Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Leukotrienes in Asthma and SAR

This topic has already been covered but the publication of the revised BTS/SIGN Asthma Guidelines prompted another look.

Montelukast (Singulair) is still being promoted, as licensed, for relief of symptoms of Seasonal Allergic Rhinitis (SAR) in patients with Asthma.

Clinical Evidence has reviewed the available evidence for Montelukast in Asthma and Seasonal Allergic Rhinitis. In both cases the addition of Montelukast was considered likely to be beneficial. This category is used when evidence is less well established. In this case this is because evidence of benefit exists but direct active comparisons are not available or there are studies that are at odds with each other.

The new Asthma Guidelines have not changed the current steps and the original advice with respect to the use of Mentelukast in Asthma patients with SAR still applies.

Action: Ensure Asthma symptoms are controlled using the appropriate step of the BTS/SIGN Asthma Guidelines. This may involve use of a leukotriene receptor antagonist, like Montelukast. Once Asthma symptoms are controlled attention can be turned to controlling symptoms of SAR.

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