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

See Also

• Asthma

References

Medscape