Montelukast

Montelukast is a prescription medication used to treat the symptoms of asthma and itchy, stuffy, or runny nose caused by allergies. It is also used to prevent bronchospasm (difficulty breathing) during exercise. Montelukast belongs to a group of drugs called leukotriene inhibitors which work by blocking leukotrienes, natural substances responsible for swelling in the airways, and tightening of muscles of airways, as well as nasal symptoms caused by allergies.

This medication comes in tablet, granule, and chewable tablet forms to be taken by mouth. It is usually taken once daily, with or without food. It should be taken in the evening if treating asthma, or 2 hours before exercise if treating difficulty breathing caused by exercise.

Common side effects of montelukast include cough, fever, headache, and sore throat.

Montelukast is a prescription medication used to treat symptoms of asthma and itchy, stuffy, or runny nose caused by allergies. t is also used to prevent bronchospasm (difficulty breathing) during exercise.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Montelukast may be found in some form under the following brand names:

• Singulair

The most common side effects of montelukast include:

• upper respiratory infection
• fever
• headache
• sore throat
• cough
• stomach pain
• diarrhea
• earache or ear infection
• flu
• runny nose
• sinus infection

Other side effects of montelukast include:

• increased bleeding tendency, low blood platelet count
• allergic reactions [including swelling of the face, lips, tongue, and/or throat (which may cause trouble breathing or swallowing), hives and itching]
• dizziness, drowsiness, pins and needles/numbness, seizures (convulsions or fits)
• palpitations
• nose bleed, stuffy nose
• diarrhea, heartburn, indigestion, inflammation of the pancreas, nausea, stomach or intestinal upset, vomiting
• hepatitis
• bruising, rash, severe skin reactions (erythema multiforme) that may occur without warning
• joint pain, muscle aches and muscle cramps
• tiredness, swelling

Montelukast may cause serious side effects. See "Drug Precautions". 

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of montelukast. For more information ask your healthcare provider or pharmacist.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Seizure medicines (carbamazepine, phenobarbital, phenytoin)
• Rifamycin antibiotics (rifabutin, rifampin, rifapentine)

This is not a complete list of montelukast drug interactions. Ask your doctor or pharmacist for more information.

Do not take montelukast if you are allergic to any of its ingredients.

Montelukast may cause serious side effects.

• Behavior and mood-related changes. Tell your doctor right away if you have mood-related changes.
• Increase in certain white blood cells (eosinophils) and possible inflamed blood vessels throughout the body (systemic vasculitis). Rarely, this can happen in people with asthma who take montelukast. This usually, but not always, happens in people who also take a steroid medicine by mouth that is being stopped or the dose is being lowered. 

If you have asthma and aspirin makes your asthma symptoms worse, continue to avoid taking aspirin or other medicines called non-steroidal anti-inflammatory drugs (NSAIDs) while taking montelukast.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of montelukast, there are no specific foods that you must exclude from your diet when receiving montelukast.

Before receiving montelukast, tell your healthcare provider if you:

• are allergic to aspirin
• have phenylketonuria. Montelukast chewable tablets contain aspartame, a source of phenylalanine

Tell your healthcare provider about all of your medical conditions, including if you are pregnant or breastfeeding.

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Montelukast falls into category B. There are no well-done studies that have been done in humans with montelukast. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if monelukast crosses into human breast milk. Because of the potential for serious harm in nursing infants from monelukast, a decision should be made whether to discontinue nursing or to discontinue montelukast, taking into account the importance of the medication to the mother.

For anyone who takes montelukast:

• Take montelukast exactly as prescribed by your healthcare provider. Your healthcare provider will tell you how much montelukast to take, and when to take it.
• Do not stop taking montelukast or change when you take it without talking with your healthcare provider.
• You can take montelukast with food or without food. 
• If you or your child misses a dose of montelukast, just take the next dose at your regular time. Do not take 2 doses at the same time.
• If you take too much montelukast, call your healthcare provider or a Poison Control Center right away.

For adults and children 12 months of age and older with asthma:

• Take montelukast one time each day, in the evening. Continue to take montelukast every day for as long as your healthcare provider prescribes it, even if you have no asthma symptoms.
• Tell your healthcare provider right away if your asthma symptoms get worse, or if you need to use your rescue inhaler medicine more often for asthma attacks.
• Do not take montelukast if you need relief right away from a sudden asthma attack. If you get an asthma attack, you should follow the instructions your healthcare provider gave you for treating asthma attacks.
• Always have your rescue inhaler medicine with you for asthma attacks.
• Do not stop taking or lower the dose of your other asthma medicines unless your healthcare provider tells you to.

For people 6 years of age and older for the prevention of exercise-induced asthma:

• Take montelukast at least 2 hours before exercise.
• Always have your rescue inhaler medicine with you for asthma attacks.
• If you take montelukast every day for chronic asthma or allergic rhinitis, do not take another dose to prevent exercise-induced asthma. Talk to your healthcare provider about your treatment for exercise-induced asthma.
• Do not take 2 doses of montelukast within 24 hours (1 day).

For adults and children 2 years of age and older with seasonal allergic rhinitis, or for adults and children 6 months of age and older with perennial allergic rhinitis:

• Give montelukast oral granules to your child exactly as instructed by your healthcare provider.
• Do not open the packet until ready to use.
• Take montelukast 1 time each day, at about the same time each day.

Montelukast 4-mg oral granules can be given:

• right in the mouth; or
• dissolved in 1 teaspoonful (5 mL) of cold or room temperature baby formula or breast milk; or
• mixed with 1 spoonful of one of the following soft foods at cold or room temperature: applesauce, mashed carrots, rice, or ice cream.

Give the child all of the mixture right away, within 15 minutes.

Do not store any leftover montelukast mixture (oral granules mixed with food, baby formula, or breast milk) for use at a later time. Throw away any unused portion.

Do not mix montelukast oral granules with any liquid drink other than baby formula or breast milk. Your child may drink other liquids after swallowing the mixture.

Take montelukast exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose of montelukast prescribed for you or your child's condition is based on age:

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

If you take too much montelukast, call your local Poison Control Center or seek emergency medical attention right away.

• Store montelukast at 59°F to 86°F (15°C to 30°C).
• Keep montelukast in the container it comes in.
• Keep montelukast in a dry place and away from light.