From the Guidelines
There is no FDA-approved combined tablet containing both fexofenadine and montelukast, so no standard recommended dose exists for such a combination product. These medications are typically prescribed separately. For adults, the standard dose of fexofenadine is 180 mg once daily or 60 mg twice daily, while montelukast is typically prescribed as 10 mg once daily, usually taken in the evening 1. If both medications are needed for allergy or asthma management, they should be taken according to their individual dosing schedules. These medications work through different mechanisms - fexofenadine blocks histamine receptors to reduce allergy symptoms like sneezing and itching, while montelukast blocks leukotriene receptors to reduce inflammation in airways. Patients should consult their healthcare provider before combining these medications to ensure appropriate dosing and to check for potential interactions with other medications they may be taking.
Some key points to consider when prescribing these medications include:
- Fexofenadine is preferred over first-generation antihistamines due to its non-sedating properties 1
- Montelukast is approved for the treatment of seasonal allergic rhinitis and perennial allergic rhinitis, and may be considered in patients who have both asthma and rhinitis 1
- The combination of montelukast and intranasal corticosteroids has been studied in patients with chronic rhinosinusitis with nasal polyps, but the results have been mixed 1
Overall, the decision to prescribe fexofenadine and montelukast should be based on the individual patient's needs and medical history, and patients should be closely monitored for any potential side effects or interactions. It's also important to note that there is no significant difference in efficacy between LTRA and oral antihistamines, with loratadine as the usual comparator 1. The most recent and highest quality study 1 does not provide a clear recommendation for the use of a combined fexofenadine and montelukast tablet, and therefore the individual dosing schedules for each medication should be followed.
From the Research
Recommended Dose for Combined Fexofenadine and Montelukast Tablet
The recommended dose for a combined fexofenadine and montelukast tablet in adults can be determined based on the available studies.
- The study 2 used a combination of montelukast 10 mg and fexofenadine 120 mg in adults with allergic rhinitis.
- Another study 3 evaluated the bioequivalence of a fixed-dose combination tablet containing 120 mg fexofenadine and 10 mg montelukast.
- Additionally, a study 4 used a combination of montelukast 10 mg once a day and fexofenadine 240 mg twice a day in patients with prurigo nodularis or pemphigoid nodularis.
Key Findings
- The combination of montelukast and fexofenadine was found to be effective in reducing symptoms of allergic rhinitis 2 and prurigo nodularis or pemphigoid nodularis 4.
- The bioequivalence study 3 demonstrated that the fixed-dose combination tablet was equivalent to the components administered separately.
- The most commonly used dose in the studies was montelukast 10 mg and fexofenadine 120 mg 2, 3.