Name Montelukast
Classes Respiratory Agent
Antiasthmatic
Antiallergic Agent
Diseases Asthma
Respiratory Disease
Runny Nose
Sneezing

Montelukast

Montelukast belongs to a class of drugs called the leukotriene receptor antagonist. The cysteinyl leukotrienes (LTC4 , LTD4 , LTE4 ) are products of arachidonic acid metabolism and are released from various cells, including mast cells and eosinophils. These eicosanoids bind to cysteinyl leukotriene (CysLT) receptors. The CysLT type-1 (CysLT1) receptor is found in the human airway (including airway smooth muscle cells and airway macrophages) and on other pro-inflammatory cells (including eosinophils and certain myeloid stem cells). Montelukast causes inhibition of airway cysteinyl leukotriene receptors.

 

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: 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

 

Most common adverse reactions associated with montelukast are:

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

 

  • 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

 

Contraindication

Contraindicated in patients hypersensitive to Montelukast.