Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 7 , ISSUE 2 ( July-December, 2018 ) > List of Articles


Skin Rash and Mild Bruising: Is Montelukast a Safe Drug?

Deep Inder, Seema Manak, Faiz Akram, Pawan Kumar

Keywords : Bruising, hypersensitivity, montelukast, skin rash

Citation Information : Inder D, Manak S, Akram F, Kumar P. Skin Rash and Mild Bruising: Is Montelukast a Safe Drug?. Indian J Respir Care 2018; 7 (2):105-107.

DOI: 10.4103/ijrc.ijrc_3_18

License: CC BY-NC-SA 4.0

Published Online: 02-12-2022

Copyright Statement:  Copyright © 2018; Indian Journal of Respiratory Care.


Montelukast is one of the commonly used drugs in asthma patients. It is prescribed along with inhalational corticosteroids. Although a relatively safe drug, there is a probability of occurrence of skin rashes and skin bruising. Authors present a case report of a 64-year-old chronic asthmatic woman, reporting widespread erythematous eruptions with mild skin bruising and generalized pruritus mostly affecting her lower abdomen and upper extremities. The rash appeared 28 days after introduction of montelukast (10 mg OD). The physician excluded other attributable factors such as trauma, autoimmune disorders such as Churg-Strauss syndrome, and food allergy. Reappearance of rashes after montelukast introduction and complete resolution of the skin rashes after discontinuing it confirms montelukast as offending drug. Naranjo causality assessment score also revealed a “certain/definite” relationship to the montelukast. Long-term safety of montelukast needs to be reviewed by prescribing physicians to prevent adverse reaction.

  1. Peters-Golden M, Gleason MM, Togias A. Cysteinyl leukotrienes: Multi-functional mediators in allergic rhinitis. Clin Exp Allergy 2006;36:689-703.
  2. Tayeb MM. Allergy to montelukast sodium treated effectively by protracted oral desensitization: First case report. J Aller Ther 2013;4:2.
  3. Gollapudi RR, Teirstein PS, Stevenson DD, Simon RA. Aspirin sensitivity: Implications for patients with coronary artery disease. JAMA 2004;292:3017-23.
  4. Inder D, Rehan HS, Yadav M, Manak S, Kumar P. IFN-a-2a (Interferon) and ribavirin induced suicidal attempt in a patient of chronic HCV: A rare case report. Indian J Pharmacol 2011;43:210-1.
  5. Fal AM, Kopec A. Status of leukotrienes in the pathophysiology of asthma. Necessity for antileukotrienes treatment. Pneumonol Alergol Pol 2010;78:68-73.
  6. Shirasaki H, Kanaizumi E, Seki N, Fujita M, Kikuchi M, Himi T, et al. Localization and up-regulation of cysteinyl leukotriene-2 receptor in human allergic nasal mucosa. Allergol Int 2013;62:223-8.
  7. Girszyn N, Amiot N, Lahaxe L, Cuvelier A, Courville P, Marie I, et al. Churg-strauss syndrome associated with montelukast therapy. QJM 2008;101:669-71.
  8. Joos S, Miksch A, Szecsenyi J, Wieseler B, Grouven U, Kaiser T, et al. Montelukast as add-on therapy to inhaled corticosteroids in the treatment of mild to moderate asthma: A systematic review. Thorax 2008;63:453-62.
  9. Callero-Viera A, Infante S, Fuentes-Aparicio V, Zapatero L, Alonso-Lebrero E. Neuropsychiatric reactions to montelukast. J Investig Allergol Clin Immunol 2012;22:452-3.
  10. Harugeri A, Parthasarathi G, Sharma J, D'Souza GA, Ramesh M. Montelukast induced acute hepatocellular liver injury. J Postgrad Med 2009;55:141-2.
  11. Incecik F, Onlen Y, Sangun O, Akoglu S. Probable montelukast-induced hepatotoxicity in a pediatric patient: Case report. Ann Saudi Med 2007;27:462-3.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.