Review
by Wajan Alqathanin,
Hani Alshammari,
Zahra Alqattan,
Layaly Allwaish,
Norah Alhemaidi,
Eman Albathali,
Tahani Alruwaili,
Riyadh Alharbi,
Abdulrahman Akshah,
Refal Aljali,
Yasser Alasmari,
Awatif Alnami,
Abdullah Alzahrani,
Leen Abdullah,
Khluod Alkhowailed,
Mohammed Kanan,
30 December 2024
Allergic rhinitis (AR) is a common inflammatory condition of the nasal mucosa, affecting 10–30% of adults and 40% of children globally. This systematic review assessed the efficacy and safety of fexofenadine and montelukast, individually and combined, for AR treatment. A literature search using PubMed, Scopus, and Web of Science identified 162 studies, with eight meeting the inclusion criteria. The combination of fexofenadine and montelukast showed superior efficacy over monotherapy in reducing nasal and non-nasal AR symptoms. Patients experienced significant relief from sneezing, itching, and nasal congestion, with rapid onset of action, indicating a synergistic effect on the histamine and leukotriene pathways. Quality of life also improved, reflecting the efficacy of the combination treatment. The safety profile of the combination therapy was similar to that of monotherapy, with the common adverse events being mild headaches and gastrointestinal distress. No new safety concerns have emerged, suggesting the viability of combination therapy for long-term AR management. However, the potential neuropsychiatric effects of montelukast require further monitoring. Despite some methodological limitations, evidence supports the incorporation of fexofenadine and montelukast combination therapy into the clinical guidelines for AR management, providing an effective, well-tolerated, and flexible treatment option to reduce symptoms and improve patient outcomes.