Allergic rhinitis montelukast

Montelukast (Singulair) is a leukotriene receptor antagonist approved for treatment of seasonal allergic rhinitis. It is effective alone or in combination with an antihistamine. 

Baena-Cagnani CE, Berger WE, Du-Buske LM Comparative effects of desloratadine versus montelukast on asthma symptoms and use of (Jj agonists in patients with seasonal allergic rhinitis and asthma. Int Arch Allergy Immunol 2003 130 307-313. 

Meltzer, E. O., Malmstrom, K., Lu, S., et al. (2000) Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis a randomized, placebo-controlled clinical trial. J. Allergy Clin. Immunol. 105, 917-922. 

Meltzer E, Malmstrom K, Lu S, Brenner B, Wie L, Weinstein S, et al Concomitant montelukast and loratidine as treatment for seasonal allergic rhinitis. Placebo-controlled clinical trail. J Allergy Clin Immunol 2000 105 917-922. 

Nayak A. A review of montelukast in the treatment of asthma and allergic rhinitis. Expert Opin Pharmacother. 2004 5 679-686. 

Aside from 11, -receptor antagonists, the symptoms of seasonal allergies may also be treated with leukotriene receptor antagonists. The lone successful drug from this class is montelukast (Singulair, A.16) (Figure A.4). Montelukast is most often prescribed to treat asthma but can be used for allergic rhinitis as well. 

Wilson AM, Orr LC, Coutie WJ, Sims ELI, Lipworth BJ. A comparison of once daily fexofenadine versus the combination of montelukast plus loratadine on domicihary nasal peak flow and symptoms in seasonal allergic rhinitis. Qin Exp Allergy 2002 32(l) 126-32. 

TABLE 93—8. Dosage Regimens for Montelukast in Treatment of Allergic Rhinitis ... 

Montelukast sodium is a leukotriene receptor antagonist that blocks the effects of specific leukotrienes in the respiratory airways, thereby reducing bronchoconstriction, edema, and inflammation. It is indicated in the prophylaxis and chronic treatment of asthma in patients 12 months and older and in relief of symptoms of seasonal allergic rhinitis in patients 2 years and older. 

Healthy subjects were given terfenadine 60 mg every 12 hours for 14 days, with montelukast 10 mg daily from day 8 to day 14. It was found that the terfenadine pharmacokinetics and the QTc interval were unaltered by concurrent use. No adverse interactions were seen in large numbers of patients given montelukast 10 or 20 mg and loratadine 10 mg, and the combination was found to be beneficial in the treatment of allergic rhinitis and conjunctivitis. No special precautions are therefore needed if these drugs are given concurrentiy. 

Malstrom K, Meltzer E, Prenner B, Lu S, Weinstein S, Wolfe J, Wei LX, Reiss TF. Effects of montelukast (a leukottiene receptor antagonist), loratadine, montelukast + loratadine and placebo in seasonal allergic rhinitis and conjunctivitis. J Allergy Clin Immunol (1998) 101, S97. 

There were no significant differences in adverse events or suspected adverse reactions between montelukast 5 or 10 mg and placebo in Japanese patients with seasonal allergic rhinitis [99 ]. Similar findings were reported in children with allergic rhinitis [100 ]. 

Pranlukast versus montelukast There was no significant difference in adverse events between pranlukast 450 mg and montelukast 5 or 10 mg in a double-blind non-inferiority study in seasonal allergic rhinitis [111 ]. Diarrhea, thirst, and somnolence were suspected adverse reactions that occurred in over 1% in any of the three groups. One patient in each montelukast group withdrew because of diarrhea, which was considered a serious adverse event and which resolved on withdrawal. 

Okubo K, Baba K. Therapeutic effect of montelukast, a cysteinyl leukotriene receptor 1 antagonist, on Japanese patients with seasonal allergic rhinitis. Allergol Int 2008 57(3) 247-55. 

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