Taking Bilastine (Blexten) with Montelukast: Safety and Efficacy
Yes, you can safely take Bilastine (Blexten) together with Montelukast as there are no significant drug interactions between these medications, and this combination may provide complementary benefits for allergic conditions.
Mechanism of Action and Rationale
These medications work through different mechanisms:
- Bilastine (Blexten): A second-generation antihistamine that blocks H1 receptors, reducing symptoms like sneezing, itching, and rhinorrhea
- Montelukast: A leukotriene receptor antagonist (LTRA) that blocks leukotrienes, reducing inflammation and helping with nasal congestion
Evidence Supporting Combination Use
The combination of antihistamines with montelukast has been studied and found to be both safe and potentially more effective than either medication alone:
A 2023 Phase III randomized clinical trial specifically evaluated the fixed-dose combination of Bilastine 20mg and Montelukast 10mg in patients with allergic rhinitis, finding it to be efficacious and well-tolerated 1
The combination of antihistamines and LTRAs may provide additive benefits for allergic rhinitis symptoms, as noted in rhinitis management guidelines 2
For patients with both allergic rhinitis and asthma, this combination can be particularly beneficial as montelukast is approved for both conditions 2
Safety Considerations
Both medications have favorable safety profiles when used individually:
- Montelukast has shown a safety profile similar to placebo in controlled clinical trials 3
- Bilastine is a non-sedating antihistamine with minimal side effects
The combination has not shown any significant adverse drug interactions in clinical studies 1
Special Considerations
FDA Boxed Warning for Montelukast: In March 2020, the FDA added a Boxed Warning for montelukast regarding neuropsychiatric events (mood changes, behavior changes, suicidal thoughts) 2. Be aware of these potential side effects.
Asthma Management: If you have asthma along with allergic rhinitis, this combination may be particularly beneficial. Montelukast is approved for both conditions and can help manage combined upper and lower airway symptoms 2, 4.
Alternative Options: If this combination doesn't provide adequate symptom control, intranasal corticosteroids are generally more effective than the combination of antihistamine and LTRA for allergic rhinitis 2.
Dosing Recommendations
- Bilastine (Blexten): Typically 20mg once daily
- Montelukast: 10mg once daily (for adults)
Conclusion
The combination of Bilastine (Blexten) and Montelukast is safe and may provide complementary benefits for allergic symptoms. This combination can be particularly useful if you have both allergic rhinitis and asthma, as montelukast addresses both conditions.