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. 

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 or allergic rhinitis and also cause uncomfortable bronchoconstriction that tightens 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 more than 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 from constricting.  

According to the American Academy of Allergy Asthma and 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 zafirlukast (Accolate), montelukast (Singulair), 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.

In a review of eight studies using montelukast, researchers confirmed that when compared to placebo, montelukast provided relief of symptoms that was similar to loratadine (Claritin) yet less relief than provided with nasal inhaled steroids. 

How are leukotriene modifiers taken to manage allergies and asthma?

Leukotriene modifiers are available in granules, tablets, and chewable tablets.  Allow about three days to two weeks for leukotriene inhibitors to offer full benefit for management of allergies and asthma.

Are there side effects with leukotriene modifiers?

Possible side effects with leukotriene modifiers include flu-like symptoms, feeling nervous or excitable, headache, stomachache, nausea or vomiting, and nasal congestion.

Who should not use leukotriene modifiers for allergies?

The safety and effectiveness of using leukotriene inhibitors for treatment of asthma in children under 12 months or the treatment of perennial allergic rhinitis in infants under 6 months has not been established. Women who are pregnant or breastfeeding should discuss these medicines with their physicians before taking them.