leukotriene agonists and 5-lipoxygenase inhibitors

Hi Folks

Need to tap into your direct experience of leukotriene agonists and / or 5-lipoxygenase inhibitors.

Currently pattern is a need for 5 / 10 Day Oral Steroid Burst about every 4 to 5 Weeks.

Thinking about asking my Consultant to give me one of the above if I need to have another Steroid Burst in the next couple of weeks.

I gather that leukotriene agonists and 5-lipoxygenase inhibitors are sometimes offered where Inhaled and / or Oral Steroids don't seem to be helping much (I've had exacerbations even while on Oral Steroids).

If you've given leukotriene agonists and / or 5-lipoxygenase Inhibitors a fair try I'd love to here from you (even if just a one-line reply such as 'worked well' or 'little benefit').

For anyone interested in this topic but without direct experience of these drugs, below is a brief explanatory extract pinched from the web:

'.....Leukotriene receptor antagonists, such as montelukast, zafirlukast, and pranlukast, and 5-lipoxygenase inhibitors, like zileuton and hypericum perforatum, can be used to treat these diseases. They are less effective than corticosteroids for treating asthma, but more effective for treating certain mast cell disorders....'

Thanks in anticipation.

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  • I take Montelukast and have done for years. Definitely better with and immunology suggested 10mg am and pm.

    As to steroids I take maintenance dose 4mgs and that has reduced my need for bursts of higher dose though I do need. I am brittle so not typical

  • Thanks for that.

  • Hi Matman

    I started on Montelukast about 3 months ago. Before then, I had mild hayfever that didn't affect my asthma, but this year it's started to. I've also had problems with nasal polyps / lack of sense of smell - I think due to sensitivity to pollution. Since taking the Montelukast, I haven't had an exacerbation and my sense of smell has been good too. I also take 200mcg of Clenil Modulite twice per day. I did have a cold a few weeks ago and my Peak Flow dropped from a typical 450 down to 380. It was a very nasty cold, though more of a head cold than chest.

    The real test will come when I get a cold that goes onto my chest - which has always been my trigger in the past. I'm not sure if the Montelukast will help with that but we'll see.

    If you have an allergic component to your asthma, it's probably worth a conversation with your consultant about these drugs - it certainly looks like you need something else with all those oral steroids!

    Good luck

  • Appreciated

  • I've been taking Montelukast for about three years now. My GP suggested I try it as despite being on Symbicort (which is a combination steroid + long acting reliever inhaler) I was waking up in the morning with a cough and a slightly lower peak flow than in the evening and it seemed to solve that problem. Now, if I miss a more than one dose, my asthma worsens, otherwise it seems much more stable.

    Hope that helps - I'm not an expert, but I'm sure there are others on here who are!

  • Cheers for that. Interesting that missing just a dose or two is risky.

  • Hi. I have been on montelukast for 4 years, apart from when I stopped it for a while as I didn't think I needed it and my peak flow in the morning went plummeting down again. If you are someone who wakes up wheezy or with low pf it may work quite well, and keep you going through the night. At first I got very vivid dreams but those stopped after a few weeks and I sleep really soundly too. I am coming out of an exacerbation and stills on oral steroids at the moment but montelukast is what pulled me out of my last long exacerbation and my consultant has told me not to stop it. It works well for me.

  • Thanks Jenhcat.

  • I was put on Montelukast 18 months ago and within a week I was feeling so much better.

    I have allergic asthma and I had been struggling on regular max dose seretide plus oral steroid courses & antibiotics a few times a year when I could barely move. It felt like everything could trigger me. It was ridiculous!

    Montelukast really helped, i've only needed one course of steroid tablets since and that was after a cold.

    Only side effects I got was feeling tired first few weeks and I seem to get drunk quicker! If you do get prescribed it take it literally just before bed. It makes you sleepy first hr after you take it.

    Hope that's useful to you :-)

    Good luck!

  • hi emsterB, are u still taking montelukast until now? I am prescribed to take it and its been 6months now and still dont know if its really helping me

  • Yeah I am still taking it, and if I miss a dose I notice the difference. My asthma nurse says that Montelukast works very well for some people and not at all for others. Sounds weird, but that's what she said!

  • Very much appreciated. Thanks for that.

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