Montelukast is a leukotriene receptor antagonist indicated for:

• Prophylaxis and chronic treatment of asthma in patients 12 months of age and older 
• Acute prevention of exercise-induced bronchoconstriction (EIB) in patients 6 years of age and older
• Relief of symptoms of allergic rhinitis (AR): seasonal allergic rhinitis (SAR) in patients 2 years of age and older, and perennial allergic rhinitis (PAR) in patients 6 months of age and older

Asthma

Allergic rhinitis

• Asthma: Once daily in the evening for patients 12 months and older.
• Acute prevention of EIB: One tablet at least 2 hours before exercise for patients 6 years of age and older.
• Seasonal allergic rhinitis: Once daily for patients 2 years and older.
• Perennial allergic rhinitis: Once daily for patients 6 months and older.

Dosage (by age)

• 15 years and older: one 10-mg tablet.
• 6 to 14 years: one 5-mg chewable tablet.
• 2 to 5 years: one 4-mg chewable tablet or one packet of 4-mg oral granules. 
• 6 to 23 months: one packet of 4-mg oral granules.

Patients with both asthma and allergic rhinitis should take only one dose daily in the evening.

For oral granules: Must administer within 15 minutes after opening the packet (with or without mixing with food) 

Oral granules

Sachet Powder

Most common adverse reactions associated with montelukast are:

• upper respiratory infection
• fever
• headache
• pharyngitis
• cough
• abdominal pain
• diarrhea
• influenza
• rhinorrhea
• sinusitis
• otitis 

URTI (Upper Respiratory Tract Infection)	Fever	Headache
Pharyngitis	Coughing	Sinusitis

• Do not prescribe Montelukast to treat an acute asthma attack 
• 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 non-steroidal anti-inflammatory agents while taking Montelukast 
• Neuropsychiatric events have been reported with Montelukast. Instruct patients to be alert for neuropsychiatric events. Evaluate the risks and benefits of continuing treatment with Montelukast if such events occur 
• Systemic eosinophilia, sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome, has been reported. These events usually, but not always, have been associated with the reduction of oral corticosteroid therapy 
• Inform patients with phenylketonuria that the 4-mg and 5-mg chewable tablets contain phenylalanine