Usefulness of montelukast to prevent adverse reactions to COX-2 selective inhibitors: a case report.
Nonsteroidal anti-inflammatory drug (NSAID)-sensitivity is a frequent condition in patients with chronic urticaria and/or asthma. The physiopatologic process underlying respiratory and cutaneous reactions probably involves an increased production of cysteinyl leukotrienes. Cyclooxygenase 2 (COX-2) selective inhibitor, has been proposed as the main alternative to control pain and inflammatory diseases in these patients. However, a small percentage of patients with NSAID-induced skin reactions does not even tolerate COX-2 selective inhibitors. We report a very infrequent case of a patient with NSAID, paracetamol and COX-2 selective inhibitors sensitivity in whom we induced tolerance to paracetamol and celecoxib using the leukotriene receptor antagonist montelukast prior to oral challenges.
Serrano
C
C
Allergy Unit. Hospital Clinic. Barcelona. Spain.
Valero
A
A
Picado
C
C
D000085:Acetates / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D003521:Cyclopropanes; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides
D000085:Acetates; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast