Montelukast, Levocetrizine

Montelukast and Levocetirizine combination medication may be prescribed for the treatment of persistent allergic rhinitis.


Montelukast/ Levocetrizine

Rid-AR, Infinair, Telekast-L, Alocet M, Viznil


Cipla, Pfizer, Lupin, Vilberry Healthcare, Indi Pharma


Montelukast 10 mg / Levocetrizine 5 mg


Montelukast, Levocetrizine


Montelukast and Levocetirizine have become medications in the field of therapeutic drugs, especially when it comes to treating allergic conditions. Understanding their properties and how they work is crucial for both healthcare professionals and patients.

What are Montelukast and Levocetirizine?

Montelukast and Levocetirizine are commonly used in the field to treat allergies and conditions such as asthma. These medications, although effective, have properties and mechanisms of action.

Overview of their pharmacological classification

Montelukast falls into the category of drugs known as leukotriene receptor antagonists. Its main purpose is to help prevent asthma symptoms such as wheezing, difficulty breathing, tightness in the chest and coughing.

Levocetirizine belongs to the group of antihistamines. It is specifically designed to alleviate allergic symptoms like rhinitis and chronic urticaria.

How Montelukast and Levocetirizine Work

The remarkable effectiveness of Montelukast and Levocetirizine can be credited to their ways of working, influencing complex biochemical pathways and reducing allergic symptoms.

Mechanism of action

Montelukast: Montelukast functions as a blocker of leukotrienes which are chemicals released by the body in response to inhaling an allergen. These chemicals cause inflammation in the lungs and constriction of the muscles surrounding the airways, leading to symptoms of asthma.

Levocetirizine: This antihistamine works by inhibiting histamine, a substance produced by the body during an allergic reaction. Doing it alleviates sneezing, itching, and a runny nose caused by allergies.

Biochemical pathways affected

Both Montelukast and Levocetirizine work by impacting biochemical pathways in order to achieve their therapeutic effects. Montelukast targets the receptor for cysteinyl leukotriene, resulting in reduced inflammation and relaxation of the muscles in the airways. On the other hand, Levocetirizine primarily acts on the H1 histamine receptor, inhibiting histamine-related actions and providing relief from allergic symptoms.

Dosage and Administration

To maximize the advantages while avoiding any unwanted side effects, it is crucial to follow the suggested dosages and methods of administration.

Standard dosage guidelines

Montelukast is usually recommended as a 10mg tablet for adults to be taken a day in the evening. The dosage for children, varies depending on their age and weight. Levocetirizine is commonly prescribed to adults and children above six years old in the form of a 5mg tablet to be taken daily. Younger children may receive a dosage.

Route of administration

Montelukast and Levocetirizine are typically taken by mouth in the form of tablets or oral solutions. This allows for administration and quick absorption into the body.

Duration of treatment

The duration of treatment can differ depending on how severe the condition is and how the patient responds. Some people may only need a short-term treatment during seasons when allergies are prevalent, while others might find it helpful to continue with a longer course of treatment. It's always important to seek advice from a healthcare professional who can provide recommendations.

Uses of Montelukast and Levocetirizine

Montelukast and Levocetirizine(1) have gained recognition among the medicinal treatments for allergic reactions and chronic respiratory conditions in modern medicine. Their mode of action, deeply rooted in pharmacology, makes them essential components of contemporary therapeutic practices.Montelukast and Levocetirizine is also used for Covid-19 Treatment (2)

1. MIMS - Full Prescribing Information

2. National library of Medicine - Levocetirizine and montelukast in the COVID-19 treatment paradigm

Primary indications and FDA-approved uses

Both Montelukast and Levocetirizine are known and widely used medications for specific medical conditions. The Food and Drug Administration (FDA) has approved their use for purposes.

  • Montelukast: Primarily known for its effectiveness in reducing asthma attacks, the FDA has approved it for both preventing and treating asthma in adults and children. It is also recommended for relieving symptoms of year-round allergic rhinitis.(1)
  • Levocetirizine: Recognized as an effective antihistamine, it is FDA-approved to treat year-round allergic rhinitis and chronic idiopathic urticaria in individuals above the age of 6, addressing the treatment gap in allergic conditions.(2)

1. NCBI - Long-term treatment with montelukast and levocetirizine combination in persistent allergic rhinitis: review of recent evidence

2. Science Direct - Montelukast with desloratadine or levocetirizine for the treatment of persistent allergic rhinitis

Allergic Rhinitis

Allergic Rhinitis

Benefits in allergic reactions

The complex dance of reactions in allergic responses often leads to a range of distressing symptoms. In this regard, Montelukast and Levocetirizine prove to be remedies;

  • Montelukast: By inhibiting the release of leukotrienes, which are powerful inflammatory substances released during allergic responses, Montelukast prevents bronchoconstriction and inflammation, providing relief from symptoms like wheezing and difficulty breathing.
  • Levocetirizine: By blocking the H1 histamine receptor, Levocetirizine reduces the vasodilatory and increased permeability effects caused by histamine, thereby alleviating symptoms such as itching, redness, and swelling.

Role in chronic respiratory conditions

Chronic respiratory diseases, which involve inflammation and narrowing of the airways, present significant challenges in terms of health issues. The strategic use of Montelukast and Levocetirizine can play a role in such situations.

  • Montelukast: Its effectiveness is not limited to acute allergic episodes. In conditions like asthma, it helps reduce the sensitivity of the airways, strengthens lung function, and decreases the frequency and severity of flare-ups.
  • Levocetirizine: Although its primary focus is on treating symptoms, there is emerging evidence suggesting additional benefits in chronic respiratory conditions, particularly when allergies contribute to the problem.

Off-label Uses of Montelukast and Levocetirizine

In the world of medical treatments, it's not uncommon for drugs that were initially developed for specific purposes to have unexpected uses. This is the case with Montelukast and Levocetirizine. While they are commonly used to treat allergies and asthma, recent research suggests that they may have potential benefits, expanding their range of therapeutic applications.

Potential therapeutic benefits in other conditions

Uncovering possibilities in therapy often arises from chance discoveries or dedicated research efforts. Montelukast and Levocetirizine show promising prospects for off-label use; Montelukast's initial findings indicate its potential in neuroinflammatory conditions, specifically in regulating certain markers of inflammation. Levocetirizine: There is a growing interest in exploring its role beyond being an antihistamine, particularly in chronic idiopathic urticaria.

Latest research and findings

The exploration of the uses of these medications is driven by cutting-edge research, which offers insights into new treatment approaches;

1. Neuroprotective Role: Recent studies suggest that Montelukast may have neuroprotective properties, especially in conditions like Alzheimer's disease. However, comprehensive research is needed to confirm these findings.

2. Chronic Pruritus: A growing body of evidence indicates that Levocetirizine could be effective in relieving itching even when it is not traditionally associated with allergies.

3. Respiratory Infections: Given the global health crises, preliminary investigations are underway to determine if Montelukast plays a role in influencing the progression of certain respiratory infections.

It is important to approach any therapeutic proposal with caution. While there may be possibilities on the horizon, rigorous clinical validation is necessary to ensure both safety and effectiveness.

Composition of Montelukast and Levocetirizine Tablets

The careful design of Montelukast and Levocetirizine tablets showcases the advancements in technology. These tablets bring together a combination of active and inactive ingredients, each serving a crucial purpose in delivering effective treatment while ensuring patient well-being.

Active ingredients and their concentrations

The key components of these tablets are the substances that produce the intended medicinal effects. Montelukast, available in 10 mg strengths for adults, acts as a blocker of leukotriene receptors, targeting the inflammatory pathways associated with asthma and allergic reactions. Levocetirizine, generally found in 5 mg doses, effectively alleviates symptoms by blocking histamine receptors.

Inactive components and their role

In addition to the components, there are various additional elements in tablets often referred to as 'inactive' that contribute specific characteristics. These elements help improve the stability, appearance, and how easily the tablet is absorbed by the body.

  • Binders: These ingredients make sure that the tablet stays together and maintains its integrity.
  • Fillers are used to increase the bulk of the tablet, making it easier to measure doses.
  • Disintegrants: These substances help dissolve the tablet quickly in the digestive system.
  • Colorants & Flavoring Agents: They enhance the visual appeal and taste of the tablets.
  • Preservatives: Their role is to prevent contamination and extend the shelf life.

Side Effects of Montelukast and Levocetirizine

While it's true that Montelukast and Levocetirizine are widely used in the treatment of allergies and respiratory conditions, it's crucial for healthcare professionals to be aware of their side effects. This awareness is essential in making clinical decisions and prioritizing patient safety.

Common side effects

Less common side effects and their implications

Although they are less common, there are side effects that, while not occurring frequently, can have important implications for patients and require immediate medical attention. In terms of effects mood changes, hallucinations, or agitation have occasionally been observed, particularly with the use of Montelukast.

When it comes to effects, it is possible for symptoms such as wheezing or difficulty breathing to occur unexpectedly. Additionally, elevations in liver enzymes or the development of jaundice could indicate issues with the liver.

Interactions with Other Drugs

A thorough understanding of the relationship between Montelukast, Levocetirizine, and other concurrently used medications is crucial to prevent any unwanted effects on their effectiveness or how they are processed in the body.

Drugs that may enhance or diminish effects

When Montelukast is taken together with medications, it can either enhance or reduce its effects. For example, if Montelukast is taken with Ritonavir, the plasma concentrations of Montelukast may increase. Additionally, consuming alcohol can worsen the effects of Levocetirizine.

Implications of consuming alcohol or caffeine

Substances from outside the body, such as alcohol and caffeine, can influence how these treatments work;

  • Alcohol; It can increase feelings of drowsiness and sedation, particularly when taken with Levocetirizine. It's important to be cautious.
  • Caffeine: The stimulating effects of caffeine might potentially offset the effects of Levocetirizine, although each person may have a different response.

Warnings and Precautions

In the field of therapeutics, although drugs are powerful tools in fighting diseases, they also come with certain risks and considerations. Montelukast and Levocetirizine, despite their effectiveness in treatment, require awareness of their possible contraindications and precautionary measures.

Contraindications for use

There are situations where these medications should not be used;

1. Montelukast: If a patient is known to have a hypersensitivity to Montelukast or any of its ingredients, they should avoid using it.

2. Levocetirizine: Patients with end-stage disease or those undergoing hemodialysis should not take Levocetirizine.

Situations of careful administration

In medical situations, it is important to be extra cautious when considering the use of these medications;

  • Patients who have experienced liver damage caused by drugs in the past.
  • Individuals who are prone to experiencing symptoms triggered by medication.
  • People, with phenylketonuria, particularly when it comes to chewable tablets.

Important precautions before and during treatment

Patient safety is importance and requires a structured protocol before and during treatment. This includes evaluating kidney and liver function before starting therapy, consistently monitoring for any neuropsychiatric symptoms, and conducting regular checkups to identify any potential side effects that may arise.

Special Populations

Due to the diversity among individuals, including differences in age, physiological state, and concurrent health conditions, it is essential to customize medication plans to meet these requirements.

Administration to the Elderly

Elderly patients, who have naturally declining abilities, can sometimes present challenges in finding the right treatment approach. Adjusting dosages is important for patients with reduced kidney function, particularly when using Levocetirizine. It's crucial to monitor these patients due to their increased vulnerability to dizziness, low blood pressure, and even cognitive issues.

Administration to Pregnant Women and Nursing Mothers

The way drugs interact with the changes that occur in a pregnant woman's body and during breastfeeding requires careful consideration of the balance between the advantages they offer and the potential risks involved. Although there have been limited studies on the impact of these drugs on development, they suggest that there are no significant harmful effects.

However, it is still important to proceed with caution. When it comes to breastfeeding while Montelukast can be found in breast milk, the status of Levocetirizine is not yet clear. It is crucial to evaluate the benefits, versus any potential risks before making a decision.

Administration to Children

In order to provide treatment for children, it is important to consider their unique physiological characteristics. This includes prescribing age doses of medications like Montelukast, which may vary for children between the ages of 2 and 5 as well as those aged 6 to 14. Similarly, the dosages of Levocetirizine are adjusted based on a child's age and kidney function. It is crucial to monitor for any side effects that are specific to pediatric patients, such as neuropsychiatric effects or potential impacts on growth.

Overdosage and its Management

In the field of treatment, it is crucial to follow the prescribed dosages with great care. Taking amounts of Montelukast or Levocetirizine can lead to a range of symptoms that require immediate medical attention.

Symptoms of overdose

An overdose typically leads to a range of changes in a person's health. When it comes to Montelukast, individuals may experience restlessness, unhappiness, or even extreme drowsiness in severe cases. As for Levocetirizine, an overdose could bring about feelings of drowsiness, irregular heartbeats, or trembling as warning signs.

Immediate steps and medical interventions

When faced with a drug overdose, it is crucial to act. Follow these steps;

1. Stop the person from taking any more of the drug

2. Make sure their airway is clear and that they are breathing properly.

3. Check for signs of stability in their circulation.

4. If it has been more than an hour since ingestion, you might want to think about giving them activated charcoal.

5. It is absolutely necessary to seek medical help in this situation.

Remember, time is of the essence when dealing with an overdose, so don't hesitate to take action and get assistance as soon, as possible.

Storage Recommendations

The effectiveness and quality of Montelukast and Levocetirizine depend greatly on how they're stored. Following the recommended storage guidelines helps maintain their benefits.

Optimal storage temperature

Changes in temperature can have an impact on the effectiveness of these medications; Montelukast. It's best to store it at a temperature between 20°C and 25°C. Levocetirizine: It works well when kept in an environment with a temperature ranging from 15°C to 30°C.

Precautions to prevent degradation

To ensure that the drug remains effective for a period, it is important to take certain precautions. These include protecting the medication from sunlight, making sure the containers are tightly sealed after use, and avoiding excessively humid or damp environments.

Handling Precautions

These incredible medications have completely changed how we approach treatment. It's crucial to handle them with care to guarantee their effectiveness and safety.

Safety guidelines for dispensing and administering

Dispensing and administering go beyond provision; they are considered an art governed by safety guidelines. It is important to sanitize your hands before handling anything.

If there is a chance of contact, it's advisable to wear gloves. Always check the expiry date of the medication before giving it out. Lastly, make sure patients are properly informed about dosage and administration.

Proper disposal methods for unused medication

It is important to dispose of expired medication correctly to avoid any harm to the environment and accidental ingestion. Medications should never be flushed down toilets or drains.

Instead, you can use drug take-back programs or official disposal sites. If those options are not available, you can mix the medication with something unappealing, seal it in a bag, and throw it away with your household trash.


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