inhaled corticosteroid + long-acting beta-agonist + montelukast

The drug combination "inhaled corticosteroid + long-acting beta-agonist + montelukast" is a triple therapy approach used primarily for asthma management. This combination includes three distinct medication classes that work through different mechanisms to control asthma symptoms. ## Description This is a combination therapy consisting of three components: 1. **Inhaled Corticosteroids (ICS)**: Anti-inflammatory medications that reduce airway inflammation, a key component of asthma pathophysiology. Examples include fluticasone, budesonide, mometasone, and beclomethasone[1][4]. 2. **Long-Acting Beta-Agonists (LABA)**: Bronchodilators that relax airway smooth muscles for up to 12-24 hours, improving airflow. Common LABAs include salmeterol, formoterol, and vilanterol[2][3][7]. 3. **Montelukast**: A leukotriene receptor antagonist that blocks the effects of leukotrienes, which are inflammatory mediators involved in both asthma and allergic rhinitis[4][6]. This triple therapy approach is typically used for patients with moderate to severe asthma who remain symptomatic despite treatment with an ICS/LABA combination. Montelukast is added as a third controller medication to improve asthma control and potentially reduce the required dose of inhaled corticosteroids[1][6]. ## Clinical Evidence Research shows that montelukast can be effective as add-on therapy for patients with asthma and concurrent allergic rhinitis who remain uncontrolled on ICS or ICS/LABA therapy[1]. However, studies have also demonstrated that the combination of a leukotriene receptor antagonist (like montelukast) and a LABA is inferior to the combination of an ICS and a LABA for asthma control[2][3]. The triple therapy approach (ICS + LABA + montelukast) is particularly beneficial for patients with both asthma and allergic rhinitis, as montelukast is effective for both conditions[6]. ## Administration This combination is not available as a single inhaler or product. Instead, patients typically use: - An ICS/LABA combination inhaler (such as Breo Ellipta, Dulera, or Wixela Inhub)[7] - Oral montelukast tablets (brand name Singulair) taken separately[4] ## Side Effects Potential side effects include: - ICS: Mouth and throat irritation, oral yeast infections - LABA: Increased risk of severe asthma attacks when used without an ICS - Montelukast: Rarely associated with psychological reactions including agitation, aggression, hallucinations, depression, and suicidal thinking[4]

Other names

ICS/LABA + montelukastinhaled corticosteroid/LABA + montelukast