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Efficacy and Safety of Fexofenadine and Montelukast Combination Therapy in Allergic Rhinitis Management: A Systematic Review

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https://doi.org/10.54963/entu.v14i3.874
Wajan Alqathanin, Hani Alshammari, Zahra Alqattan, Layaly Allwaish, Norah Alhemaidi, Eman Albathali, Tahani Alruwaili, Riyadh Alharbi, Abdulrahman Akshah, Refal Aljali, Yasser Alasmari, Awatif Alnami, Abdullah Alzahrani, Leen Abdullah, Khluod Alkhowailed, & Mohammed Kanan. (2024). Efficacy and Safety of Fexofenadine and Montelukast Combination Therapy in Allergic Rhinitis Management: A Systematic Review. ENT Updates, 14(3). https://doi.org/10.54963/entu.v14i3.874
Volume 14 Issue 3 (2024)
Copyright (c) 2024 Wajan Alqathanin, Hani Alshammari, Zahra Alqattan, Layaly Allwaish, Norah Alhemaidi, Eman Albathali, Tahani Alruwaili, Riyadh Alharbi, Abdulrahman Akshah, Refal Aljali, Yasser Alasmari, Awatif Alnami, Abdullah Alzahrani, Leen Abdullah, Khluod Alkhowailed, Mohammed Kanan
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors

  • Wajan Alqathanin International Higher School of Medicine
  • Hani Alshammari
    Department of Pharmacy, Rafha General Hospital, Northern Border Health Cluster, Rafha 76321, Saudi Arabia
  • Zahra Alqattan Department of Nursing, PHC-Khuwaildiya, Qatif 32636, Saudi Arabia
  • Layaly Allwaish Head of Pharmacy Department, Vision Eye Center, Hail 55422, Saudi Arabia
  • Norah Alhemaidi Department of Nursing, North Area Armed Forced Hospital, King Khalid Military City, Hafr Al-Batin 39748, Saudi Arabia
  • Eman Albathali Department of Nursing, North Area Armed Forced Hospital, King Khalid Military City, Hafr Al-Batin 39748, Saudi Arabia
  • Tahani Alruwaili Department of Pharmacy, Turaif General Hospital, Northern Border Health Cluster, Turaif 75311, Saudi Arabia
  • Riyadh Alharbi Department of Pharmacy, Security Forces Hospital, Riyadh 12411, Saudi Arabia
  • Abdulrahman Akshah Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Refal Aljali Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Yasser Alasmari Pharmaceutical Care Department, Aseer Health Cluster, Abha 62521, Saudi Arabia
  • Awatif Alnami Department of pharmacy, King Fahad Hospital, Albaha 65732, Saudi Arabia
  • Abdullah Alzahrani Department of Doctor of Pharmacy, College of Pharmacy, Umm-Al-Qura University, Makkah 24382, Saudi Arabia
  • Leen Abdullah Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Khluod Alkhowailed Department of Doctor of Pharmacy, College of Pharmacy, Qassim University, Buraydah 52571, Saudi Arabia
  • Mohammed Kanan Department of Pharmacy, Rafha General Hospital, Northern Border Health Cluster, Rafha 76321, Saudi Arabia

Allergic rhinitis (AR) is a common inflammatory condition of the nasal mucosa, affecting 10–30% of adults and 40% of children globally. This systematic review assessed the efficacy and safety of fexofenadine and montelukast, individually and combined, for AR treatment. A literature search using PubMed, Scopus, and Web of Science identified 162 studies, with eight meeting the inclusion criteria. The combination of fexofenadine and montelukast showed superior efficacy over monotherapy in reducing nasal and non-nasal AR symptoms. Patients experienced significant relief from sneezing, itching, and nasal congestion, with rapid onset of action, indicating a synergistic effect on the histamine and leukotriene pathways. Quality of life also improved, reflecting the efficacy of the combination treatment. The safety profile of the combination therapy was similar to that of monotherapy, with the common adverse events being mild headaches and gastrointestinal distress. No new safety concerns have emerged, suggesting the viability of combination therapy for long-term AR management. However, the potential neuropsychiatric effects of montelukast require further monitoring. Despite some methodological limitations, evidence supports the incorporation of fexofenadine and montelukast combination therapy into the clinical guidelines for AR management, providing an effective, well-tolerated, and flexible treatment option to reduce symptoms and improve patient outcomes.

Keywords:

Allergic Rhinitis Fexofenadine Montelukast Second‑Generation Antihistamines Fixed‑Dose Combi‑ nations

Author Biography

Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia

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