Montelukast/ Rupatadine

• OP: Montelukast 10 mg + Rupatadine 10 mg
• Oral solutions/syrups may be available for pediatric use in some markets.

• Take once daily, preferably in the evening.
• With or without food.
• Avoid alcohol and sedatives due to possible drowsiness (from Rupatadine).

• Montelukast: Leukotriene receptor antagonist (LTRA); blocks leukotriene D4 at the cysteinyl leukotriene receptor – reduces inflammation and bronchoconstriction.
• Rupatadine: Second-generation antihistamine; blocks H1 histamine receptors and PAF (platelet-activating factor) receptors.
• Together, they offer:
  • Anti-allergic
  • Anti-inflammatory
  • Bronchodilatory benefits

Montelukast:

• Headache
• Abdominal pain
• Mood changes (rare: agitation, depression, suicidal thoughts)
• Sleep disturbances

Rupatadine:

• Drowsiness
• Headache
• Dry mouth
• Fatigue
• Increased appetite

Combination:

• Generally well-tolerated; monitor for additive drowsiness or rare neuropsychiatric effects.

• Hypersensitivity to montelukast, rupatadine, or any components
• Severe hepatic impairment (Rupatadine)
• Use caution in patients with a history of psychiatric illness (Montelukast)

• Montelukast:
  • Limited significant interactions
  • Phenobarbital, rifampin: May reduce efficacy
• Rupatadine:
  • CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): Increase plasma levels