Montelukast-Induced Generalized Urticaria

Minciullo, Paola Lucia; Saija, Antonella; Bonanno, D.; Ferlazzo, Edoardo; Gangemi, Sebastiano

doi:10.1345/aph.1d547

Cited by 30 publications

(19 citation statements)

References 16 publications

(13 reference statements)

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“…However, only two case reports also described generalized urticaria induced by antileukotriene treatment in ASA-induced urticaria 21 and in asthmatic patients. 35 Thus, the results of the controlled studies and clinical experience indicate that these agents are generally safe and well-tolerated, with an incidence of adverse effects generally comparable with placebo. [26][27][28][29][30][31][32][33] Learning points…”

Section: Discussionmentioning

confidence: 97%

Is there a role for antileukotrienes in urticaria?

et al. 2006

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SummaryIn vitro and in vivo clinical and experimental data have suggested that leukotrienes play a key role in inflammatory reactions of the skin. Antileukotriene drugs, i.e. leukotriene receptor antagonists and synthesis inhibitors, are a new class of anti-inflammatory drugs that have shown clinical efficacy in the management of asthma. We searched the MedLine database and carried out a manual search on journals specializing in allergy and dermatology for the use of antileukotriene drugs in urticaria. Montelukast might be effective in chronic urticaria associated with aspirin or food additive hypersensitivity or with autoreactivity to intradermal serum injection when taken with an antihistamine but not in moderate chronic idiopathic urticaria. Evidence for the effectiveness of zafirlukast and the 5-lipoxygenase inhibitor, zileuton, in chronic urticaria is mainly anecdotal. In addition, there is anecdotal evidence of effectiveness of antileukotrienes in primary cold urticaria, delayed pressure urticaria and dermographism. No evidence exists for other physical urticarias, including cholinergic, solar and aquagenic urticarias, vibratory angio-oedema, and exerciseinduced anaphylaxis.

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Section: Discussionmentioning

confidence: 97%

Is there a role for antileukotrienes in urticaria?

et al. 2006

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“…Our group [58] reported on the case of a 28-year-old man with allergic rhinitis and moderate persistent asthma who developed generalized urticaria 5 days after starting on montelukast and inhaled fluticasone. His symptoms disappeared 1 day after the suspension of both drugs.…”

Section: Skin and Subcutaneous Tissue Disordersmentioning

confidence: 99%

“…Two months later, after the resumption of montelukast and fluticasone, the patient developed urticaria again with eyelid angio-oedemas, which were successfully treated with intravenous betamethasone, achieving complete remission. The patient resumed only inhaled fluticasone without any further adverse reactions [58]. Tedeschi [59] reported the case of a patient with no IgE-mediated chronic urticaria, exacerbated by various medications including montelukast.…”

Section: Skin and Subcutaneous Tissue Disordersmentioning

confidence: 99%

Montelukast-Induced Adverse Drug Reactions: A Review of Case Reports in the Literature

Calapai¹,

Casciaro²,

Miroddi³

et al. 2014

Pharmacology

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Background: Montelukast, a leucotriene receptor antagonist, binds the cysteinyl leucotriene type 1 receptor. Montelukast is commonly prescribed to asthma patients as add-on therapy to inhaled corticosteroids. Several clinical trials emphasized that montelukast can be considered a safe drug. However, recent evidence reconsidered the benefit/risk ratio of the use of montelukast for both paediatric and adult patients. Summary: The present review analyzed the previous published case reports regarding montelukast-induced adverse drug reactions (ADRs). They included agitation, anxiety, depression, sleep disturbance, hallucinations, suicidal thinking and suicidality, tremor, dizziness, drowsiness, neuropathies and seizures. The immune system can be involved, in particular, cases of Churg-Strauss syndrome have been published. Furthermore, it can induce hypersensitivity reactions, including anaphylaxis and eosinophilic infiltration. In addition, hepatobiliary, pancreatic and uropoietic disorders have been observed. Some of these cases are characterized by severe prognosis (i.e. neurological deficit and fatal hepatotoxicity). Key Message: The use of montelukast can be burdened by several ADRs, of which physicians should be aware in their clinical practice. A better understanding of the mechanisms causing ADRs after using montelukast could help researchers and clinicians in defining a risk-reduction strategy aimed to lessen montelukast toxicity. More accurate epidemiological studies, in order to discover risk factors favouring montelukast-associated ADRs, are demanded.

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“…1 Rare but serious adverse effects have been reported with montelukast use, including ChurgStrauss syndrome, 2 hepatotoxicity, 3 generalized urticaria, 4 and eyelid angioedema. 4 We pre sent a case of possible montelukast-induced angioedema.…”

Section: Purposementioning

confidence: 99%