Taking Montek LC For Allergic Rhinitis. Is It The Right Treatment?

Posted on Wed, 1 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 1 Jan 2014 Answered on

Wed, 22 Jan 2014 Last reviewed on

Question : I have been,aged 35, suffering from allergic rhinitis for the last few years mainly during the winter season.So I have to take one Montek LC tablet(Montelukast Sodium and Levocetrizine hydro) daily at night during winter season to get relieved from it.Is the treatment is going to right direction? Provide me with better prescription.

Answered by Dr. Prahlad Duggal (54 minutes later)

Brief Answer: Use intra nasal steroid spray Detailed Answer: Hi, Thanks for the query. Allergic rhinitis is a common condition and anti histaminics and anti leukotrienes are used for controlling the symptoms. This is what you are also using. Oral medicines have some side effects like sedation. Also continuous use of anti histaminics leads to enzyme induction in liver and the effect wears off after prolonged use. A break in use is needed after few weeks to have optimum effect. Intra nasal sprays of anti allergics like azelastine and intra nasal steroids like fluticasone are the main stay of treatment for allergic rhinitis. So, in your case, use of nasal spray of intra nasal steroids should be used and you should consult your treating doctor regarding this. Feel free to ask another query. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prahlad Duggal (10 hours later)

Good morning sir, I have received your reply.I have been advised to use Intra nasal sprays of anti allergics like azelastine and intra nasal steroids like fluticasone. Now you are requested to send a prescription with their brand names and application/administration. More over, you mentioned some side effects of the medicine I am using.I only use during winter season (5-6 months),so is here any chance of enzyme induction in liver? One more request-If you kindly let me understand about enzyme induction in liver.

Answered by Dr. Prahlad Duggal (1 hour later)

Brief Answer: Barand names in descriptive answer Detailed Answer: Thanks for the query. You can use a combination nasal spray which is available by the names- Duonase, Combinase AQ and there are many others also. You are to use one puff twice daily in both the nostrils. Fluticasone nasal sprays are available by the brand names like- Flomist, Furamist, Flixonase, Avamys and many others. Dosage is same as above. The most common side effect is sedation. Liver enzyme induction- Most of the drugs we take are metabolized in liver by certain enzymes. When a particular drug enters liver, liver enzymes are activated. When liver is repeatedly exposed to the a particular drug, the enzymes for metabolizing that drug gets increased in quantity and the metabolism of that drug becomes faster and the action of drug decreases (no other side effect only effect decreases). When we discontinue the drug, the situation again returns to the normal. This is in brief and in as non-medical language as I can I have tried to explain the process.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prahlad Duggal (10 hours later)

Four days ago I missed my tablet(Montek Lc) for a night.As a result I had been attacked by the disease so violently that i can not breathe well with blockage of nostrils and whopping cough.From yesterday I started taking one Azivent tab(Azithromycin) and one Montek Lc tab.But it is a pity to mention here that the situation still remains unrelieved.Can I start the medicines as you prescribed right now discontinuing the present ones?

Answered by Dr. Prahlad Duggal (2 hours later)

Brief Answer: Use oral med with spray for 3 days Detailed Answer: Thanks for the query. Steroid nasal sprays take few days to produce effect. So, in acute condition, use of oral medicines for 3-4 days along with nasal sprays and then stopping oral medicines is the right strategy. Oral medicines can be as described by you. If the condition is very severe, Use of oral steroid (prednisolone) for a short course (2 days) along with medicines you are already taking will help. In case the problem does not go, consult an ENT and he/she can titrate and then taper off the medicines as per standard practice. Feel free to ask another query. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar