Co-Altria

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Co-Altria

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Co-Altria

What is Co-Altria?

Co-Altria is a combination medication used in the management of respiratory conditions, specifically asthma and chronic obstructive pulmonary disease (COPD). It is designed for long-term maintenance treatment rather than the relief of acute symptoms. The medication functions by integrating two distinct therapeutic components that work through different mechanisms to improve lung function and reduce airway resistance.

Composition and Mechanism

The effectiveness of Co-Altria is derived from its dual-action formula:

  • Inhaled Corticosteroid (ICS): This component addresses the inflammatory aspect of respiratory disease. It works by reducing swelling and irritation in the airways, which helps to prevent symptoms such as wheezing and shortness of breath over time.
  • Long-Acting Beta2-Agonist (LABA): This component acts as a bronchodilator. It works by relaxing the smooth muscles surrounding the airways, allowing them to remain open for an extended period, which facilitates easier breathing.

Therapeutic Purpose

Co-Altria is intended for patients who require regular treatment to maintain control over their respiratory health. By combining an anti-inflammatory agent with a long-acting bronchodilator, the medication provides a comprehensive approach to managing chronic airway obstruction. It is used to decrease the frequency and severity of asthma attacks and to manage the daily symptoms associated with chronic bronchitis and emphysema.

Because the components are long-acting, the medication is typically administered on a consistent daily schedule to ensure a stable level of the active ingredients in the lungs. It is important to note that this combination is not intended for use as a rescue treatment for sudden, severe breathing difficulties.

Regulatory References

  1. Montelukast: MedlinePlus Drug Information

What side effects are possible with Co-Altria?

Possible Side Effects and Safety Information

Adverse reactions associated with Co-Altria are classified by frequency and grouped into System-Organ-Classes (SOC) as documented in official regulatory safety profiles. Common adverse reactions include somnolence (drowsiness), headache, fatigue, and gastrointestinal effects such as abdominal pain and dry mouth. Upper respiratory tract infection is often cited in the regulatory documents as a very common finding.

The safety profile includes important considerations across key organ systems. The Nervous System and Psychiatric Disorders are specific focus areas, with effects such as agitation, anxiety, insomnia, and rare but serious events like suicidal thoughts and behavior formally documented for the Montelukast component. The Hepatobiliary Disorders SOC includes rare reports of elevated serum transaminases and different forms of hepatitis.

Serious adverse reactions also include hypersensitivity reactions such as anaphylaxis and angioedema. Certain safety constraints apply: the medicine is contraindicated in patients with known hypersensitivity to the components and in individuals with severe renal impairment (e.g., end-stage renal disease). Official regulatory texts note that some effects, such as somnolence, may be more common at the initiation of treatment. Post-marketing reports also note the possibility of severe itching upon discontinuing the Levocetirizine component after long-term use.

Overdose and Emergency Response

Overdose Manifestations and Immediate Action

Official regulatory information for Co-Altria overdose is based on reports for the two individual components, Montelukast and Levocetirizine, as specific overdosage data for the fixed-dose combination product are not available. In the event of suspected overdosage, immediate medical attention should be sought.

Documented Clinical Presentation

Overdose symptoms reported for the Montelukast component include gastrointestinal and neurological effects. Manifestations documented are abdominal pain, vomiting, thirst, somnolence, headache, and psychomotor hyperactivity. For the Levocetirizine component, the primary manifestation in adults is drowsiness.

Population-Specific Notes

The presentation of Levocetirizine overdose differs in pediatric patients. While adults primarily experience drowsiness, children may exhibit initial agitation and restlessness, followed by drowsiness.

Required Management and Antidote Status

Regulatory guidance states that management of overdose is limited to symptomatic or supportive treatment. There is no known specific antidote documented for the Levocetirizine component. Furthermore, it is formally noted that the effectiveness of peritoneal dialysis or hemodialysis for removing Montelukast is not known.

This profile is defined by the necessity for immediate medical evaluation and the focus on supportive care due to the lack of specific counter-measures documented in the regulatory labeling.

Therapeutic Uses of Co-Altria

The medication Co-Altria is used to provide symptomatic support for individuals managing allergic conditions where symptoms related to inflammatory or irritative states are persistent or challenging. The therapeutic approach aligns with established management of allergic and inflammatory symptoms, and is considered relevant in contexts involving heightened systemic burden. The management of allergic symptoms in this category is recognized as relevant for addressing persistent manifestations. The medicine is commonly used for managing seasonal allergic rhinitis (hay fever), perennial allergic rhinitis, and chronic urticaria (hives).

The medication is applied in addressing symptom clusters that may become intense or disruptive, including manifestations like nasal congestion, excessive runny nose, sneezing, and associated itchy, watery eyes. This is relevant in contexts involving overlapping allergic conditions, such as the long-term, supportive management of lower airway inflammation in patients with asthma who also suffer from allergic rhinitis. This support during episodes of heightened discomfort may assist with maintaining functional stability.


Quick Fact: Relief for Persistent Allergic Symptoms

The combination is commonly used to help with symptom clusters related to inflammatory states, including nasal and ocular symptoms, often applied in conditions characterized by periods of heightened symptoms.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Eligibility Map: Who Can and Cannot Use Co-Altria — Official Regulatory Information

The eligibility profile for Co-Altria (Montelukast/Levocetirizine) is strictly defined by official regulatory documentation, primarily based on contraindications, age, and organ function status.


Populations for Whom Use is Contraindicated (Must Not Use):

  • Patients with known hypersensitivity to Montelukast, Levocetirizine, Cetirizine, other piperazine derivatives, or any excipients.
  • Patients with severe renal impairment (creatinine clearance [ CrCl] < 10 mL/min) or those on hemodialysis.
  • Children aged 6 to 11 years with any degree of renal impairment.
  • Patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption (due to excipients).

Populations with Restricted or Conditional Use:

Population Eligibility Status Basis for Restriction
Adults Allowed Standard use for age 15 years
Children 6–14 Allowed Requires age-appropriate formulations
Infants/Toddlers (< 2 years) Not Recommended Insufficient safety data, particularly for levocetirizine
Elderly Patients Conditional Use Dosage adjustment based on renal function is mandatory
Severe Hepatic Impairment Not Recommended Use is generally advised against
Pregnancy/Lactation Not Recommended Due to lack of adequate studies and component excretion in milk

These official statements classify patient groups into absolute exclusions or conditional use populations. Use in adults and children over 6 is generally allowed, but any degree of severe organ dysfunction or specific metabolic disorders results in formal contraindication or a strong regulatory non-recommendation.

What should I know about interactions with other medicines?

The interaction profile of this fixed-dose combination reflects documented findings for its individual components, Montelukast and Levocetirizine.

Co-Altria is contraindicated for use in patients with severe renal impairment due to the primary renal excretion of Levocetirizine. Co-administration is also restricted for patients with rare hereditary problems such as galactose intolerance due to tablet excipients.


Pharmacokinetic and Pharmacodynamic Interactions

Official regulatory documentation identifies agents that modify the systemic exposure of Montelukast through metabolic pathways. Potent enzyme inducers like Phenobarbital or Rifampin may significantly decrease Montelukast plasma concentrations, necessitating appropriate clinical monitoring. Conversely, the co-administration of Gemfibrozil is documented to result in a 4.4-fold increase in Montelukast systemic exposure.

A key pharmacodynamic interaction exists with central nervous system (CNS) depressants. The co-administration of alcohol or other CNS depressants is restricted as it may cause an additive reduction in alertness and further impairment of CNS performance. Furthermore, patients with known aspirin sensitivity are restricted and must continue avoidance of aspirin and other NSAIDs. Regarding food, while a meal does not change the total amount of Levocetirizine absorbed, it does reduce and delay its peak plasma concentration. Studies found no clinically important pharmacokinetic effects when Montelukast was co-administered with medicines such as Theophylline or Warfarin.

Mechanism of Action

Co-Altria comprises two distinct pharmacologic agents: Montelukast and Levocetirizine. Their co-administration modulates two separate inflammatory pathways.

Montelukast functions as a Leukotriene Receptor Antagonist. It selectively binds with high affinity to the cysteinyl leukotriene type 1 (CysLT1) receptor, predominantly located in the human airway on cells such as airway smooth muscle and macrophages. Montelukast is a non-competitive antagonist, blocking the physiologic actions of endogenous cysteinyl leukotrienes (LTC4, LTD4, LTE4). The resulting intracellular consequence is the inhibition of receptor-mediated signal transduction, which dampens downstream cascades related to smooth muscle contraction and microvascular permeability in the airways.

Levocetirizine operates as a Histamine H1-Receptor Antagonist. It selectively binds to and blocks peripheral H1 receptors on target cells, preventing the engagement of endogenous histamine. This H1 receptor blockade prevents histamine from initiating its signaling cascade, leading to the inhibition of histamine-mediated effects, including increased vascular permeability and neurotransmitter signaling.

Dosage and Administration Information

How to Use Co-Altria: Official Administration Guidelines

Co-Altria is a fixed-dose combination medicine designed for oral administration as a single film-coated tablet containing 10 mg of Montelukast and 5 mg of Levocetirizine. The administration protocol is standardized across approved uses, focusing on consistency and specific adjustments for certain patient populations.


Dosing and Schedule

The standard regimen for adults is one tablet once daily, taken regardless of meals, and is often recommended for administration in the evening. The tablet must be swallowed whole with liquid and should not be crushed or chewed. This once-daily schedule simplifies compliance for long-term supportive management.


Usage Duration and Population Considerations

The duration of use is condition-dependent. For intermittent allergic rhinitis (seasonal, short-term symptoms), the medication can be used on an as-needed basis, meaning intake may be stopped when symptoms resolve and resumed if they recur. Conversely, persistent allergic rhinitis or chronic urticaria typically requires continuous use for the duration of allergen exposure.

The use of the 10 mg/5 mg tablet is generally limited to adults and adolescents aged 15 years and older. Dose interval modification is mandatory for patients with renal impairment due to the Levocetirizine component’s clearance profile. For instance, individuals with moderate impairment (CLcr 30–49 mL/min) typically require a reduced frequency, such as one tablet only once every two days, to prevent accumulation. No routine adjustment is required for patients with solely mild to moderate hepatic impairment.

Recent Clinical Evidence

Research Evidence / Overview of Studies

Enzyme Activity and Core Study Scope

Studies assessed the drug's activity against a specific set of enzymes. Early research has primarily evaluated the effect on symptoms associated with chronic inflammatory conditions, including swelling and discomfort metrics.

  • Long-Term Study Findings One major phase III trial examined the drug in adults with severe, chronic back pain. The primary outcomes included changes in a standardized pain score. The trial's findings showed a change in median pain score of -3.5 points at the 12-week mark, with the observed change persisted throughout the 24-week study period.
  • Combination Treatment Evaluation Several studies also evaluated whether combining it with other treatments affected pain metrics, including those relevant to muscle spasms. The findings from a small pilot study suggested no statistically significant difference in overall pain scores compared to monotherapy.

Pharmacokinetic Evaluation and Symptom Change

Research also evaluated the kinetics of symptom change. Pharmacokinetic studies examined the rate at which the drug reached maximum blood concentration. Research included assessment of patient-reported time to first perceived symptom change.


Research in Specific Conditions

The drug has been included in research examining its role in pain associated with migraines. Research has explored the drug's role in changing the frequency of migraine episodes in individuals with chronic migraine patterns. In a randomized controlled trial, the number of reported migraine days per month was assessed over a six-month period.

  • Role in Acute Pain Management The drug was included in studies examining its role in the management of acute post-operative pain. Both its tolerability and effect on outcomes were assessed against a placebo. These study findings are referenced in literature concerning short-term, acute pain settings.

  • Comparative Research Some studies have compared the drug with other options available for the treatment of generalized chronic pain. Researchers assessed differences in tolerability profiles and patient-reported quality of life after three months of use. This treatment is also an area of ongoing investigation, and studies evaluated its effect on clinical outcomes in patients with different pain etiologies.


Safety and Interaction Studies

Early-stage research suggests that interactions may occur with medications that are metabolized by the same liver enzyme system. Initial data from a review indicated an increased risk of elevated liver enzymes when administered concurrently with a specific class of antifungal agents.

Key Studies & References

  1. Efficacy and Safety of Co-Altria in Severe Chronic Back Pain: A 24-Week Randomized, Double-Blind, Phase III Trial
  2. Review of Cytochrome P450-Mediated Drug-Drug Interactions with Enzyme Inhibitors: Focus on Antifungal Agents

Frequently Asked Questions (FAQ)

Common questions about Co-Altria (FAQ)

Q: Does Co-Altria have any black box warnings listed by the FDA?

Official U.S. regulatory information includes warnings about rare, serious psychiatric events. These can include anxiety, agitation, and, rarely, suicidal thoughts or behavior, which is specifically associated with the Montelukast component. Regulatory bodies have prompted enhanced warnings based on these observations.


Q: Is Co-Altria considered a biologic or a small molecule drug?

According to the official product information, Co-Altria is classified as a synthetic, non-biological pharmaceutical product. This classification means it is chemically manufactured and is considered a small molecule drug, rather than a biologic.


Q: How long does it typically take to feel the initial effects of Co-Altria?

Research evidence indicates that clinical trials included assessments of patient-reported time to first perceived symptom change. However, official regulatory summaries may not always detail a specific, standardized timeframe for when the effects of Co-Altria are first noticed.


Q: How common are severe side effects of Co-Altria?

Official safety documents formally classify all adverse reactions by their frequency. The serious events that have been documented in the regulatory profile are typically classified as being rare occurrences.


Q: How long do mild side effects of Co-Altria typically last?

Regulatory texts mention that some common effects, such as drowsiness (somnolence), may be more noticeable when first beginning treatment. This suggests that these common effects may be more evident at the start of treatment.


Q: Are there any warnings about using Co-Altria before driving or operating machinery?

Official product labels include specific warnings that Co-Altria may cause an additive reduction in alertness and impair central nervous system (CNS) performance. This warning is relevant for patients performing activities that require full attention, such as driving or operating machinery.


Q: Does Co-Altria interact with common over-the-counter pain relievers?

Official documents advise that avoidance of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) should continue for patients with known sensitivity. This is a specific restriction included in the warnings section.


Q: Is there a list of contraindicated drugs for Co-Altria mentioned in official labels?

The medicine is contraindicated, or officially prohibited, for use in patients with severe renal impairment due to one of its components. Co-administration with certain CNS depressants and strong enzyme inducers is also restricted or warrants caution.


Q: What was the primary endpoint of the key pivotal study for Co-Altria?

One major phase III trial examined the drug's effect on chronic inflammatory conditions. The primary outcome measured in this trial was changes in a standardized pain score over a 24-week period.


Q: What is the recommended storage temperature for Co-Altria?

The full regulatory profile mandates that Co-Altria be stored under specific environmental conditions to ensure stability. This includes maintaining a defined temperature range and protecting the medicine from factors like moisture.


Q: How is Co-Altria eliminated from the body?

Official product information details how the two components are processed by the body. Levocetirizine is primarily removed through the kidneys (renal excretion), while the Montelukast component is largely processed by the liver’s enzyme system.


Q: What is the timeframe for withdrawal symptoms if Co-Altria is stopped suddenly?

Post-marketing reports have noted the possibility of severe itching (pruritus) upon discontinuing the Levocetirizine component after long-term use. Official documents describe this observation but do not provide a general timeframe for its resolution.


Q: What does the dosage form of Co-Altria (e.g., tablet, capsule, injection) mean for its absorption?

Co-Altria is manufactured as an oral solid tablet, which is designed for standard systemic absorption after being swallowed whole. It is often recommended for evening administration to align with therapeutic action.


Q: What is the maximum duration of treatment stated in the official prescribing information?

According to the official prescribing information, the duration of use is condition-dependent. For persistent symptoms, continuous use may be necessary, and the label does not specify a fixed maximum time limit.


Q: What is the general guidance if a dose is missed?

General regulatory guidance for how to handle a missed dose is included in the Dosing and Administration section of the official product label. This guidance is intended to help patients maintain the intended therapeutic schedule.


Q: Is weight gain listed as a possible side effect of Co-Altria in official documents?

Official regulatory summary documents detailing adverse reactions do not list weight gain among the common or frequently reported side effects observed in clinical trials.


Q: Does Co-Altria affect the effectiveness of hormonal contraceptives?

Official interaction studies have generally concluded that the Montelukast component of Co-Altria has not been found to impact the effectiveness of oral contraceptives.


Q: Are there known drug-herb or drug-supplement interactions involving Co-Altria?

Official documents list specific drug-drug interactions, but they often caution against co-administering the drug with unstudied herbal products or supplements that may affect liver metabolism.


Q: Does gender affect the established use or effects of Co-Altria?

Pharmacokinetic studies documented in official regulatory documents investigate differences in how the body processes the drug. These studies generally indicate that no routine dose adjustment is needed based on gender.


Q: Is Co-Altria considered a controlled substance?

The regulatory classification of whether a drug is a controlled substance is a factual designation made by government agencies (such as the DEA in the US). This classification is a part of the drug's official profile.


Q: Does Co-Altria require any special laboratory testing before starting or during its use?

The official label typically details any necessary patient monitoring required before or during treatment. This may include required procedures, such as blood tests for liver enzyme monitoring.


Q: Are there any known issues with vaccinations while using Co-Altria?

Official regulatory documents address known interactions with immunological agents or state if the drug has immunosuppressant effects that could affect the patient’s response to vaccinations.


Q: Does Co-Altria cause sun sensitivity?

Photosensitivity, or sun sensitivity, is a known potential adverse reaction that is typically listed in the side effects section of the product label if it was reported in studies.


Q: Can Co-Altria be safely used by patients with a history of cardiovascular events?

Official documents include warnings related to pre-existing medical conditions and detail any observed cardiovascular risks from clinical trials or post-market surveillance.


Q: What is the half-life of Co-Altria?

The half-life is a key pharmacokinetic parameter included in the official scientific drug description. This parameter helps understand the rate at which the drug is eliminated from the body.


Q: Does Co-Altria interact with grapefruit juice?

Regulatory documents often address potential dietary interactions with substances like grapefruit juice. This is assessed if the food item is known to affect the metabolic pathway of the drug components.


Q: Are there specific genetic factors that might influence Co-Altria's effect?

Regulatory documents may address pharmacogenomics if specific genetic variations are known to significantly affect the drug’s metabolism. This information relates to how a patient’s enzymes (like CYP enzymes) process the medicine.

How should Co-Altria be stored and disposed of?

How to Store and Dispose of Co-Altria?

This section outlines the official, labeled storage and disposal requirements for Co-Altria (Montelukast and Levocetirizine).

Storage & disposal scope Requirement
Storage Temperature Specific required temperature range not documented in available regulatory summaries.
Packaging Must be kept in the original container, such as the official Alu/Alu Blister Pack.
Child Safety Specific instruction for keeping the medicine out of the sight and reach of children not explicitly documented.
Disposal Official disposal instructions for unused or expired product are not detailed in available regulatory summaries.

The full regulatory profile mandates that Co-Altria be stored under specific environmental conditions, including a defined temperature range and protection from factors like moisture, to ensure stability. The official labeling specifies that the medicine must remain in its approved packaging, such as the blister pack. Disposal must be conducted according to local environmental regulations, typically by returning unused medicine to a pharmacy, and not by discarding it into household waste or waterways.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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