A fixed-dose combination oral suspension of a third-generation selective H1-antihistamine (Levocetirizine) and a leukotriene receptor antagonist (Montelukast). It provides synergistic action for comprehensive management of allergic conditions by blocking both histamine-mediated early-phase allergic responses and leukotriene-mediated late-phase inflammatory responses. It is widely prescribed in India for pediatric and adult allergic rhinitis and chronic urticaria.
Adult: 5 ml (one teaspoonful) once daily in the evening. Contains Levocetirizine 2.5mg + Montelukast 4mg.
Note: Shake the bottle well before use. Use the measuring cup or spoon provided. Can be taken with or without food, but for consistent Montelukast absorption, it is preferable to take it at a fixed time, usually in the evening. Do not mix with other liquids. Rinse measuring device after use.
The combination exerts a dual inhibitory effect on the allergic inflammatory cascade. Levocetirizine competitively and selectively inhibits histamine H1 receptors on vascular endothelial cells, sensory nerves, and other effector cells, preventing histamine-mediated vasodilation, increased vascular permeability, itching, and sneezing. Montelukast is a potent and selective antagonist of the cysteinyl leukotriene type 1 (CysLT1) receptor, blocking the action of leukotrienes (LTC4, LTD4, LTE4) which are potent mediators of bronchoconstriction, increased vascular permeability, mucus secretion, and eosinophil recruitment.
Pregnancy: Levocetirizine: Category B (Animal studies show no risk, inadequate human studies). Montelukast: Category B. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Not first-line in pregnancy.
Driving: May impair ability to drive or operate machinery. Patients should not engage in such activities until their individual response is known, especially during initial therapy or dose changes. Levocetirizine has lower sedation potential than older antihistamines but risk exists.
| CNS Depressants (Alcohol, Benzodiazepines, Opioids) | Additive sedative effect with Levocetirizine. | Moderate |
| Rifampicin, Phenobarbital, Phenytoin | May reduce plasma concentrations of Montelukast by inducing CYP enzymes. | Moderate |
| Gemfibrozil | May increase Montelukast plasma concentration by inhibiting CYP2C8. | Mild |
| Theophylline | Montelukast may decrease the plasma concentration of Theophylline slightly. Monitor levels. | Mild |
Same composition (Levocetirizine (2.5mg/5ml) + Montelukast (4mg/5ml)), different brands: