Singular (montelukast) is a once-a-day prescription medicine that was originally developed to treat asthma . However, Singulair has since been found to be an effective treatment for allergic rhinitis (also known as hay fever) in some patients.
Let's take a closer look at Singulair, including its indications and side effects, and how its mechanism of action is unique to traditional allergic rhinitis medications.
Singulair is indicated for the prevention and treatment of chronic asthma. It has also been approved for the relief of allergic rhinitis symptoms, both seasonal and persistent, when these symptoms have not been well controlled with other treatments.
Seasonal allergic rhinitis is usually caused by pollen from trees, grasses, and weeds. In other words, a person with seasonal allergic rhinitis will predictably develop symptoms every year in the spring and summer when pollen levels are high.
On the other hand, perennial allergic rhinitis occurs throughout the year and is usually caused by household allergens such as dust mites , cockroaches, mold spores, or animal dander. Interestingly, Singulair can also be used to prevent exercise-induced asthma .
Use not indicated on the label
Singulair is sometimes used off-label (meaning it is not approved by the Food and Drug Administration or FDA) to treat chronic hives (hives) or hives caused by non-steroidal anti-inflammatory drugs (NSAIDs).
Symptoms of allergic rhinitis include sneezing, a runny nose, and a stuffy nose. Some people also experience itchy eyes, nose, throat, and inner ear, as well as fatigue and coughing.
In addition to these burdensome physical symptoms, allergic rhinitis can affect other aspects of a person's life. For example, research shows that allergic rhinitis negatively affects sleep, quality of life, cognitive function, and productivity at school or at work .
That is why avoiding allergens and taking medications are the keys to fighting allergic rhinitis. When taking medications, doctors use a gradual approach, that is, as symptoms worsen, the doctor prescribes another medication.
For example, for mild symptoms of allergic rhinitis, your doctor may recommend antihistamines. If symptoms persist and / or affect a person's quality of life, the doctor may "step up" therapy and recommend an intranasal corticosteroid . For severe persistent symptoms, your doctor may prescribe antihistamines and intranasal corticosteroids.
Since the benefits may not outweigh the risk of possible neuropsychiatric side effects, the FDA recommends not treating allergic rhinitis with Singulair unless the patient has been helped by alternative treatments.
How does it work
Unlike other medications used to treat allergic rhinitis (such as Claritin or Allegra ), Singulair is not an antihistamine. An antihistamine is a drug that blocks the action of histamine, a chemical released by certain cells in the body in response to allergens. Rather, Singulair blocks another inflammatory mediator called leukotrienes.
Singulair alone is not a good remedy for allergic rhinitis and asthma, although it can treat both conditions to some extent. However, some people respond well to Singulair and it may be the only medicine needed to treat their allergies or asthma.
Singular is generally considered a relatively safe drug, although side effects can occur.
Some of the more common reported side effects include :
- Humor changes
- Headache or dizziness
- Abdominal pain, heartburn, indigestion, nausea, or changes in bowel movements.
- Toothache or infection
- Ear infection or pain
- Muscular weakness
- Conjunctivitis ("conjunctivitis")
- Flu-like symptoms
If you are taking Singulair and experience any symptoms that bother you, talk to your doctor. Feel free to seek immediate help for any serious side effects, such as closing your throat or breathing difficulties.
Get the word of drug information
If you are allergic, it is important to remember that Singulair is not your only option. As mentioned above, you can also take antihistamines.
Other treatment options include steroid nasal sprays, over-the-counter nasal sprays, oral decongestants, combination decongestants, antihistamines, and anticholinergic and antihistamine nasal sprays.
Be sure to talk to your healthcare provider about your treatment plan if your symptoms do not improve and / or affect your quality of life. There are several therapeutic approaches, so rest assured that you will feel better, but this can be a process of trial and error.
Frequently asked questions
No. Instead of blocking histamines to prevent allergy symptoms, Singular blocks leukotrienes, a chemical that some people release when exposed to something they are allergic to. Leukotrienes cause allergy symptoms such as coughing, inflammation of the airways, and shortness of breath.
No. The FDA recommends that doctors avoid prescribing Singulair (montelukast) for allergic rhinitis or mild asthma symptoms because this drug increases the risk of agitation, depression, trouble sleeping, and suicidal thoughts and actions. In 2020, a black box warning was added to Singulair to highlight these risks.
There is some limited evidence that montelukast can help prevent the development of more serious symptoms in people hospitalized with COVID-19. More research is needed to confirm how beneficial this drug is.