be used to treat many types of allergies. The list below includes mast cell stabilizers approved by the U.S. Food and Drug Administration (FDA) and their pricing:

List of mast cell stabilizers

Some other medications such as antihistamines that demonstrate mast cell stabilizing effects include:

• Zaditor (ketotifen)
• >Pataday (olopatadine)
• Patanol (olopatadine)
• Bepreve (bepotastine)
• Lastacaft (alcaftadine)
• Optivar (azelastine)

What are mast cell stabilizers?

Mast cell stabilizers are a group of medications that block the release of histamine and other powerful inflammatory mediators (leukotrienes and prostaglandins) from mast cells. Mast cells are involved in conditions such as allergic conjunctivitis, rhinitis, anaphylaxis, and asthma. By stabilizing mast cell activity, these medications help reduce inflammation to relieve allergic reactions associated with these conditions.

How do mast cell stabilizers work?

Mast cells are a type of immune cell that plays an essential role in your body’s response to foreign substances (antigens). They are present in your mucous as well as the connective tissues throughout your body. In your eyes, they are found in the mucous membrane (conjunctiva) that protects your eyes.

Mast cell stabilizers are thought to work through the inhibition of the IgE-regulated calcium channel to prevent calcium from crossing cell membranes. Without calcium inside the cells, the granules that contain histamine, cytokines, and prostaglandins cannot exit the cell via mast cell degranulation. Clinical trials showed that this leads to a decrease in or prevention of allergic symptoms. By inhibiting the release of histamine and not histamine receptors, they are better at preventing allergic symptoms than treating them.

What conditions are mast cell stabilizers used to treat?

Mast cell stabilizers are a class of medications used in the treatment of:

• Mastocytosis (build-up of mast cells in your tissues)
• Seasonal allergic conjunctivitis (pink eye)
• Perennial allergic conjunctivitis and other ocular allergies
• Asthma
• Seasonal allergic rhinitis
• Vernal keratoconjunctivitis

Are mast cell stabilizers safe?

The use of mast cell stabilizers is relatively safe and effective when taken as prescribed. Most of these medications are now found over the counter and have been used for decades without any major adverse reactions.

You should not take mast cell stabilizers if you have had a hypersensitivity reaction to any ingredient in the drug formulation. You should also make sure your healthcare provider is aware if you have kidney or liver disease or are pregnant or breastfeeding.

While there are no documented drug interactions with mast cell stabilizers, you should make sure your healthcare provider knows all the medications you take, including prescription drugs, over-the-counter medications, vitamins, and supplements.

Can you take mast cell stabilizers while you are pregnant or breastfeeding?

Because there is little systemic absorption with inhaled or topical mast cell stabilizers, they are generally thought of as safe to use during pregnancy and lactation. Intal (cromolyn sodium) is preferred over inhaled corticosteroids to treat asthma during pregnancy and lactation. Discuss the risks and benefits of any medication you need with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

What are the common side effects of mast cell stabilizers?

The adverse effects you experience from mast cell stabilizers will depend on the dosage form (eye drops, oral or inhalation solution) and dose. The most common adverse effects include:

• Eye burning or stinging
• Dry eyes or irritation
• Itchy eyes
• Blurred vision
• Stye
• Headache
• Nausea
• Stomach pain
• Diarrhea
• Increased sun sensitivity
• Rash
• Runny nose

This is not a complete list of side effects and we encourage you to consult with your healthcare professional for medical advice about any possible side effects.

How much do mast cell stabilizers cost?

Mast cell stabilizers are very expensive with an average cost of around $2,000 per year for the brand name medication.

You can purchase mast cell stabilizers for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.

Related resources for mast cell stabilizers

• https://www.ncbi.nlm.nih.gov/books/NBK557473/
• https://doi.org/10.3389/fimmu.2015.00620
• https://www.drugs.com/drug-class/mast-cell-stabilizers.html
• https://www.rxlist.com/how_do_ophthalmic_mast_cell_stabilizers_work/drug-class.htm
• http://www.ncbi.nlm.nih.gov/pubmed/24811013
• https://www.sciencedirect.com/topics/neuroscience/mast-cell-stabilizer