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MONTEROS-L TAB MC
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MONTEROS-L TAB MC

MONTELUKAST SODIUM + LEVOCETRIZINE HYDROCHLORIDE IP

MONTEROS-L TAB MC is a tablet combining montelukast sodium with levocetirizine hydrochloride. It is used for allergic rhinitis, particularly where an antihistamine alone has proved insufficient, and in allergic rhinitis with coexisting asthma.

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01

Benefits

  • Levocetirizine blocks histamine, relieving sneezing, runny nose and itchy eyes with less sedation than cetirizine.
  • Montelukast blocks leukotrienes, a separate inflammatory pathway that antihistamines do not affect.
  • Together they cover more of the allergic cascade than either alone.
  • Montelukast is particularly effective for nasal blockage, which responds poorly to antihistamines.
  • Montelukast also treats the asthma that frequently coexists with allergic rhinitis.
  • Once-daily dosing, usually in the evening.
02

Side effects

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

Common
  • Drowsiness
  • Headache
  • Dry mouth
  • Abdominal pain
Less common
  • Vivid dreams or disturbed sleep
  • Dizziness
  • Nausea
  • Raised liver enzymes
Stop and get medical help if any of these occur
  • Agitation, aggression, depression, anxiety, or thoughts of self-harm — montelukast can cause serious neuropsychiatric reactions
  • Hallucinations, or marked changes in behaviour or sleep
  • Swelling of the face, lips or tongue, or difficulty breathing
  • Numbness or tingling with rash and worsening breathlessness
  • Yellowing of the skin or eyes
03

Precautions

  • 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 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, 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.
  • Stop several days before allergy skin testing; use in pregnancy and breastfeeding only on medical advice.