Montelukast for symptom control of interstitial cystitis

OBJECTIVE: To describe the effects of montelukast, a leukotriene receptor antagonist commonly used in the treatment of allergic rhinitis and asthma, on the symptoms of interstitial cystitis (IC). CASE SUMMARY: A 64-year-old male had a history of IC with previous trials of solifenacin, dutasteride, and tamsulosin and little improvement in IC symptom reduction. When montelukast 10 mg was initiated for allergic rhinitis symptoms, a substantial improvement in urinary urgency and pain during therapy was noted. This improvement subsequently disappeared when montelukast was stopped. DISCUSSION: IC, a rare occurrence in the male population, is related to an inflammatory process and has also been associated with inappropriate leukotriene release, which is the target of montelukast therapy. In general, treatment for IC includes systemic medical therapy, local bladder treatment, surgical and neurosurgical procedures, and intravesical drug installation. Currently, montelukast is Food and Drug Administration approved for use in the treatment and prevention of mild-to-moderate asthma and exercise-induced asthma, as well as treatment of seasonal and perennial allergic rhinitis. While montelukast treatment did not cure the patient's IC, it improved his quality of life through substantial symptomatic relief, including less pain and urgency. CONCLUSIONS: Montelukast may be an effective treatment option in the management of interstitial cystitis. Further research is needed to substantiate this novel use.