ZILEUTON

What is zileuton (Zyflo)?

Zileuton is part of a class of medications known as leukotriene receptor antagonists. Leukotrienes, specifically LTC4, LTD4, and LTE4, are pro-inflammatory mediators heavily involved in the mechanisms behind asthma. When provoked, leukotrienes constrict the airways, making breathing harder. Zileuton blocks leukotrienes from closing the airways, effectively making breathing easier. 

What is the relationship between zileuton and long-COVID?

For patients suffering from inflammatory respiratory symptoms of long-COVID such as wheezing, cough, exercise intolerance, and trouble breathing, zileuton may play a role in mitigating these symptoms [1]. Patients with COVID-19 have been found to have high levels of LTE4, a member of the leukotriene family, in the lung space. Zileuton could help decrease these levels. Studies have only been conducted on montelukast, a medication in the same class as zileuton. One of these studies found that adding montelukast decreased cough severity, decreased cough paroxysms per day, and a shorter duration of cough [2]. Although no formal recommendations for zileuton to treat long-COVID have been made, there is some potential for zileuton to aid in pulmonary symptoms associated with long-COVID.

¹https://www.frontiersin.org/articles/10.3389/fphar.2022.784214/full

²https://doi.org/10.1186/s43168-022-00154-6