Montelukast

Drug Class: Leukotriene receptor antagonist

• Montelukast binds with high affinity to the cysteinyl leukotriene receptors (leukotrienes D4 & E4) that are involved in the inflammatory process that causes asthma & allergic rhinitis symptoms.
• It inhibits leukotriene physiologic effects without exhibiting any agonist activity.

• It also effectively inhibits cysteinyl leukotriene receptors and reduces daytime and night-time nasal symptoms of patients with rhinitis.

Levocetirizine

Drug class: II generation Antihistamine

• Levocetirizine, is a potent second-generation antihistamine known for its comparative efficacy and lower incidence of adverse effects relative to its first-generation counterparts.

• Levocetirizine 5 mg/d was effective in reducing symptoms of allergic rhinitis; seasonal and perennial and idiopathic urticaria with improving quality of life, with an accepted tolerability profile.

COMBINATION:

• • Leukotriene receptor inhibitors can be added with antihistamines to improve day-time as well as night-time symptomatic relief.
  • Regarding all other allergic rhinitis efficacy endpoints, the combination therapy group experienced greater improvements compared with the montelukast monotherapy group.
  • Montelukast plus levocetirizine was well tolerated, with a safety profile similar to that reported for montelukast monotherapy.
  • The investigators concluded that the fixed-dose combination of montelukast plus levocetirizine was effective and safe for the treatment of perennial allergic rhinitis and asthma.