Leukotriene modifiers for allergic rhinitis


Generic Name Brand Name
montelukast Singulair

How It Works

Leukotrienes are a type of chemical that your body releases after you have contact with an allergen. This release leads to inflammation and symptoms such as a stuffy nose.

Leukotriene modifiers (leukotriene antagonists) reduce inflammation and symptoms of allergic rhinitis by blocking the action of the leukotrienes.

Why It Is Used

Leukotriene modifiers were first used to treat asthma. They are now sometimes used to treat allergic rhinitis, especially in those who also have asthma.

How Well It Works

Studies note that leukotriene modifiers reduce symptoms of allergic rhinitis compared to placebo.1 Using leukotriene modifiers in combination with antihistamines may help with nasal stuffiness better than using either medicine alone.2

Although leukotriene modifiers may relieve a stuffy nose better than antihistamines, overall they do not work as well as antihistamines. They do not work nearly as well as corticosteroid nasal sprays.

Side Effects

Leukotriene modifiers sometimes cause side effects such as vomiting, diarrhea, and headaches. Rarely, they can cause more serious problems such as mood changes, depression, hallucinations, and suicidal thinking.

Montelukast causes fewer side effects than other leukotriene modifiers not yet approved in the United States for treatment of allergic rhinitis. It is less likely to affect the liver than other leukotriene modifiers, and you do not need to have your liver checked.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Leukotriene modifiers are available in the United States only by prescription. Montelukast sodium (Singulair) has been approved for treatment of allergic rhinitis. Other leukotriene modifiers include zafirlukast (Accolate) and zileuton (Zyflo). Although these are not yet approved for treatment of allergic rhinitis, your doctor may prescribe them (unlabeled use). Zafirlukast may interact with other medicines, and zileuton may cause liver damage, although this is rare.

Women who are pregnant or breast-feeding should take these medicines only under a doctor's care.

Montelukast can be given to adults and children age 6 and older for year-round (indoor) allergies and to adults and children age 2 and older for seasonal (outdoor) allergies. Children age 7 or older can take zafirlukast.

Leukotriene modifiers are expensive.

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  1. Montelukast (Singulair) for perennial allergic rhinitis (2005). Medical Letter on Drugs and Therapeutics, 47(1220): 87–88.
  2. Sheikh A, et al. (2006). Seasonal allergic rhinitis in adolescents and adults, search date September 2005. Online version of Clinical Evidence (15).

Last Updated: July 2, 2009

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