Recommended Dosage of Levocetirizine and Montelukast Combination for Pediatric Age Groups

Dosing by Age Group

For pediatric patients, the American Academy of Pediatrics recommends levocetirizine and montelukast combination therapy should be dosed according to age: children 6-14 years should receive montelukast 5 mg with levocetirizine 5 mg once daily in the evening; children 2-5 years should receive montelukast 4 mg with levocetirizine 1.25 mg twice daily; and children 1-2 years should receive montelukast 4 mg with levocetirizine 0.125 mg/kg twice daily 1
The American Academy of Allergy, Asthma, and Immunology recommends montelukast 4 mg chewable tablet once daily in the evening for children 2-5 years 2, 3
The British Association of Dermatologists recommends levocetirizine 1.25 mg twice daily for children 2-5 years 4

The European Respiratory Society notes that levocetirizine has a longer elimination half-life (24-30 hours) in older children and adults, supporting once-daily dosing 1

The American College of Allergy, Asthma, and Immunology recommends evening administration for montelukast based on its pharmacodynamic profile 1
The National Institute for Health and Care Excellence recommends levocetirizine dose adjustment in patients with moderate renal impairment 4, 1
The FDA recommends montelukast 4 mg chewable tablet for children 2-6 years of age based on safety data rather than efficacy data 2

The American Academy of Pediatrics recommends that montelukast and levocetirizine be administered without regard to food, though taking with meals may improve gastrointestinal tolerability 5

The dosing strategy for montelukast is based on achieving comparable systemic exposure to the adult dose, with a plasma half-life ranging from 2.7 to 5.5 hours in healthy young adults, resulting in minimal drug accumulation during once-daily dosing 5