Does Montelukast (Singulair) need to be discontinued for allergy testing?

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Last updated: May 13, 2025View editorial policy

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From the Research

Singular (montelukast) should be stopped before allergy testing to ensure accurate results, as it may suppress skin test responses and lead to false-negative results. The most recent and highest quality study, 1, published in 2022, compared the efficacy of montelukast and azelastine add-on therapy in moderate to severe allergic rhinitis treatment, but did not specifically address the issue of stopping montelukast before allergy testing. However, based on the mechanism of action of montelukast as a leukotriene receptor antagonist, it is likely to affect skin test responses.

  • Unlike antihistamines, which typically need to be stopped 3-7 days before testing, leukotriene modifiers like Singular have a different mechanism of action but can still affect test accuracy.
  • It is recommended to discontinue Singular for at least 5-7 days prior to skin testing for allergies, but the exact duration may vary depending on individual circumstances.
  • The decision to stop Singular before allergy testing should be made in consultation with a healthcare provider, who can weigh the potential benefits and risks of discontinuing the medication and determine the best course of action for each patient.
  • Some providers might have different protocols regarding Singular discontinuation before testing, and in some cases, they might determine that the benefits of continuing the medication outweigh the potential impact on test results, as seen in studies such as 2, 3, and 4.

References

Research

Montelukast in the management of allergic rhinitis.

Therapeutics and clinical risk management, 2007

Research

Efficacy of montelukast during the allergy season in patients with chronic asthma and seasonal aeroallergen sensitivity.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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