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montelukast

Pronunciation

Generic Name: montelukast (mon te LOO kast)
Brand Name: Singulair

What is montelukast?

Montelukast is a leukotriene (loo-koe-TRY-een) inhibitor. Leukotrienes are chemicals your body releases when you breathe in an allergen (such as pollen). These chemicals cause swelling in your lungs and tightening of the muscles around your airways, which can result in asthma symptoms.

Montelukast is used to prevent asthma attacks in adults and children as young as 12 months old. Montelukast is also used to prevent exercise-induced bronchospasm in adults and children who are at least 6 years old.

Montelukast is also used to treat symptoms of year-round (perennial) allergies in adults and children who are at least 6 months old. It is also used to treat symptoms of seasonal allergies in adults and children who are at least 2 years old.

Do not give this medication to a child without a doctor's advice.

Montelukast is also used to prevent exercise-induced bronchoconstriction (narrowing of the air passages in the lungs) in adults and teenagers who are at least 15 years old and are not already taking this medicine for other conditions.

If you already take this medication to prevent asthma or allergy symptoms, do not use an extra dose to treat exercise-induced bronchoconstriction.

Montelukast may also be used for purposes not listed in this medication guide.

What is the most important information I should know about montelukast?

Montelukast will not work fast enough to treat an asthma attack that has already begun. Use only a fast-acting inhalation medicine to treat an asthma attack. Talk with your doctor if any of your asthma medications do not seem to work as well in treating or preventing attacks.

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It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after several weeks of treatment.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. If it seems like you need to use more of any of your medications in a 24-hour period, talk with your doctor.

If you already take this medication to prevent asthma or allergy symptoms, do not use it for exercise-induced bronchoconstriction.

Call your doctor at once if you have any mood or behavior changes, anxiety, depression, or thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking montelukast?

Do not use this medication if you are allergic to montelukast.

The chewable tablet form of this medication may contain phenylalanine. Talk to your doctor before using this form of montelukast if you have phenylketonuria (PKU).

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether montelukast passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take montelukast?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Montelukast is usually taken once daily in the evening for prevention of asthma or allergy symptoms. For exercise-induced bronchoconstriction, take a single dose at least 2 hours before you exercise, and do not take another dose for at least 24 hours. Follow your doctor's instructions.

If you already take this medication to prevent asthma or allergy symptoms, do not use it for exercise-induced bronchoconstriction.

Swallow the regular tablet whole, with a glass of water.

The chewable tablet must be chewed completely before you swallow it.

The oral granules can be placed directly into the mouth and swallowed, or mixed with a spoonful of applesauce, mashed carrots, rice, or ice cream. Oral granules can also be mixed with 1 teaspoon of baby formula or breast milk. Do not use any other type of liquid for mixing the granules. Other liquids can be taken before or after taking the medicine.

After opening or mixing the oral granules, you must use them within 15 minutes. Do not save an open packet or mixed medicine for later use.

Montelukast will not work fast enough to treat an asthma attack that has already begun. Use only a fast-acting inhalation medicine to treat an asthma attack. Talk with your doctor if any of your asthma medications do not seem to work as well in treating or preventing attacks.

It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after several weeks of treatment.

Asthma is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice, even if you have no asthma symptoms.

If you also take a steroid asthma medicine, do not stop using it suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. If it seems like you need to use more of any of your medications in a 24-hour period, talk with your doctor.

Store at room temperature away from moisture and heat. Do not open a packet of oral granules until you are ready to use the medicine.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking montelukast?

Avoid situations or activities that may trigger an asthma attack.

If your asthma symptoms get worse when you take aspirin, avoid taking aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) while you are taking montelukast. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.

Montelukast side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

  • mood or behavior changes, anxiety, depression, or thoughts about suicide or hurting yourself;

  • tremors or shaking;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • severe sinus pain, swelling, or irritation;

  • worsening asthma symptoms; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • headache;

  • stomach pain, heartburn, upset stomach, nausea, diarrhea;

  • tooth pain;

  • tired feeling;

  • fever, stuffy nose, sore throat, cough, hoarseness; or

  • mild rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Montelukast dosing information

Usual Adult Dose for Allergic Rhinitis:

10 mg orally once a day. For asthma, the dose should be taken in the evening. For allergic rhinitis, the time of administration may be individualized to suit patient needs. Patients with both asthma and allergic rhinitis should take only one dose daily in the evening.

Usual Adult Dose for Asthma -- Maintenance:

10 mg orally once a day. For asthma, the dose should be taken in the evening. For allergic rhinitis, the time of administration may be individualized to suit patient needs. Patients with both asthma and allergic rhinitis should take only one dose daily in the evening.

Usual Adult Dose for Bronchospasm Prophylaxis:

10 mg taken orally at least 2 hours before exercise. Additional doses should not be taken within 24 hours of a previous dose. Patients already taking montelukast daily for another indication (including chronic asthma) should not take an additional dose to prevent exercise induced bronchospasm. All patients should have available for rescue a short-acting beta 2 agonist. Daily administration of montelukast for the chronic treatment of asthma has not been established to prevent acute episodes of exercise induced bronchoconstriction.

Usual Pediatric Dose for Allergic Rhinitis:

Montelukast should be taken once daily. For asthma, the dose should be taken in the evening. For allergic rhinitis, the time of administration may be individualized to suit patient needs. Patients with both asthma and allergic rhinitis should take only one dose daily in the evening.

15 years or older with asthma or allergic rhinitis:
10 mg orally once a day.

6 years to 14 years with asthma or allergic rhinitis:
5 mg chewable tablet orally once a day.

2 years to 5 years with asthma or allergic rhinitis:
4 mg chewable tablet or 4 mg granules orally once a day.

1 year to 2 years with asthma:
4 mg granules orally once a day in the evening.

6 months to 23 months with perennial allergic rhinitis:
4 mg granules orally once a day.

Usual Pediatric Dose for Asthma -- Maintenance:

Montelukast should be taken once daily. For asthma, the dose should be taken in the evening. For allergic rhinitis, the time of administration may be individualized to suit patient needs. Patients with both asthma and allergic rhinitis should take only one dose daily in the evening.

15 years or older with asthma or allergic rhinitis:
10 mg orally once a day.

6 years to 14 years with asthma or allergic rhinitis:
5 mg chewable tablet orally once a day.

2 years to 5 years with asthma or allergic rhinitis:
4 mg chewable tablet or 4 mg granules orally once a day.

1 year to 2 years with asthma:
4 mg granules orally once a day in the evening.

6 months to 23 months with perennial allergic rhinitis:
4 mg granules orally once a day.

Usual Pediatric Dose for Bronchospasm Prophylaxis:

15 years or older:
10 mg taken orally at least 2 hours before exercise.

6 years to 14 years:
5 mg chewable tablet orally at least 2 hours before exercise.

Additional doses should not be taken within 24 hours of a previous dose. Patients already taking montelukast daily for another indication (including chronic asthma) should not take an additional dose to prevent exercise induced bronchospasm. All patients should have available for rescue a short-acting beta 2 agonist. Daily administration of montelukast for the chronic treatment of asthma has not been established to prevent acute episodes of exercise induced bronchoconstriction.

What other drugs will affect montelukast?

Tell your doctor about all other medicines you use, especially:

  • phenobarbital (Luminal, Solfoton); or

  • rifampin (Rifadin, Rifater, Rifamate, Rimactane).

This list is not complete and other drugs may interact with montelukast. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about montelukast.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 12.02. Revision Date: 2012-04-17, 3:25:43 PM.

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