Montelukast Sodium and Levocetirizine are two widely used medicines to manage allergies and breathing problems like asthma and allergic rhinitis. Both belong to different classes of drugs but work together to provide better and longer-lasting relief from symptoms such as sneezing, runny nose, itchy eyes, hives, and breathing discomfort.
This combination therapy is often prescribed when one medicine alone is not enough to control allergy symptoms. While Levocetirizine helps block histamine, the chemical responsible for allergy reactions, Montelukast works by blocking leukotrienes, substances that cause swelling and tightening in the airways. Together, they help reduce both nasal symptoms and breathing issues, offering complete relief.
Both medicines are approved by health authorities. Montelukast Sodium received FDA approval in 1998 for treating asthma and allergies, while Levocetirizine got its FDA approval in 2007 for managing allergic conditions like hay fever and hives.
What Are Montelukast Sodium and Levocetirizine?
Montelukast Sodium is a type of medicine called a leukotriene receptor antagonist. It works by blocking leukotrienes, chemicals in the body that cause inflammation, swelling, and tightening of airways. This makes it useful for treating asthma and allergic rhinitis (inflammation inside the nose).
Levocetirizine belongs to a group of drugs called H1 antihistamines. It blocks histamine, a chemical that causes sneezing, itching, watery eyes, and runny nose during allergic reactions.
When Montelukast and Levocetirizine are used together, they offer synergistic effects. This means they work better as a combination than when taken alone. Levocetirizine controls histamine-related symptoms like sneezing and itching, while Montelukast helps with swelling and airway issues caused by leukotrienes. Together, they provide complete relief from allergies and breathing problems.
Uses and Indications
The Montelukast Sodium and Levocetirizine combination is widely used to treat different types of allergies and breathing problems. Together, they help manage both nasal symptoms and airway issues.
Here are the main conditions this combination treats:
- Asthma: Helps prevent and control asthma symptoms like shortness of breath, wheezing, and chest tightness by reducing airway inflammation.
- Allergic Rhinitis (Seasonal and Perennial): Treats common allergy symptoms like sneezing, runny nose, itchy eyes, and nasal congestion caused by pollen, dust, or pet dander.
- Chronic Urticaria (Hives): Reduces skin rashes, itching, and hives that last for weeks or months, offering relief from long-term skin allergies.
- Exercise-Induced Bronchoconstriction: Helps prevent breathing difficulties and airway tightening triggered by physical activity, especially in people with asthma.
Some doctors may also prescribe this combination for off-label uses, such as nasal polyps or other allergy-related conditions, based on research studies and patient needs. Always follow your doctor’s advice for the best results.
Dosage and Administration
| Age Group / Condition | Montelukast Dose | Levocetirizine Dose | Administration Guidelines |
|---|---|---|---|
| Adults & Adolescents (12+ years) | 10 mg once daily | 5 mg once daily | Preferably in the evening, with or without food |
| Children (6–11 years) | 5 mg once daily (if prescribed separately) | 2.5–5 mg once daily (based on weight) | Doctor’s advice, with or without food |
| Children below 6 years | Not usually recommended | Not recommended without doctor’s advice | Follow pediatrician’s instructions |
| Renal Impairment | No major adjustment | Dose reduction needed (as kidneys process Levocetirizine) | Follow doctor’s guidance |
| Hepatic Impairment | Monitor liver function (Montelukast is processed by liver) | No major adjustment | Consult doctor |
How Montelukast and Levocetirizine Work (Mechanism of Action)
Montelukast Sodium and Levocetirizine work together to control both breathing problems and allergy symptoms. They target two different pathways in the body that cause allergic reactions and asthma.
Montelukast Sodium:
This medicine is a leukotriene receptor antagonist. It works by blocking leukotriene D4 at the cysteinyl leukotriene receptor. Leukotrienes are chemicals in the body that cause swelling, inflammation, and tightening of the airways.
According to a study published on ScienceDirect, leukotriene antagonists like Montelukast significantly improve lung function in asthma patients.
This makes Montelukast effective for asthma, exercise-induced bronchoconstriction, and allergic rhinitis.
Levocetirizine:
This medicine is a second-generation H1 antihistamine. It selectively inhibits peripheral H1 receptors, which blocks histamine, the chemical responsible for symptoms like sneezing, runny nose, itching, and watery eyes.
By reducing histamine-related inflammation, Levocetirizine helps control common allergy symptoms without causing much drowsiness.
When used together, Montelukast and Levocetirizine provide a dual-action effect. They help manage both nasal symptoms and airway inflammation, offering complete relief from allergies and breathing problems.
Side Effects
Like all medicines, Montelukast Sodium and Levocetirizine can cause some side effects. Most side effects are mild and go away on their own, but some can be serious and require medical attention.
Common Side Effects:
- Headache
- Drowsiness or sleepiness (more common with Levocetirizine)
- Dry mouth
- Fatigue
- Stomach pain or nausea
These side effects are usually temporary and improve as your body adjusts to the medicine.
Serious Side Effects (Rare):
Neuropsychiatric symptoms (linked with Montelukast):
- Mood changes
- Feeling restless, anxious, or depressed
According to studies published on ScienceDirect, leukotriene receptor antagonists like Montelukast have been associated with rare but serious neuropsychiatric side effects, including mood swings, especially in young patients.
Allergic reactions (linked with Levocetirizine):
- Rash, hives, itching
- Swelling of the face, lips, tongue, or throat
- Difficulty breathing
If you experience any serious side effects, stop taking the medicine and consult your doctor immediately.
Precautions and Warnings
Before taking Montelukast Sodium and Levocetirizine, it is important to follow certain precautions to ensure the medicine is safe and effective for you. Always use this combination under a doctor’s supervision, especially if you have any health conditions.
Pregnancy and Breastfeeding:
- This medicine should be taken during pregnancy only if clearly needed. There are limited studies in humans, but animal studies have not shown harm to the baby.
- Levocetirizine and Montelukast may pass into breast milk. If you are breastfeeding, consult your doctor before taking this combination.
Liver or Kidney Disease:
- People with kidney disease should be careful because Levocetirizine is processed by the kidneys. Your doctor may adjust the dosage or suggest a different medicine.
- Montelukast is processed by the liver. If you have liver problems, inform your doctor to avoid any complications.
History of Mental Health Issues:
Montelukast has been linked to mood changes, anxiety, and depression in some cases. If you have a history of mental health issues like depression, inform your doctor before starting this medicine.
Importance of Medical Supervision:
- Always follow your doctor’s instructions regarding dosage and duration.
- Do not self-medicate or change the dose without medical advice.
- Inform your doctor about any other medicines, vitamins, or supplements you are taking to avoid interactions.
Drug Interactions
The Montelukast Sodium and Levocetirizine combination can interact with other medicines, supplements, or alcohol, which may increase the risk of side effects or reduce the effectiveness of the treatment. Always inform your doctor about any medications or supplements you are using before starting this combination.
Potential Interactions:
Theophylline (Asthma or COPD medicine):
- When taken with Levocetirizine, Theophylline can increase the levels of Levocetirizine in the body, which may raise the chance of side effects like drowsiness or fatigue.
Ritonavir (HIV medicine):
- Ritonavir can affect how Montelukast is broken down in the body. This may lead to higher levels of Montelukast, increasing the risk of side effects.
Alcohol and Sedatives:
Taking alcohol or sedatives (like sleeping pills or anti-anxiety medications) with this combination can increase drowsiness and slow down mental alertness.
Recommendations for Avoiding Adverse Interactions:
- Inform your doctor about all prescription, non-prescription, vitamins, and herbal supplements you are using.
- Avoid alcohol or limit its use while on this medicine to reduce the risk of drowsiness.
- Do not combine this medicine with sedatives or anti-depressants without your doctor’s approval.
- If you experience unusual dizziness, fatigue, or difficulty concentrating, consult your doctor right away.
Comparison with Other Antihistamines
| Feature | Montelukast + Levocetirizine | Cetirizine Alone | Loratadine Alone |
|---|---|---|---|
| Type of Drug | Leukotriene antagonist + H1 antihistamine | H1 antihistamine only | H1 antihistamine only |
| Main Use | Allergies + asthma + hives | Allergies + hives | Seasonal allergies |
| Effectiveness | More effective in combined allergy and asthma symptoms | Effective for mild to moderate allergies | Effective for mild allergies |
| Drowsiness | Low (Levocetirizine causes less than Cetirizine) | Moderate (can cause sleepiness) | Very low (non-drowsy) |
| Onset of Action | Within 1 hour | 1–2 hours | 1–3 hours |
| Duration | Up to 24 hours | Up to 24 hours | Up to 24 hours |
| Combination Benefits | Controls both airway inflammation and histamine response | Only controls histamine response | Only controls histamine response |
Conclusion
The Montelukast Sodium and Levocetirizine combination offers effective relief from allergy symptoms and breathing problems like asthma, allergic rhinitis, and hives. By working together, these two medicines help control both nasal allergies and airway inflammation, providing complete and long-lasting comfort.
While this combination is generally safe and well-tolerated, it is important to be aware of possible side effects and drug interactions. Always consult your healthcare provider before starting or stopping this medicine. Your doctor will guide you on the right dosage and ensure it’s safe for your specific health condition.
FAQs
What is Montelukast Sodium and Levocetirizine used for?
The Montelukast Sodium and Levocetirizine combination is used to treat allergies, asthma, allergic rhinitis, hives, and breathing problems like exercise-induced bronchoconstriction. Together, they reduce inflammation and control allergy symptoms like sneezing, itchy eyes, and wheezing.
What is the main purpose of Montelukast?
Montelukast is mainly used to treat asthma and allergic rhinitis. It helps prevent airway swelling, bronchospasm, and controls breathing issues by blocking leukotrienes, the chemicals that cause inflammation in the airways.
Is Levocetirizine used for a cough?
Levocetirizine is an antihistamine that helps relieve cough caused by allergies, especially if the cough is due to post-nasal drip or allergic rhinitis. It is not effective for coughs caused by infections or other medical conditions.
What are the side effects of Montelukast?
Common side effects of Montelukast include headache, stomach pain, and fatigue. In rare cases, it may cause mood changes, anxiety, depression, or suicidal thoughts. Always consult your doctor if you notice any unusual symptoms.
Does Montelukast make you sleepy?
Montelukast generally does not cause drowsiness. It is known as a non-sedating medicine. However, when combined with Levocetirizine, there may be a small chance of drowsiness, depending on how your body responds.
Why is Montelukast taken at night?
Montelukast is usually taken in the evening or at night because asthma symptoms and allergy-related breathing problems often get worse at night. Taking it at night helps control symptoms during sleep
When is the best time to take Montelukast Levocetirizine?
The best time to take Montelukast and Levocetirizine is in the evening, as this helps manage nighttime allergies and asthma symptoms better. It can be taken with or without food, but taking it at the same time daily is recommended.
Is Monticope good for cold?
Monticope is a brand that contains Montelukast and Levocetirizine. It is not used for viral colds but helps relieve allergy-related cold symptoms like runny nose, sneezing, and nasal congestion. For viral infections, consult your doctor.
