Overview
Montelukast is a leukotriene receptor antagonist used for the prophylaxis and chronic treatment of asthma and allergic rhinitis. It works by blocking cysteinyl leukotriene receptors, reducing bronchoconstriction and inflammation. It is not indicated for the relief of acute asthma attacks.
Mechanism of Action
Selectively blocks cysteinyl leukotriene receptors (CysLT1), inhibiting leukotriene-mediated effects including bronchoconstriction, increased vascular permeability, and eosinophil recruitment.
Indications
- Prophylaxis and chronic treatment of asthma in adults and pediatric patients 12 months and older
- Relief of symptoms of seasonal allergic rhinitis in patients 2 years and older
- Relief of symptoms of perennial allergic rhinitis in patients 6 months and older
Common Doses
- 10 mg
- 5 mg
- 4 mg
Dosage
Once daily in the evening for asthma; once daily at any time for allergic rhinitis. Dosage varies by age: 10 mg for adults and adolescents ≥15 years, 5 mg for children 6-14 years, 4 mg for children 2-5 years, and 4 mg oral granules for children 6-23 months.
Contraindications
- Hypersensitivity to any component of this product
Side Effects
- Headache
- Upper respiratory infection
- Pharyngitis
- Fever
- Abdominal pain
- Cough
- Neuropsychiatric events (agitation, aggression, depression, suicidal thoughts)
- Allergic reactions including anaphylaxis
Interactions
- No dose adjustment needed with theophylline, prednisone, prednisolone, oral contraceptives, terfenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative hypnotics, NSAIDs, benzodiazepines, decongestants, or CYP enzyme inducers
Counseling Points
- Take once daily as prescribed, even when symptom-free
- Not for relief of acute asthma attacks - keep rescue inhaler available
- Report any mood or behavior changes, depression, or suicidal thoughts
- Take chewable tablets on an empty stomach for better absorption
- Store oral granules in original packet until use