Levolukast is a brand name for a combination medication containing levocetirizine and montelukast, prescribed to children to manage allergic conditions and asthma. Levocetirizine is a second-generation antihistamine that blocks histamine, a chemical responsible for allergy symptoms like sneezing, runny nose, and itching. Montelukast is a leukotriene receptor antagonist, which blocks another chemical messenger (leukotriene) to reduce inflammation in the airways and nasal passages. While effective, the combination can cause a range of side effects that parents should be aware of. These side effects can vary in severity and depend on the child's age and overall health.
Common Side Effects
Most children tolerate Levolukast well, and many common side effects are temporary, resolving as the child’s body adjusts to the medication. It is important to monitor your child for these reactions and consult a doctor if they persist or cause significant discomfort.
- Drowsiness or Sleepiness: Levocetirizine, the antihistamine component, is known to cause drowsiness. This is one of the most frequently reported side effects and can affect a child's energy levels and alertness. Some children may feel more tired or weak than usual.
- Gastrointestinal Issues: Stomach pain, nausea, vomiting, diarrhea, or constipation are common, particularly in younger children. These symptoms are typically mild but should be managed with proper hydration and diet.
- Headache: Mild to moderate headaches can occur. If your child complains of persistent headaches, consult a doctor.
- Cold-like Symptoms: Nasopharyngitis (inflammation of the nose and throat), cough, and fever are reported, especially in children between 6 and 11 years old.
- Dry Mouth: The antihistamine component can cause dryness in the mouth.
Serious and Less Common Side Effects
Although less common, some side effects are more serious and require immediate medical attention. The montelukast component is particularly associated with neuropsychiatric effects.
Neuropsychiatric Changes
Parents and caregivers should closely observe for any changes in their child's mood or behavior. Studies have noted that neuropsychiatric reactions may be more prevalent than typically reported.
- Agitation and Irritability: Unexplained restlessness, anxiety, or aggression should be reported to a doctor immediately.
- Sleep Disturbances: Some children experience changes in their sleep patterns, including sleep difficulties, interrupted sleep, and nightmares.
- Mood Changes: Cases of depression, anxiety, and in very rare instances, suicidal thoughts have been associated with montelukast.
- Hyperactivity: Increased energy levels and hyperactivity have also been reported in some children.
Other Significant Reactions
- Severe Allergic Reactions: Anaphylaxis is a rare but life-threatening allergic reaction. Symptoms include a widespread rash, swelling of the face, tongue, or throat, and difficulty breathing. Seek immediate emergency help if these occur.
- Liver Problems: While rare, signs of liver issues, such as yellowing of the skin or eyes (jaundice), should be reported to a healthcare provider.
- Urinary Issues: Some children, especially those with pre-existing conditions, may experience painful or difficult urination.
Side Effects by Age Group
Different age groups may experience different side effects.
- Ages 1 to 5: Common side effects include fever, diarrhea, and vomiting. Some children in this group may also experience otitis media (middle ear infection).
- Ages 6 to 11: Common side effects include cough, fever, and sleepiness. Nosebleeds are also reported.
- Older Children: The side effects are similar to those in adults, with sleepiness and headache being most common.
Comparison of Levolukast Components' Side Effects
The side effect profile of Levolukast reflects the combined effects of its two active ingredients. The table below compares the common side effects associated with each component individually.
| Side Effect | Levocetirizine (Antihistamine) | Montelukast (Leukotriene Antagonist) |
|---|---|---|
| Drowsiness/Sleepiness | Very Common | Less Common, but can contribute |
| Headache | Common | Common |
| Gastrointestinal Issues | Diarrhea, vomiting | Abdominal pain, nausea |
| Fever | Common in children | Common |
| Mood/Behavior Changes | Less frequent, but reported | Significant risk, including agitation, anxiety, and depression |
| Allergic Reactions | Severe reactions possible | Severe reactions possible |
Managing Levolukast Side Effects
For minor side effects, specific strategies can help manage the symptoms.
- For Nausea and Upset Stomach: Giving the tablet with food can help alleviate stomach discomfort.
- For Diarrhea: Ensure your child drinks plenty of fluids, such as water or squash, to prevent dehydration.
- For Headaches: Encourage your child to rest and stay hydrated. A pharmacist or doctor can recommend appropriate painkillers if needed.
- For Sleepiness: Avoid activities that require alertness, like cycling or sports, until you know how the medication affects your child. Discuss the timing of doses with your doctor.
- For Mood and Behavior Changes: Immediately report any significant or unusual changes to your child's pediatrician. Do not stop the medication suddenly without medical guidance.
When to Seek Medical Attention
It is important to contact a healthcare provider if side effects are concerning or severe. Seek immediate medical help if your child experiences any of the following:
- Signs of a severe allergic reaction, including swelling of the face, lips, or tongue; hives; or trouble breathing.
- Worsening mood or behavior, such as agitation, aggression, or depression.
- Difficulty or pain during urination.
- Yellowing of the skin or eyes (jaundice).
Conclusion
Levolukast kid tablets provide effective relief for pediatric allergies and asthma, but they carry potential side effects, with some notable risks associated with the montelukast component. While common side effects are often mild and temporary, parents and caregivers must remain vigilant for more serious neuropsychiatric symptoms and severe allergic reactions. Adhering to the prescribed dosage, monitoring for any adverse reactions, and maintaining open communication with your child's pediatrician are the best ways to ensure a positive and safe treatment outcome. Never alter the dose or stop the medication abruptly without professional medical advice.
A note on research
While Levolukast is a brand name for a combination drug, research on its individual components, montelukast and levocetirizine, provides a thorough understanding of potential side effects. A study published in the National Institutes of Health journal (PMC) highlighted a higher prevalence of neuropsychiatric adverse drug reactions associated with montelukast than previously reported in children.
