Accolate
Meaning of Accolate: A preventer rather than a reliever, blocking one specific chemical pathway of asthma instead of damping inflammation broadly.
Definition of Accolate
Accolate is a brand name for zafirlukast, a tablet taken regularly to help prevent asthma symptoms. It blocks the receptors for leukotrienes, chemicals released during an allergic reaction that tighten the muscle around the airway, swell the lining and increase mucus. It acts over hours and days rather than minutes, so it does not relieve an attack already underway.
What are leukotrienes, and why block them?
When an allergic trigger reaches the airway, mast cells and other immune cells release a set of signaling chemicals. Leukotrienes are among the most powerful of them. They make the muscle wrapped around the airway contract, make the lining swell and leak, and drive mucus production, all of which narrow the tube air has to move through. Occupying the receptor they act on prevents that chain of events. The drug is a targeted antagonist rather than a broad anti-inflammatory, so its effect is narrower and more predictable than that of an inhaled steroid.
How does it fit alongside other asthma treatments?
| Treatment | Role | Speed |
|---|---|---|
| Short acting inhaler | Relieves an attack by relaxing airway muscle | Minutes |
| Inhaled steroid | Reduces airway inflammation broadly | Days to weeks |
| Leukotriene receptor blocker | Blocks one specific chemical pathway | Hours to days |
Because it is swallowed rather than inhaled, it is sometimes chosen where inhaler technique is a problem, and it also helps the allergic rhinitis that so often accompanies asthma. It is generally an addition to inhaled treatment rather than a replacement for it.
What matters in taking it?
Food substantially reduces how much of the drug is absorbed, so timing relative to meals affects how well it works. It raises the blood level of warfarin by slowing its breakdown in the liver, so clotting tests are watched when the two are combined. Liver injury has been reported and is occasionally serious, so symptoms such as persistent nausea, unusual tiredness or yellowing of the skin prompt liver testing.
How does it compare with montelukast?
Zafirlukast and montelukast act on the same receptor and serve the same purpose. Montelukast is taken once daily and is not affected by food, which has made it much the more widely prescribed of the two. Both carry warnings about changes in mood and behavior, including agitation, disturbed sleep and depression, reported in adults and in children. Neither relieves symptoms that are already present, and both work only while they are taken regularly.
Also known as
Used in a sentence
Zafirlukast, sold as Accolate, was added to inhaled therapy for persistent asthma with prominent allergic symptoms.
Good to know
Zafirlukast is a preventive treatment with no effect on an attack already in progress, and the amount absorbed falls substantially when it is taken with food.