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Tuesday, May 19, 2009

FAQ about Leukotriene Blockers for asthma

What follows are some of the most common questions asked in the Q&A section of and my humble answers. Today's focus is Leukotriene blockers.

What is an allergy/ asthma attack? It is an immune response. Your immune system is normally reserved to protect your body from enemies, like bacteria and viruses. But, at some point the bodies of us asthmatics became sensitive to things that are not supposed to be considered as bad guys, such as dust, mold, trees, certain foods and medicines, etc.

When our bodies are exposed to any of these things our immune system triggers a response. In essence, it sends out chemicals that cause cells in your body to release the army, which in this case are called chemical mediators. Histamine and Leukotrienes are two such mediators that irritate us unfortunate souls with allergies and asthma.

What are Leukotriene blockers? Leukotrienes are chemical mediators released by your body when you are exposed to something you are allergic to. When released they attack to cells in your lungs and trigger your air passages to become inflamed, produce excessive secretions, and contract (bronchospasm). All of this results in a narrowing of the air passages in you lungs, thus causing asthma.

Leukotriene blockers literally block the action of leukotrienes, and thus prevent asthma. However, these medicines only work if taken every day, even when we are feeling good.

Why can't I just take an antihistamine like Claritin? Antihistamines are what the word says: anti-histamine. They block the chemical mediators called histamine from attaching to your nose, eyes and throat. This prevents allergy symptoms like itchy, watery eyes and sneezing. Histamines do have an effect on the lungs, but not as much of an effect as leukotrienes.

What are some common Leukotriene blockers? Accolate and Singulair are the leukotriene blockers available at this time. (For a list of all asthma medicines check out this link).

Which one is the best? Where I live and work Singulair seems to be the most commonly prescribed (and is what I take). However, I'm not sure if it is any better than the others.

Since medicines can have different effects for different patients, which one works best may depend on the patient. Likewise, which one is prescribed may also be based on the personal preference of the patient and/or prescribing physician. And, while side effects are rare, if you have a side effect to one of these meds your doctor may prescribe one of the alternatives.

For many asthmatics this type of medicine is the only medicine that is needed to control asthma. For other asthmatics, a combination of this and other asthma medicines are necessary.

Do all asthmatics benefit from these meds: According to The Harvard Medical School guide to taking control of asthma, 40% of asthmatics notice no benefit from these meds. Likewise, it is not possible to predict who will benefit from this medicine.

Are Leukotriene blockers a steroid: No. This is great because these medicines help reduce inflammation without the use of a steroid. However, some asthmatics may still need a steroid to help with chronic inflammation. A combination of the two medicines has worked great for many asthmatics, including myself.

What are the side effects of these meds? That's one of the nice things about this medicine is that there are relatively few side effects. However, as any Gallant Asthmatic, you should always be vigilant for possible side effects, especially when you first start taking a new medicine.

I hate taking meds all day long. Can I take it just once or twice a day? Accolate is taken twice a day, and Singulair is taken only once. This makes compliance a breeze. Singulair is recommended to be taken after you brush your teeth before bed. Accolate should be taken when you brush your teeth in the morning and then again before bed.

How long does it take to start working? It takes 5-7 days to really get established in your system, and therefore should be taken every day for the treatment of chronic asthma, and not as a treatment of accute system.

However, there is one exception. Both Singulair and Accolate have been found to work well for asthmatics who only have asthma symptoms when exercising. These meds may be used 1-2 hours prior to exercising to help with excercise induced asthma.

Hey, if you have any further questions about Leikotriene blockers or any other respiratory medicine, feel free to ask in the comments below or email me at or in the question section at


Anonymous said...

Are you noticing any psych side effects from the Singular? I've talked to several people who have trouble sleeping, mood swings, weird dreams and other issues while on singular. And isn't that the one with the suicide warning?


Freadom said...

The FDA ruled singulair not linked to suicide. Check out this link. .