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Active substance: MONTELUKAST

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SINGULAIR® Paediatric 4 mg Granules

Please tell your doctor or pharmacist if your child is taking or has recently taken other medicines,
including those obtained without a prescription.

Patient Information Leaflet


Tell your doctor if your child is taking the following medicines before starting SINGULAIR
• phenobarbital (used for treatment of epilepsy)
• phenytoin (used for treatment of epilepsy)
• rifampicin (used to treat tuberculosis and some other infections)

(montelukast sodium)

Your medicine is called SINGULAIR Paediatric 4 mg Granules but will be referred to as Singulair
Paediatric throughout the leaflet:
Read all of this leaflet carefully before your child starts taking this medicine.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, please ask your doctor or pharmacist.
• This medicine has been prescribed for your child. Do not pass it on to others. It may harm
them, even if their symptoms are the same as your child’s.
• If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
In this leaflet:
1. What SINGULAIR Paediatric is and what it is used for
2. Before SINGULAIR Paediatric is taken
3. How to take SINGULAIR Paediatric
4. Possible side effects
5. How to store SINGULAIR Paediatric
6. Further information

1. What SINGULAIR Paediatric is and what it is used for
SINGULAIR Paediatric is a leukotriene receptor antagonist that blocks substances called
leukotrienes. Leukotrienes cause narrowing and swelling of airways in the lungs. By blocking
leukotrienes, SINGULAIR Paediatric improves asthma symptoms and helps control asthma.
Your doctor has prescribed SINGULAIR Paediatric to treat your child’s asthma, preventing asthma
symptoms during the day and night.
• SINGULAIR Paediatric is used for the treatment of 6 months to 5 year old patients who are
not adequately controlled on their medication and need additional therapy.
• SINGULAIR Paediatric may also be used as an alternative treatment to inhaled
corticosteroids for 2 to 5 year old patients who have not recently taken oral corticosteroids for
their asthma and have shown that they are unable to use inhaled corticosteroids.
• SINGULAIR Paediatric also helps prevent the narrowing of airways triggered by exercise for
patients 2 years of age and older.
Your doctor will determine how SINGULAIR Paediatric should be used depending on the
symptoms and severity of your child's asthma.
What is asthma?
Asthma is a long-term disease.
Asthma includes:
• difficulty breathing because of narrowed airways. This narrowing of airways worsens and
improves in response to various conditions.
• sensitive airways that react to many things, such as cigarette smoke, pollen, cold air,
or exercise.
• swelling (inflammation) in the lining of the airways.
Symptoms of asthma include: Coughing, wheezing, and chest tightness.

Before SINGULAIR Paediatric is taken

Tell your doctor about any medical problems or allergies your child has now or has had.
Do not give SINGULAIR Paediatric to your child if he/she
• is allergic (hypersensitive) to montelukast or any of the other ingredients of SINGULAIR
Paediatric (see 6. Further information).
Take special care with SINGULAIR Paediatric
• If your child’s asthma or breathing gets worse, tell your doctor immediately.
• Oral SINGULAIR Paediatric is not meant to treat acute asthma attacks. If an attack occurs,
follow the instructions your doctor has given you for your child. Always have your child’s
inhaled rescue medicine for asthma attacks with you.
• It is important that your child take all asthma medications prescribed by your doctor.
SINGULAIR Paediatric should not be used instead of other asthma medications your doctor
has prescribed for your child.
• If your child is on anti-asthma medicines, be aware that if he/she develops a combination of
symptoms such as flu-like illness, pins and needles or numbness of arms or legs,
worsening of pulmonary symptoms, and/or rash, you should consult your doctor.
• Your child should not take acetyl-salicylic acid (aspirin) or anti-inflammatory medicines
(also known as non-steroidal anti-inflammatory drugs or NSAIDs) if they make his/her
asthma worse.
Taking other medicines
Some medicines may affect how SINGULAIR Paediatric works, or SINGULAIR Paediatric may
affect how your child's other medicines work.

Taking SINGULAIR Paediatric with food and drink
SINGULAIR Paediatric granules can be taken without regard to the timing of food intake.
Pregnancy and breast-feeding
This subsection is not applicable for the SINGULAIR Paediatric 4 mg granules since they are
intended for use in children 6 months to 5 years of age, however the following information is
relevant to the active ingredient, montelukast.
Use in pregnancy
Women who are pregnant or intend to become pregnant should consult their doctor before taking
SINGULAIR. Your doctor will assess whether you can take SINGULAIR during this time.
Use in breast-feeding
It is not known if SINGULAIR appears in breast milk. You should consult your doctor before taking
SINGULAIR if you are breast-feeding or intend to breast-feed.
Driving and using machines
This subsection is not applicable for the SINGULAIR Paediatric 4 mg granules since they are
intended for use in children 6 months to 5 years of age, however the following information is
relevant to the active ingredient, montelukast.
SINGULAIR is not expected to affect your ability to drive a car or operate machinery. However,
individual responses to medication may vary. Certain side effects (such as dizziness and
drowsiness) that have been reported very rarely with SINGULAIR may affect some patients’
ability to drive or operate machinery.

3. How to take SINGULAIR Paediatric
• This medicine is to be given to a child under adult supervision. Your child should take
SINGULAIR Paediatric every evening.
• It should be taken even when your child has no symptoms or if he/she has an acute
asthma attack.
• Always have your child take SINGULAIR Paediatric as your doctor has told you. You should
check with your child’s doctor or pharmacist if you are not sure.
• To be taken by mouth
For children 6 months to 5 years of age:
One sachet of SINGULAIR Paediatric 4 mg granules to be taken by mouth each evening.
If your child is taking SINGULAIR Paediatric, be sure that your child does not take any other
products that contain the same active ingredient, montelukast.
For children 6 months to 2 years old, SINGULAIR Paediatric 4 mg granules are available.
For children 2 to 5 years old, SINGULAIR Paediatric 4 mg chewable tablets and SINGULAIR
Paediatric 4 mg granules are available. The SINGULAIR Paediatric 4 mg granules formulation is
not recommended below 6 months of age.
How should I give SINGULAIR Paediatric granules to my child?
• Do not open the sachet until ready to use.
• SINGULAIR Paediatric granules can be given either:
directly in the mouth;
OR mixed with a spoonful of cold or room temperature soft food (for example,
applesauce, ice cream, carrots and rice).
• Mix all of the contents of the SINGULAIR Paediatric granules into a spoonful of cold or room
temperature soft food, taking care to see that the entire dose is mixed with the food.
• Be sure the child is given the entire spoonful of the granule/food mixture immediately (within
15 minutes). IMPORTANT: Never store any granule/food mixture for use at a later time.
• SINGULAIR Paediatric granules are not intended to be dissolved in liquid. However, your
child may take liquids after swallowing the SINGULAIR Paediatric granules.
• SINGULAIR Paediatric granules can be taken without regard to the timing of food intake.
If your child takes more SINGULAIR Paediatric than he/she should
Contact your child’s doctor immediately for advice.
There were no side effects reported in the majority of overdose reports. The most frequently
occurring symptoms reported with overdose in adults and children included abdominal pain,
sleepiness, thirst, headache, vomiting, and hyperactivity.

If you forget to give SINGULAIR Paediatric to your child
Try to give SINGULAIR Paediatric as prescribed. However, if your child misses a dose, just
resume the usual schedule of one sachet once daily.
Do not give a double dose to make up for a forgotten dose.
If your child stops taking SINGULAIR Paediatric
SINGULAIR Paediatric can treat your child’s asthma only if he/she continues taking it.

Keep out of the sight and reach of children.
Do not use this medicine after the date shown by the six numbers following EXP on the sachet.
The first two numbers indicate the month; the last four numbers indicate the year. This medicine
expires at the end of the month shown.
Store in the original package in order to protect from light and moisture.

It is important for your child to continue taking SINGULAIR Paediatric for as long as your doctor
prescribes. It will help control your child’s asthma.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist
how to dispose of medicines no longer required. These measures will help to protect the

If you have any further questions on the use of this product, ask your child’s doctor or pharmacist.

6. Further information

4. Possible side effects

What SINGULAIR Paediatric contains
• The active substance is montelukast. Each sachet of granules contains montelukast sodium
which corresponds to 4 mg of montelukast.
• The other ingredients are: Mannitol, hyprolose and magnesium stearate.

Like all medicines, SINGULAIR Paediatric can cause side effects, although not everybody gets
In clinical studies with SINGULAIR Paediatric 4 mg granules, the most commonly reported side
effects (occurring in at least 1 of 100 patients and less than 1 of 10 paediatric patients treated)
thought to be related to SINGULAIR Paediatric were:
• diarrhoea
• hyperactivity
• asthma
• scaly and itchy skin
• rash
Additionally, the following side effects were reported in clinical studies with either SINGULAIR 10
mg film-coated tablets, SINGULAIR Paediatric 5 mg or 4 mg chewable tablets:
• abdominal pain
• headache
• thirst
These were usually mild and occurred at a greater frequency in patients treated with SINGULAIR
than placebo (a pill containing no medication).
The frequency of possible side effects listed below is defined using the following convention:
Very common (affects at least 1 user in 10)
Common (affects 1 to 10 users in 100)
Uncommon (affects 1 to 10 users in 1,000)
Rare (affects 1 to 10 users in 10,000)
Very rare (affects less than 1 user in 10,000)
Additionally, while the medicine has been on the market, the following have been reported:
• upper respiratory infection (Very common)
• increased bleeding tendency (Rare)
• allergic reactions including swelling of the face, lips, tongue, and/or throat which may cause
difficulty in breathing or swallowing (Uncommon)
• behaviour and mood related changes [dream abnormalities, including nightmares,
trouble sleeping, sleepwalking, irritability, feeling anxious, restlessness, agitation including
aggressive behaviour or hostility, depression (Uncommon); tremor, disturbance in attention,
memory impairment (Rare); hallucinations, disorientation, suicidal thoughts and actions
(Very rare)]
• dizziness, drowsiness, pins and needles/numbness, seizure (Uncommon)
• palpitations (Rare)
• nosebleed (Uncommon), swelling (inflammation) of the lungs (Very rare)
• diarrhoea, nausea, vomiting (Common); dry mouth, indigestion (Uncommon)
• hepatitis (inflammation of the liver) (Very rare)
• rash (Common); bruising, itching, hives (Uncommon); tender red lumps under the skin most
commonly on your shins (erythema nodosum), severe skin reactions (erythema multiforme)
that may occur without warning (Very rare)
• joint or muscle pain, muscle cramps (Uncommon)
• fever (Common); weakness/tiredness, feeling unwell, swelling (Uncommon)

What SINGULAIR Paediatric looks like and contents of the pack
SINGULAIR Paediatric 4 mg granules are white granules.
SINGULAIR Paediatric 4 mg comes in cartons of 28 sachets.
Manufacturer and Product Licence Holder
SINGULAIR Paediatric is manufactured by Merck Sharp & Dohme BV, Waarderweg 39, PO Box
581, 2003 PC Haarlem, The Netherlands. It is procured from within the EU by the Product
Licence Holder: Swinghope Ltd, Brandon House, Marlowe Way, Croydon CR0 4XS UK.
Repackaged by Interport Ltd, Brandon House, Marlowe Way, Croydon CR0 4XS UK.

PLPI 10380/1427
Leaflet revision date: 10/03/2015.
Singulair® is a registered trademark of Merck & Co., Inc., USA.
Information is given by
In UK: Asthma UK, Providence House, Providence Place, London N1 ONT. Alternatively phone
the Asthma UK Adviceline on 08457 010203, Monday to Friday 9 am to 5 pm, calls charged at
local rate.
In Ireland: The Asthma Society of Ireland, Eden House, 15-17 Eden Quay, Dublin 1. Alternatively
phone The Asthma Live Line on 01 8788122, Monday, Wednesday, Thursday 10am to 1pm, or 01
8788511 9am to 5pm, or The Asthma Line on callsave 1850 44 5464.
(The Asthma UK and The Asthma Society of Ireland are independent charities working to conquer
asthma and are not associated with Merck Sharp & Dohme Limited.)

In asthmatic patients treated with montelukast, very rare cases of a combination of symptoms
such as flu-like illness, pins and needles or numbness of arms and legs, worsening of pulmonary
symptoms and/or rash (Churg-Strauss syndrome) have been reported. You must tell your doctor
right away if your child gets one or more of these symptoms.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. You can also report side effects directly via the Yellow Card
Scheme at: By reporting side effects you can help provide more
information on the safety of this medicine.


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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.