Singulair/Montelukast: Not just for asthma? Part 2
As I wrote previously, for whatever reason, I suck at keeping up with my nasal corticosteroids. But I do take pills as well as inhalers a couple (or more) times a day, and I rarely failed to take Singulair—who knows what gives on that, I could’ve also just been a greener, not burned-out asthmatic, or… it could just be less burdensome therapeutically. So, I began to look at the research, contemplating if it was worthwhile to present to Dr. Smartypants at my December appointment that we consider revisiting Singulair for my perennial (year-round) allergic rhinitis. It didn’t work for my asthma, but given that was before my rhinitis was identified, I didn’t know if it had positively impacted my sinuses.
Well, my sinuses answered the question for me—after yet another Nasonex hiatus, I returned from Switzerland and got stuffy. I actually presumed I was getting sick after two transatlantic flights and a cumulative twenty-four hours on planes in five days. Except, nope. I restarted the nasal steroids and I think probably due to the amount of gunk in my nose, they took a long time to take effect (to the point where, since antihistamines didn’t help, I was trying to clear my nose by way of eating Sweet Chilli Heat Doritos. Anything is worth a shot (especially when it is also delicious), but it also made an attempt at Singulair worth a shot again, too.
Consulting the literature: Singulair for Allergic Rhinitis
Singulair has many other uses than just asthma, and allergic rhinitis, like I have, is one of them.
In a Twitter conversation (more on that in a moment), Dr. Jason Lee stated montelukast is barely more effective than placebo. Remember, we must be mindful that simply taking a treatment may affect our perception of symptoms).
In one study, the randomized group taking a standard dose of 10 mg montelukast without any other meds for allergic rhinitis experienced a decrease in nasal symptoms, with a mean score decrease of -0.36 from baseline. However, the placebo group score also decreased -0.25, meaning the change between placebo and montelukast was not that great.1 Interestingly, a higher dose of montelukast, at 20 mg, actually scored worse on nasal symptom improvement than the group on only 10 mg, coming in at a mean score point difference of -0.29.1
Do you get muscle cramps caused by your asthma medicine?