Levocetirizine 5mg tablets

IntroductionOral H1 antihistamines are the first-line treatment for patients with allergic rhinitis, while it is uncertain which kind and dosage of the antihistamines are more effective in improving symptoms of patients.ObjectiveTo evaluate the efficacy of different oral H1 antihistamine treatments on patients with allergic rhinitis by performing a network meta-analysis.MethodsThe search was executed in PubMed, Embase, OVID, the Cochrane Library and ClinicalTrials.gov for relevant studies. The network meta-analysis was performed by using Stata 16.0, and the outcome measures of the analysis were symptom score reductions of patients. Relative risks with 95% Confidence Intervals were used in the network meta-analysis to compare the clinical effect of treatments involved, and Surface Under the Cumulative Ranking Curves (SUCRAs) were also calculated to rank the treatments' efficacy.Results18 eligible randomized controlled studies, involving a total of 9419 participants, were included in this meta-analysis. All the antihistamine treatments outperformed placebo in total symptom score reduction and each individual symptom score reduction. According to the results of SUCRA, rupatadine 20 mg and rupatadine 10 mg were ranked relatively high in reductions of total symptom score (SUCRA: 99.7%, 76.3%), nasal congestion score (SUCRA: 96.4%, 76.4%), rhinorrhea score (SUCRA: 96.6%, 74.6%) and ocular symptom score (SUCRA: 97.2%, 88.8%); rupatadine 20 mg and levocetirizine 5 mg were ranked relatively high in reductions of nasal itching score (SUCRA: 84.8%, 83.4%) and sneezing score (SUCRA: 87.3%, 95.4%); loratadine 10 mg was ranked the lowest in each symptom score reduction besides placebo.ConclusionThis study suggests that rupatadine is the most effective in alleviating symptoms of patients with allergic rhinitis among different oral H1 antihistamine treatments involved, and rupatadine 20 mg performs better than rupatadine 10 mg. While loratadine 10 mg has inferior efficacy for patients to the other antihistamine treatments.

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Allergic rhinitis (AR) significantly impairs quality of life and often necessitates combination therapies for optimal symptom control. This study aimed to evaluate the efficacy of montelukast-antihistamine combination therapy in patients with AR by using a network meta-analysis. A comprehensive search was conducted using PubMed, Embase, MEDLINE, Scopus, the Cochrane Library, and Google Scholar up to April 2025. The treatment strategies included montelukast alone, antihistamine monotherapies (loratadine, desloratadine, levocetirizine, and fexofenadine), their respective combinations with montelukast, including bilastine. Outcomes included daytime and nighttime symptom scores, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and individual symptoms. Both pairwise and network meta-analyses were conducted. Thirty studies (4,486 patients) were included. Montelukast combinations with desloratadine (standardized mean difference [SMD] = -0.51), levocetirizine (SMD = -0.44), and loratadine (SMD = -0.31) significantly improved daytime nasal symptoms compared to montelukast alone. Only montelukast-levocetirizine improved nighttime symptoms (SMD = -0.21) and RQLQ (SMD = -0.48). The combinations with desloratadine or levocetirizine were superior for nasal obstruction, sneezing, and itching, while nasal discharge improved only with montelukast-levocetirizine. No treatment significantly improved eye symptoms. Surface under the cumulative ranking curve rankings generally favored combination therapies, though trends varied by outcome. Desloratadine monotherapy ranked highest for nasal itching. Although some comparisons require cautious interpretation, montelukast-based combination therapy demonstrated greater efficacy than monotherapy for multiple AR symptoms. These results highlight the importance of selecting therapeutic strategies based on the predominant symptom profile of individual patients.

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BackgroundAllergic rhinitis (AR) is an atopic condition affecting over 400 million people worldwide, impairing quality of life and often leading to complications such as asthma and sinusitis. Montelukast, a leukotriene receptor antagonist, is often used in combination with second-generation antihistamines (sgAHs) to enhance symptom control. However, the relative efficacy of different montelukast-sgAH combinations remains unclear.ObjectiveTo evaluate and compare the efficacy of montelukast combined with various sgAHs versus montelukast monotherapy in patients with AR.MethodsRandomized controlled trials (RCTs) comparing montelukast-sgAH combinations to montelukast alone were identified from 5 electronic databases up to 2025. Outcomes included Total Nasal Symptom Score (TNSS; 0-12), Daytime and Nighttime Nasal Symptom Scores (DNSS, NNSS; 0-3), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ; 0-6). Risk of bias (RoB) was assessed using Cochrane RoB 2.0. A frequentist network meta-analysis with subgroup analysis and meta-regression was performed using RStudio and Jeffreys's Amazing Statistics Program.ResultsSeventeen RCTs involving 2,655 participants were included. For TNSS improvement, montelukast + desloratadine combination is significantly better than monotherapy in adults (mean difference [MD] = -0.92 [-1.15 to -0.69]) and children (MD = -1.95 [-3.46 to -0.44]). Effects on RQLQ and DNSS were inconsistent, while NNSS improved with montelukast-levocetirizine (P = 0.0384). Heterogeneity was high, but most studies showed low risk of bias. No serious adverse events were reported.ConclusionMontelukast-sgAH combinations may improve symptoms over monotherapy, especially with desloratadine in both adults and children. However, variability across outcomes and high heterogeneity warrant cautious interpretation and further research.

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BackgroundAllergic rhinitis is largely treated by using antihistamines and nasal sprays, either alone or in combination. However, these measures ease out the symptoms but do not address causative factors, and have their share of side effects and limitations. An Ayurvedic herbo-mineral formulation, IMMBO, has been reported to be effective in treating allergic rhinitis.ObjectiveThe present study was carried out to evaluate the efficacy, safety, and tolerability of the Ayurvedic herbo-mineral formulation in comparison with a fixed-dose combination of levocetirizine and montelukast.MethodThis was a randomized, comparative, clinical study carried out on 250 patients at a medical college in India. The patients were enrolled according to the eligibility criteria of the study and randomized into two groups, to receive either Ayurvedic herbo-mineral formulation, IMMBO, or a combination of levocetirizine and montelukast for 28 days. Total nasal symptom score (TNSS) and Immunoglobulin E (IgE) were calculated for evaluation of efficacy parameters.  Result: At the end of therapy both IMMBO and levocetirizine and montelukast combination showed significant improvement in TNSS in both treated population and per protocol population. The IMMBO group had a statistically higher reduction in TNSSs compared to the levocetirizine + montelukast group (-5.70 vs. -3.31; p<0.01). There was a statistically significant difference in the reduction of IgE levels between the groups (-351.54 vs. -208.79; p<0.05).  Conclusion: The findings of this study establish prima facie evidence about the efficacy and safety of Ayurvedic formulation. However, the said Ayurvedic formulation needs to be further developed scientifically.

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