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Case Report


Usefulness of montelukast to prevent adverse reactions to COX-2 selective inhibitors: a case report


C. Serrano, A. Valero, C. Picado

Allergy Unit. Hospital Clínic. Barcelona. Spain

J Invest Allergol Clin Immunol 2005; Vol. 15(2): 156-157



Summary. Nonsteroidal anti-inflammatory drug (NSAID)-sensitivity is a frequent condition in patients with chronic urticaria and/or asthma. The physiopatologic process underlying respiratory and cutaneous reactions probably involves an increased production of cysteinyl leukotrienes. Cyclooxygenase 2 (COX-2) selective inhibitor, has been proposed as the main alternative to control pain and inflammatory diseases in these patients. However, a small percentage of patients with NSAID-induced skin reactions does not even tolerate COX-2 selective inhibitors.
We report a very infrequent case of a patient with NSAID, paracetamol and COX-2 selective inhibitors sensitivity in whom we induced tolerance to paracetamol and celecoxib using the leukotriene receptor antagonist montelukast prior to oral challenges.

Key Words: celecoxib, montelukast, NSAID sensitivity, paracetamol