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Related Experiment Videos

Montelukast-induced generalized urticaria.

Paola L Minciullo1, Antonella Saija, Domenica Bonanno

  • 1Department of Human Pathology, Division and School of Allergy and Clinical Immunology, University of Messina, 98123 Messina, Italy.

The Annals of Pharmacotherapy
|April 29, 2004
PubMed
Summary

Montelukast, a common asthma medication, can cause generalized urticaria (hives). This case highlights a probable link between montelukast and skin reactions, emphasizing the need for physician awareness.

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Area of Science:

  • Pharmacology
  • Dermatology
  • Allergy and Immunology

Background:

  • Montelukast is a widely prescribed antileukotriene for asthma and allergic rhinitis.
  • The increasing use of montelukast necessitates a thorough understanding of its potential adverse effects.
  • Generalized urticaria is a significant dermatological reaction that can impact patient quality of life.

Observation:

  • A 28-year-old male patient with allergic rhinitis and asthma developed generalized urticaria shortly after initiating montelukast and inhaled fluticasone.
  • Symptoms resolved upon discontinuation of both medications and recurred upon re-challenge with montelukast, along with eyelid angioedema.
  • The patient tolerated inhaled fluticasone monotherapy without adverse reactions, suggesting montelukast as the causative agent.

Findings:

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  • A probable causal relationship was established between montelukast treatment and the development of generalized urticaria and angioedema.
  • The Naranjo probability scale indicated a probable association between the skin manifestations and montelukast.
  • Diagnostic dechallenge and rechallenge supported montelukast as the trigger for the adverse cutaneous reaction.

Implications:

  • Physicians should consider montelukast as a potential cause of generalized urticaria in patients with asthma or allergic rhinitis.
  • Awareness of this adverse reaction is crucial for timely diagnosis and management, potentially preventing severe allergic responses.
  • This case underscores the importance of pharmacovigilance for antileukotriene medications.