Montelukast

Administration

  • Type: Leukotriene modifier
  • Dosage Forms: granules, chewable and conventional tablets
  • Routes of Administration: PO
  • Common Trade Names: Singulair

Adult Dosing

  • Asthma (prophylaxis), allergic rhinitis: 10mg PO daily
  • Exercise-induced asthma: 10mg 2h prior to exercise max 10mg daily

Pediatric Dosing

  • 12-24mo: 4 mg (granules) PO daily
  • 2-6y: 4 mg PO daily
  • 6-15y: 5 mg PO daily
  • >15y: 10mg PO daily

>15 years: 10 mg PO daily

Special Populations

Pregnancy Rating

  • Category B

Lactation risk

  • Low risk to infant

Renal Dosing

  • Adult:
  • Pediatric:

Hepatic Dosing

  • Adult:
  • Pediatric:

Contraindications

  • Allergy to class/drug
  • Caution using chewable tablets in phenylketonuria (contain phenylalanine)

Adverse Reactions

Serious

  • Systemic eosinophilia with vasculitis consistent with Churg-Strauss syndrome
  • Neuropsychiatric events: aggressive behavior/agitation, anxiousness, hallucinations, suicidal ideation, somambulism

Common

  • Headache, dizziness
  • Abdominal pain, dyspepsia, gastroenteritis
  • Elevated LFTs
  • Viral infection, laryngitis, pharyngitis, influenza, cough, otitis, nasal congestion, bronchitis,
  • Wheezing
  • Dental pain
  • Rash, urticaria


Pharmacology

  • Half-life: 2.7-5.5h
  • Metabolism: Hepatic
  • Excretion: mostly in feces

Mechanism of Action

  • Inhibits binding of leukotriene D4 to its receptor, thus interfering with inflammatory process involved with asthma symptoms

Comments

See Also

References

Medscape

Authors:

Claire