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Montelukast: Brands, Price & Uses in Bangladesh
Montelukast is an FDA-approved leukotriene receptor antagonist with the following established indications: Prophylaxis and chronic treatment of asthma in adults and pediatric patients as young as 12…
About Montelukast
Indications of Montelukast
Montelukast is an FDA-approved leukotriene receptor antagonist with the following established indications:
- Prophylaxis and chronic treatment of asthma in adults and pediatric patients as young as 12 months of age (established, FDA-approved use).
- Prevention of exercise-induced bronchoconstriction (EIB) in patients 6 years of age and older (established, FDA-approved use).
- Relief of symptoms of seasonal allergic rhinitis in patients 2 years of age and older (established, FDA-approved use).
- Relief of symptoms of perennial allergic rhinitis in patients 6 months of age and older (established, FDA-approved use).
Because of its neuropsychiatric boxed warning, current prescribing guidance reserves Montelukast for allergic rhinitis only in patients who have an inadequate response to, or cannot tolerate, other allergy medicines. Montelukast is not indicated for the treatment of acute asthma attacks or acute bronchospasm, and it is not an antibiotic or antimicrobial agent.
Dosage & Administration of Montelukast
Dosing by Indication and Age
| Indication | Age group | Recommended dose of Montelukast |
|---|---|---|
| Asthma (prophylaxis/chronic treatment) | ≥15 years | 10 mg tablet once daily in the evening |
| 6-14 years | 5 mg chewable tablet once daily in the evening | |
| 2-5 years | 4 mg chewable tablet or oral granules once daily in the evening | |
| 12-23 months | 4 mg oral granules once daily in the evening | |
| Exercise-induced bronchoconstriction | ≥15 years | 10 mg at least 2 hours before exercise; no additional dose within 24 hours |
| 6-14 years | 5 mg chewable tablet at least 2 hours before exercise; no additional dose within 24 hours | |
| Seasonal allergic rhinitis | ≥15 years | 10 mg once daily, any time of day |
| 6-14 years | 5 mg chewable tablet once daily | |
| 2-5 years | 4 mg chewable tablet or oral granules once daily | |
| Perennial allergic rhinitis | ≥15 years | 10 mg once daily |
| 6-14 years | 5 mg chewable tablet once daily | |
| 2-5 years | 4 mg chewable tablet or oral granules once daily | |
| 6-23 months | 4 mg oral granules once daily |
Renal or Hepatic Impairment
No dosage adjustment is required in patients with mild-to-moderate hepatic impairment or in patients with renal impairment; Montelukast has not been formally studied in severe hepatic impairment.
Administration
Montelukast tablets may be taken with or without food. Oral granules may be given directly in the mouth or mixed with a spoonful of cold or room-temperature soft food (such as applesauce), or dissolved in breast milk or infant formula, and must be consumed within 15 minutes of preparation - the granules should not be dissolved in liquid for drinking, and the packet should not be opened until ready to use. For chronic conditions (asthma, perennial allergic rhinitis), Montelukast should be taken every day as prescribed, even during symptom-free periods, and it should never be used to relieve a sudden asthma attack.
Side Effects of Montelukast
Montelukast is generally well tolerated. Reported adverse effects include:
- Common: headache, abdominal pain, cough, dyspepsia, dizziness, fatigue, fever, and upper respiratory tract infection symptoms.
- Common in children: ear infection (otitis media), pharyngitis, sinusitis, diarrhea, rash, and influenza-like illness.
- Neuropsychiatric events (see boxed warning): agitation, aggressive behavior, anxiousness, abnormal dreams/hallucinations, insomnia, irritability, restlessness, depression, and rarely suicidal thinking and behavior (including completed suicide).
- Uncommon/rare: hypersensitivity reactions (rash, urticaria, angioedema, anaphylaxis), elevated liver enzymes, hepatitis, edema, palpitations, bruising/bleeding tendency, and, rarely, a systemic eosinophilic condition sometimes with vasculitic features consistent with Churg-Strauss syndrome (see Precautions and Warnings).
Patients or caregivers should seek prompt medical attention for any new or worsening mood or behavior change, or for signs of a serious allergic reaction.
Contraindications of Montelukast
Montelukast is contraindicated in patients with known hypersensitivity to Montelukast (montelukast) or to any component of the formulation.
Frequently Asked Questions about Montelukast
What is Montelukast used for?
Montelukast is used for the long-term prevention and treatment of asthma, prevention of exercise-induced bronchoconstriction, and relief of symptoms of seasonal and perennial allergic rhinitis. It is a daily controller/preventive medicine, not a rescue treatment for a sudden asthma attack.
Can Montelukast be used to treat a sudden asthma attack?
No. Montelukast is not a bronchodilator and does not work quickly enough to relieve an acute asthma attack. Patients should always keep their prescribed fast-acting rescue inhaler available for sudden symptoms.
Does Montelukast cause mood or behavior changes?
Montelukast carries a boxed warning for serious neuropsychiatric events, including agitation, aggression, anxiety, depression, abnormal dreams, and, rarely, suicidal thinking or behavior. Patients and caregivers should watch for any new or worsening mood, behavior, or thinking changes and report them to a physician immediately.
Can Montelukast be used during pregnancy?
Montelukast should be used during pregnancy only if clearly needed, as advised by a physician. Because poorly controlled asthma itself carries risks to both mother and baby, treatment is often continued during pregnancy under medical supervision when required; a physician should always be consulted.
Is Montelukast safe for children?
Montelukast is approved for children as young as 6 months (perennial allergic rhinitis) using oral granules, and from 12 months for asthma, with age-specific doses and formulations. Caregivers should be especially alert for behavior or mood changes in children taking Montelukast.
What should I do if I take too much Montelukast?
If an overdose of Montelukast is suspected, seek immediate medical attention or contact a poison control center/emergency services right away rather than attempting home treatment.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.