Montelukast
What is it?
Montelukast is a medication used primarily to control and prevent the symptoms of allergic rhinitis and asthma. The brand name for this medication in the U.S. is Singulair.
It is in a class of medications known as leukotriene receptor antagonists.
It works by blocking the receptor for a chemical produced by the body known as leukotriene D4.
Inflammatory reactions in the body are really quite complex chain reactions.
Leukotriene D4 binding to its receptor is one step in the chain reaction involved in the development of allergic and asthmatic reactions.
The medication blocks the ability of Leukotriene D4 to bind to its receptor, and thus blocks the reaction at this step.
This medicine is not something that one takes when they are having an allergy or asthma attack. It won’t really do too much good once the reaction is already taking place.
Instead, this medicine is taken on a regular scheduled basis (usually every 24 hours at bedtime) and works to prevent reactions.
As mentioned, it is marketed under the brand name Singulair.
What is the normal dose?
It is available in 4mg, 5mg, and 10mg tablets. It is available as regular tablets, as chewable tablets, and as granules.
The usual dose for adults is 10mg daily.
For kids 1-5 years old, it is usually 4mg daily.
For kids 6-14 years old, it is usually 5mg daily.
For kids above 14 years old, the adult dose is usually given.
It is also used for kids 6-23 months old for allergic rhinitis at a dose of 4mg.
It is also used on an as needed basis for prevention of exercise induced asthma in people 15 years and older. In this scenario, it is given at a dose of 10 mg given at least 2 hours prior to the exercise. The maximum dose is 10mg in a 24 hour period.
What are the side effects?
Like all medications, there are lots of potential side effects.
Common ones include headache, flu-like symptoms, abdominal pain, cough, dizziness, fatigue, asthenia (feeling week without actual loss of strength), rash, fever, gastroenteritis, elevated liver enzymes, itching, hives, ear infections and upper respiratory infections in kids.
Serious (and fortunately rare) side effects include angioedema, anaphylaxis, Churg-Strauss syndrome, hepatic eosinophilic infiltration, and hepatotoxicity.
Recently, there has been some news that medications in the same class as Montelukast might be associated with mood changes and suicidal thoughts. The FDA is investigating this.
Obviously, if you are experiencing any such thoughts either before taking this medication or while taking this medication, you should discuss this in detail with your doctor.
Are there any interactions with other medications, foods, etc?
There may be interaction with Amiodarone, barbiturates, carbamazepine, neverapine, paclitaxel, phenytoins, repaglinide, rifampin, and thiazolidinediones.
Before taking this medication, be sure to discuss any other medications you are taking with your doctor.
Is there anyone who should not take this medication?
This medication should be used with caution or not at all in anyone who is allergic to drugs in this class, anyone with sever liver disease or severe asthma, and anyone currently tapering off of systemic steroids.
Additionally anyone with Phenylketonuria (PKU) should discuss this with their doctor as some forms of Singulair (the chewable tablets) contain aspartame.
Additional Information:
For more information about this medication, please take a look at the patient leaflet published by the manufacturer.
This link was kindly provided by a French Monkey in Allemagne and is posted at his request.
