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Leukotriene receptor antagonists (LTRAs)

Also in: हिन्दी தமிழ் मराठी తెలుగు ಕನ್ನಡ বাংলা ગુજરાતી മലയാളം

Leukotriene receptor antagonists (LTRAs) are medicines taken by mouth that block leukotrienes, chemicals that narrow the airways and swell the lining of the nose. They are used to help prevent asthma symptoms, often alongside an inhaled steroid, to prevent narrowing of the airways caused by exercise, and to relieve symptoms of allergic rhinitis. They do not relieve a sudden asthma attack. Examples include montelukast and zafirlukast.

Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.

How do Leukotriene receptor antagonists (LTRAs) work?

During an allergic reaction, cells in the airways and nose release cysteinyl leukotrienes, which tighten airway muscle, cause swelling and mucus, and draw in inflammatory cells. LTRAs block the receptor these leukotrienes act on, called the CysLT1 receptor, which reduces these effects.

Active ingredients of this type

These active ingredients belong to Leukotriene receptor antagonists (LTRAs). They are listed A to Z.

  • Montelukast: Montelukast is a leukotriene receptor antagonist, a medicine taken by mouth to help prevent asthma symptoms and relieve allergy symptoms.

Common questions

Can LTRAs affect mood or behaviour?

Yes, rarely. Montelukast can cause mood and behaviour changes such as agitation, bad dreams, trouble sleeping, depression and suicidal thoughts. In 2020 the US FDA added a boxed warning about this. People taking it, and parents of children taking it, should watch for such changes and contact a doctor straight away if they appear.

Can an LTRA be used during an asthma attack?

No. LTRAs help prevent symptoms over time and do not open the airways quickly. During an attack, use the reliever inhaler your doctor prescribed, and get urgent medical help if it does not work.

Sources

  1. SINGULAIR (montelukast sodium) tablets, chewable tablets and oral granules: full prescribing information (revised 6/2021). Organon, US FDA-approved labeling
  2. FDA requires Boxed Warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair); advises restricting use for allergic rhinitis (Drug Safety Communication, 4 March 2020). US Food and Drug Administration
  3. Montelukast. StatPearls, National Center for Biotechnology Information (NCBI), US National Library of Medicine
  4. Zafirlukast. StatPearls, National Center for Biotechnology Information (NCBI), US National Library of Medicine
  5. ATC/DDD Index: R03DC Leukotriene receptor antagonists. WHO Collaborating Centre for Drug Statistics Methodology