MONTEROS-L AM TAB

• Levocetirizine blocks histamine, relieving sneezing, runny nose and itchy eyes with less sedation than cetirizine.
• Montelukast blocks leukotrienes, a separate inflammatory pathway, and is particularly effective for nasal blockage.
• Ambroxol thins tenacious mucus, easing the post-nasal drip and productive cough that accompany allergic airway disease.
• Covers the inflammatory, allergic and mucus components of allergic airway disease in one tablet.
• Montelukast also treats coexisting asthma, common in patients with allergic rhinitis.
• Once-daily dosing keeps the regimen simple.

Not everyone gets these. Most are mild and settle as the course finishes.

• Montelukast carries a warning for serious neuropsychiatric events, including suicidal thoughts and behaviour. Counsel the patient and family to report any mood or behaviour change, and stop the drug if it occurs.
• Montelukast is not a rescue treatment and does not relieve an acute asthma attack; the reliever inhaler must remain available.
• Do not reduce inhaled corticosteroid therapy on starting montelukast without medical advice.
• May cause drowsiness. Warn before driving or operating machinery, and avoid alcohol.
• Dose reduction is required in renal impairment; contraindicated in end-stage renal disease.
• Do not take alongside cetirizine — it is the same drug as the levocetirizine component.
• Use with care in active peptic ulcer disease because of the ambroxol, and maintain good fluid intake for the mucolytic to work.
• Use in pregnancy and breastfeeding only on medical advice.