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Montelukast (brand name Singulair) is a leukotriene receptor antagonist which is used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergies.
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Singulair is used to prevent asthma attacks in adults and children as young as 12 months old.
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Prophylaxis 10 mg PO 2 hours before exercise; do not take additional dose within 24 hours If taking drug for another indication, do not take additional dose to prevent exercise-induced bronchospasm (EIB) Patients aged ≥12 years with both asthma and allergic rhinitis: 1 dose PO at bedtime Patients with allergic rhinitis: Dosing time may be individualized to patient needs Granules may be taken directly; mixed in applesauce, carrots, rice, or ice cream; or dissolved in 5 m L of breast milk or baby formula (administer within 15 minutes of opening) Abdominal pain (≥2%) Eczema (≥2%) Influenza (≥2%) Laryngitis (≥2%) Pharyngitis (≥2%) Viral infection (≥2%) Wheezing (≥2%) Dental pain (2%) Dizziness (2%) Dyspepsia (2%) Elevated liver function tests (2%) Fever (2%) Gastroenteritis (2%) Nasal congestion (2%) Otitis (2%) Rash (2%) Urticaria (2%) Bronchitis (≥1%) Cough (≥1%) Sinusitis (≥1%) Upper respiratory tract infection (≥1%) Hematologic: Increased bleeding tendency, thrombocytopenia Immunologic: Hypersensitivity reactions (eg, anaphylaxis, hepatic eosinophilic infiltration) Psychiatric: Agitation, including aggressive behavior or hostility, anxiousness, depression, disorientation, dream abnormalities, hallucinations, insomnia, irritability, restlessness, somnambulism, suicidal thinking and behavior (including suicide), tremor Neurologic: Drowsiness, paresthesia or hypesthesia, seizures Cardiac: Palpitations Respiratory, thoracic, mediastinal: Epistaxis, pulmonary eosinophilia Gastrointestinal: Diarrhea, dyspepsia, nausea, pancreatitis, vomiting Hepatobiliary: Cases of cholestatic hepatitis, hepatocellular liver injury, and mixed-pattern liver injury have been reported, mostly occurring in combination with other confounding factors (eg, use of other medications, administration to patients who had underlying potential for liver disease [eg, alcohol use or other forms of hepatitis]) Dermatologic: Angioedema, bruising, erythema multiforme, erythema nodosum, pruritus, urticaria Musculoskeletal: Arthralgia, myalgia (including muscle cramps) General: Edema Not to be given for acute asthma attacks, including status asthmaticus Advise patients to have appropriate rescue medication available Inhaled corticosteroid may be reduced gradually; do not abruptly substitute montelukast for inhaled or oral corticosteroids Patients with known aspirin sensitivity should continue to avoid aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) while taking montelukast; not to be given for treatment of bronchoconstriction resulting from aspirin or NSAID intake Neuropsychiatric events (eg, abnormal dreams, agitation) reported Systemic eosinophilia reported, sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome; these events are usually (but not always) associated with tapering of PO corticosteroid therapy Use with caution in phenylketonuria; 4-mg and 5-mg chewable tablets contain phenylalanine The above information is provided for general informational and educational purposes only.
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