Contrary to what had been expected, new research shows that non-prescription pseudoephedrine controls nasal allergy symptoms just as well as the more expensive prescription drug Singulair, also known by its generic name, montelukast.

In fact, for nasal congestion, pseudoephedrine may provide better relief.

“We had expected the drugs to perform similarly in controlling nasal congestion, but we thought montelukast would provide better relief against sneezing, (runny nose), and nasal itching,” Dr. Fuad M. Baroody, from the University of Chicago, told Reuters Health. “We were surprised that both drugs did about the same.”

While pseudoephedrine is known to be an effective treatment for nasal congestion caused by allergies, it was not thought to be particular useful against other symptoms. Moreover, some people who take pseudoephedrine experience side effects such as insomnia and nervousness.

Baroody’s team anticipated that treatment with montelukast would provide broader symptom relief than pseudoephedrine and would be better tolerated.

The study, which appears in the Archives of Otolaryngology - Head and Neck Surgery, involved 58 adults allergic to ragweed who were randomized to receive a once-daily morning dose of pseudoephedrine or montelukast for 2 weeks.

Treatment with either agent provided similar and significant improvements in all aspects of quality of life. As noted, pseudoephedrine was more effective than montelukast at controlling nasal congestion, but otherwise the agents provided comparable symptom relief.

The tolerability of the agents was similar with no increase in insomnia or nervousness seen with pseudoephedrine. The researchers chalk this up to pseudoephedrine being given as one higher dose in the morning, rather than as two or more lower doses given throughout the day as is often done.

“When people pick up pseudoephedrine over the counter, most of them pick up the twice-a-day dosing,” Baroody noted. “If you take a dose before bedtime, there’s a good chance that you will experience insomnia or jitteriness.”

People “can start with pseudoephedrine, take it, and if it doesn’t give you side effects then you’re fine,” Baroody advised. “But, if it gives you side effects or you’re not getting complete relief, there are a number of prescription medications that are more effective,” he emphasized.

SOURCE: Archives of Otolaryngology - Head and Neck Surgery, February 2006.