Comparison of montelukast and pseudoephedrine in the treatment of allergic rhinitis.
OBJECTIVE
To compare montelukast sodium and pseudoephedrine hydrochloride in the treatment of seasonal allergic rhinitis.


METHODS
A 2-week, parallel, randomized, double-blind study with rolling enrollment.


METHODS
Tertiary care medical center.


METHODS
A total of 58 adult subjects with ragweed allergic rhinitis as documented by positive findings on a skin test to ragweed and history of symptoms during previous seasons.


METHODS
After recording their own baseline nasal symptoms, nasal peak inspiratory flow (NPIF), and diurnal and nocturnal rhinoconjunctivitis quality of life (QOL) scores, subjects were randomized to receive daily morning oral doses of either pseudoephedrine hydrochloride (240 mg) or montelukast sodium (10 mg) for 2 weeks. They recorded their nasal symptoms and NPIF twice daily during this time, and at the end of the study, they completed another QOL questionnaire and 2 tolerability profiles.


METHODS
Nasal symptoms, NPIF, QOL scores, and tolerability profiles.


RESULTS
Both active treatments resulted in significant improvements from baseline in all symptoms of allergic rhinitis as well as in all the domains of the QOL questionnaires. When changes from baseline were compared between treatments, there were no significant differences except in the symptom of nasal congestion, for which pseudoephedrine was more effective than montelukast. Both treatments resulted in a significant increase in NPIF over baseline with no significant difference between treatments. Both drugs were well tolerated with no differences in the tolerability profiles between treatments.


CONCLUSIONS
Pseudoephedrine and montelukast are equivalent in improving symptoms and QOL and increasing nasal airflow in patients with seasonal allergic rhinitis. The lack of the usual adverse effects in the pseudoephedrine group is ascribed to morning dosing.
Mucha
Samantha M
SM
Section of Otolaryngology-Head and Neck Surgery, The Pritzker School of Medicine, The University of Chicago, Chicago, IL 60637, USA.
deTineo
Marcy
M
Naclerio
Robert M
RM
Baroody
Fuad M
FM
D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D003521:Cyclopropanes; D004311:Double-Blind Method; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000523:psychology; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D000316:Adrenergic alpha-Agonists; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D004809:Ephedrine; C093875:montelukast