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Mast cell disease is a diverse condition with a multitude of symptoms.  Therefore, the best medication plan must be individualized for each patient.  The overall goal of medication is to stabilize the mast cells, block the action of the chemicals that are released from the mast cells, and treat the patient’s individual symptoms.

As you can imagine, many different medications can be prescribed.  It is beyond the scope of this article to list them all.  The most common first line medications according to Pharmacological treatment options for mast cell activation disease (2016) are listed below.

Medication Common Brand Names What they do….
H1 Antihistamines Benadryl, Reactine, Areius, Allegra, Claritin Histamine is a chemical released from mast cells that is responsible for many symptoms.  Histamine interacts with the body through four different receptors (H1, H2, H3, H4).  H1 antihistamines block the H1 receptors which reduces allergy like symptoms.
H2 Antihistamines Pepcid, Axid, Zantac H2 antihistamines block H2 receptors.  The best understood therapeutic benefit is a reduction in stomach acid.
Cromolyn Nalcrom, Gastrocrom Cromolyn is thought to stabilize mast cells in the digestive system.
Vitamin C Various Vitamin C is thought to reduce blood histamine levels.
Note: Medication that blocks H3 and H4 receptors are being investigated, but are not currently available.

Additional Tips

  • It is helpful to work with a specialist that has experience with similar clients.  If this is not possible, your family doctor may be willing to help you.  
  • It takes a lot of time to systematically experiment with different medications.  This is certainly a disease where patients must be patient.
  • Medications may increase symptoms.  This may be due to the fillers, not the actual medication.  Compounding pharmacies can prepare most medications without fillers or different fillers.
  • Different brand names of the same type of medication (e.g. H1 antihistamines) may have differing effects.  
  • Ideally, each medication should be tried one-at-a-time to determine which ones improve and which ones trigger symptoms.
  • Follow your physician’s instructions, but generally start with a small dose and slowly increase.
  • Be an active partner with your physician in your treatment plan.  If a new medication is prescribed, make sure you know how long it should be trialled before deciding if it is helpful.  Take the medication exactly as prescribed.