Hi Peter,

Have you tried a lower dose over a longer period of time and reducing it slowly?  I've done 2-weeks, starting at 60 mg. for several days and then reducing it slowly.  Might ask your doctor if something like that might work for you.

I don't know for sure, but I'd guess it doesn't lower the tryptase level in SM people, but it might in MCAS.  That's really a guess. Maybe someone else knows.