Pharm

Montelukast

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Montelukast, Singulair

  • See Also
  1. Leukotriene Receptor Antagonist
  2. Zafirlukast
  3. Zileuton
  1. Moderate Persistent Asthma
  2. Severe Persistent Asthma
  3. Moderate Chronic Obstructive Pulmonary Disease
  4. Aspirin-induced Asthma
  5. Exercise-Induced Bronchospasm
  6. Allergic Rhinitis
  • Medications
  • Montelukast
  1. Tablets 10 mg
  2. Oral granules 4 mg
    1. May be mixed with other foods (not with liquids) and taken within 15 minutes
  3. Chewable tablets 4 mg, 5 mg
    1. Containdicated in Phenylketonuria (contain Phenylalanine)
  • Dosing
  1. Asthma or Allergic Rhinitis
    1. Adults: 10 mg orally at bedtime
    2. Child age 6 to 14 years: 5 mg orally at bedtime
    3. Child age 2-5 years: 4 mg orally at bedtime
  2. Exercise-Induced Bronchospasm (EIB)
    1. Children age >=6 years or adults: 10 mg orally taken 2 hours before Exercise
    2. Limit to one dose (10 mg) daily
      1. Do NOT take a dose for Asthma/allergy AND a dose for EIB
  • Mechanism
  1. Attenuates bronchoconstriction and inflammation
  2. Leukotriene Receptor Antagonist (competitive inhibitor at D4 and E4 receptors)
    1. Similar to Zafirlukast (Accolate)
    2. Contrast with Leukotriene Synthesis Inhibitor (Zileuton or Zyflo)
  • Adverse Effects
  1. See Leukotriene Receptor Antagonist
  2. Dyspepsia
  3. Montelukast is associated with increased risk of Major Depression and Suicide
    1. Black box warning as of 2020
    2. https://www.fda.gov/news-events/press-announcements/fda-requires-stronger-warning-about-risk-neuropsychiatric-events-associated-asthma-and-allergy
  • Efficacy
  1. See See Leukotriene Receptor Antagonist
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Drug Interactions
  1. Montelukast levels decreased by other drugs
    1. Phenobarbital
    2. Rifampin
  • Resources
  1. Montelukast (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7636a692-558f-4649-86d9-b6699c3eeca1
  • References
  1. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
  2. (1996) Med Lett Drugs Ther 38:111-2 [PubMed]
  3. (2000) Med Lett Drugs Ther 42:22-3 [PubMed]
  4. Scow (2007) Am Fam Physician 75:65-70 [PubMed]
  5. Wilson (2001) Chest 119:2021-6 [PubMed]