Leukotriene Modifiers and Allergies

Leukotriene modifiers (leukotriene antagonists) are medicines used to manage allergic rhinitis or allergies, as well as prevent asthma. These novel drugs work by blocking the action of leukotrienes. They are typically not used as the first mode of treatment.

Leukotrienes are inflammatory chemicals the body releases after coming in contact with an allergen or allergy trigger. Leukotrienes cause tightening of airway muscles and the production of excess mucus and fluid. These chemicals play a key role in allergies, allergic rhinitis, and asthma, also causing a tightening of your airways, making it difficult to breathe.

How do leukotriene modifiers manage allergy symptoms?

Typical symptoms of allergies include sneezing, itchy nose, clear mucus, and nasal congestion. In addition, allergies cause itchy, swollen, and watery eyes (allergic conjunctivitis) and frequent throat clearing. Studies show that up to 85% of people with asthma also have symptoms of allergies. In addition, untreated allergies often cause sinusitis, sore throats, cough, sleep problems, irritability, and low productivity at school and in the workplace.

Leukotriene modifiers work by blocking the action of leukotrienes, one cause of the inflammation and nasal congestion associated with allergies. For those with allergies and asthma, leukotriene modifiers help keep bronchial tubes, airways to your lungs, from constricting.

According to the American Academy of Allergy Asthma & Immunology, leukotriene modifiers can block both the early response to allergic triggers (sneezing and itching) as well as the delayed response to allergens that result in nasal congestion.

How are leukotriene modifiers used in treating asthma?

Leukotriene modifiers are also used to prevent asthma and exercise-induced asthma. These medicines should not be used alone to treat an acute asthma attack. Leukotriene modifiers decrease the body's production of the leukotrienes that worsen both asthma and allergic reactions.

Which leukotriene modifiers are recommended for allergies?

While montelukast (Singulair),  zafirlukast (Accolate), and zileuton (Zyflo) are the leukotriene modifiers available for asthma, only montelukast is approved for the management of allergic rhinitis or allergies. Montelukast also provides relief for allergic conjunctivitis.

Research has shown that when compared to placebo, montelukast provided relief of symptoms that were similar to loratadine (Claritin), yet less relief than provided with nasal inhaled steroids. Intranasal steroids should be tried prior to any recommendation for leukotriene modifiers.