Montelukast

Montelukast is a drug that belongs to the category of Leukotriene receptor antagonist. It is a commonly prescribed drug for asthma, allergic rhinitis, and bronchospasms. It is a drug that is efficient in relieving symptoms of allergy, which include sneezing, runny nose, itchiness, etc. The primary mechanism of this drug is to block the agent that causes allergic symptoms, called Leukotrienes. Furthermore, it reduces the inflammation of the respiratory path and controls other allergic symptoms.

What are the uses of Montelukast?

Some of the uses of Montelukast include:  

• Treatment and Prophylaxis of Chronic Asthma: Montelukast is effective in both managing and preventing chronic asthma, helping individuals control their symptoms and reduce the frequency of asthma attacks.
• Prevention of Exercise-Induced Bronchospasm: It safeguards against bronchospasms triggered by physical exertion, allowing those with asthma to engage in exercise without respiratory distress.
• Symptomatic Relief of Allergic Rhinitis: Montelukast provides relief from allergic rhinitis symptoms, such as sneezing, runny nose, and nasal congestion, improving overall comfort.
• Relief from Symptoms of Hay Fever: It alleviates the discomfort associated with hay fever, addressing symptoms like itchy, watery eyes and nasal congestion. This makes it an effective choice during allergy seasons.

How and when to take Montelukast?

Take the medication as directed by the physician. It is often taken orally as a tablet, around 15 minutes after eating food. The tablet is also available in a chewable form for a younger age group. Consistency is key when taking this medication, so it's important to take it at the same time every day, or as recommended by your doctor. If you're using it to manage both asthma and allergies, taking it in the evening is also a good option. However, it can be taken in the morning or at night, depending on your personal preference.

If the medication is being taken for exercise-induced asthma, it should be taken at least one to two hours before exercise. The medications need to be continued even if one’s asthma seems to be under control unless your physician advises you to stop.

How does Montelukast work?

Montelukast is a medication used primarily to manage asthma and allergic rhinitis (hay fever). It works by targeting and blocking leukotrienes, which are inflammatory substances produced by the immune system. 

• Leukotriene Inhibition: Montelukast is classified as a leukotriene receptor antagonist. It works by specifically blocking leukotriene receptors in the body. Leukotrienes are substances that play a key role in inflammation, bronchoconstriction (narrowing of airways), and mucus production in the lungs.
• Prevention of Airway Inflammation: In conditions like asthma, allergens or irritants can trigger the release of leukotrienes, leading to inflammation and constriction of the airways. By blocking leukotriene receptors, montelukast helps to prevent this inflammatory response. This action helps to reduce swelling and inflammation in the airways, making it easier to breathe.
• Reduction of Bronchoconstriction: Leukotrienes can cause smooth muscles around the airways to contract, leading to bronchoconstriction and difficulty breathing, especially in individuals with asthma. Montelukast's ability to inhibit leukotrienes helps to relax these muscles and prevent airway constriction.
• Management of Allergic Rhinitis: Montelukast is also effective in managing allergic rhinitis (hay fever) by reducing inflammation in the nasal passages caused by allergens. It can help alleviate symptoms such as nasal congestion, sneezing, runny nose, and itching.
• Usage in Asthma and Allergic Conditions: Montelukast is typically taken regularly to control and prevent asthma symptoms and allergic reactions. It is often prescribed as part of a comprehensive treatment plan for asthma or allergic rhinitis. It is not used for immediate relief of acute asthma attacks; instead, it is used to prevent symptoms over the long term.

What are the side effects of Montelukast?

Most individuals who use these drugs do not experience the side effects, but there is a possibility of the following effects:

• Numbness and tingling of arms and legs
• Body aches or pains
• Flu-like symptoms
• Headache
• Anxiety and irritation
• Feelings of depression, confusion, cloudy memory, and attention
• Tremors and uncontrolled movements
• Sleep problems
• Compulsive behaviour

This list does not include all the side effects, and there may be others. If you experience any of the above or any other, inform your doctor at the earliest.

What precautions are to be taken while consuming Montelukast?    

• Before consuming Montelukast, let your doctor know about any previous allergies, as this product may cause allergic reactions in some.
• Make a mention of your medical history to your doctor, including liver conditions, mental & mood conditions including anxiety, depression etc.
• Mention the consumption of this drug to the dentist prior to any dental treatments.
• If you are pregnant or breastfeeding then please inform your doctor before taking this medicine.

What if I missed the dose of Montelukast?

Missing the dose might not cause any problem; you can always contact your doctor in any case. If a dose has been missed, skip that dose and move to the next regular dose. Do not double the dose to make up for the missed dose. It is advised not to take more than the prescribed dose in 24 hr.

What if there is an overdose of Montelukast?

Overdose can lead to symptoms like vomiting, severe stomach cramping, increased thirst and drowsiness. In case of an overdose, call immediately to get a medical emergency from your doctor. 

What are the storage conditions for Montelukast?

Montelukast should be stored in a cool, dry place away from light and heat. Keep this medicine away from moisture contamination, especially do not store it in bathrooms. You should also keep it away from children and pets.

Drug Interactions of Montelukast with other Medications

In order to avoid any drug interactions, it is important to mention the drug Montelukast prescribed by the doctor. Some of the common drug interactions include-


• Amiodarone
• Carbamazepine
• Fluconazole
• Imatinib
• Miconazole
• Phenytoin
• Phenobarbital
• Rifampin
• Valproic acid
• Zafirlukast

This list only states the common drug interactions, not the entire list. Consult with your doctor before taking Montelukast for other drug interactions, and get an alternative prescription if you are taking the above medicines.

How long does Montelukast take to work?

Montelukast reaches peak concentrations around 2-4 hrs after consumption. It should be taken at least 2 hr before any exercise if it is for exercise-induced asthma.

Warnings for Montelukast

• Suicidal Thoughts and Behavior: Montelukast has been associated with rare cases of suicidal thoughts or behavior. Patients should be monitored for changes in mood or behavior, especially at the beginning of treatment.
• Neuropsychiatric Events: Some patients may experience neuropsychiatric events such as agitation, aggression, hallucinations, depression, or anxiety while taking montelukast. These symptoms should be promptly reported to a healthcare provider.
• Churg-Strauss Syndrome: Montelukast should be used with caution in patients with a history of Churg-Strauss syndrome, a rare condition that causes inflammation of blood vessels.
• Liver Function Monitoring: Liver function tests should be performed periodically, especially in patients with pre-existing liver disease.
• Allergic Reactions: Serious allergic reactions to montelukast are rare but possible. Seek immediate medical attention if signs of an allergic reaction (such as rash, itching, swelling, severe dizziness, trouble breathing) occur.
• Use in Pregnancy and Breastfeeding: Montelukast should be used during pregnancy only if clearly needed and under the supervision of a healthcare provider. It is unknown if montelukast passes into breast milk, so consult a doctor before breastfeeding while taking this medication.

Dosage of Montelukast

• Asthma (Adults and Adolescents 15 Years and Older):
  • For asthma prevention and long-term control: The usual dose is 10 mg once daily in the evening.
  • For exercise-induced bronchoconstriction: Take a single 10 mg dose at least 2 hours before exercise.
• Asthma (Children 6 to 14 Years Old):
  • The recommended dose for children with asthma is 5 mg once daily in the evening.
• Allergic Rhinitis (Adults and Children 2 Years and Older):
  • The usual dose is 10 mg once daily in the evening.
• Children 6 Months to 2 Years Old:
  • Montelukast is not typically recommended for children in this age group unless specifically prescribed by a doctor.

Montelukast vs Cetirizine

Both Montelukast and cetirizine can help relieve allergic symptoms. Montelukast predominantly helps in reducing the difficulty in breathing due to asthma, chest tightness, wheezing and cough. Montelukast is better for nasal congestion when compared to cetirizine. Both Montelukast and cetirizine cannot be used as relief for acute attacks.

FAQs

1. How should Montelukast be taken?

Montelukast is typically taken once daily in the evening or as directed by a healthcare provider. It can be taken with or without food. Follow your doctor's instructions or the label on the medication for the most accurate guidance.

2. Does Montelukast make you drowsy?

Montelukast is not known to cause drowsiness as a common side effect. However, individual responses to medications may vary, so if you experience drowsiness while taking Montelukast, consult your healthcare provider.

3. Why do you have to take Montelukast at night?

Montelukast is often taken in the evening or at night because it can help manage asthma symptoms and allergies that are typically more active during these times. This timing aligns with the body's natural rhythms and can provide better symptom control.

4. What is the difference between Montelukast and Cetirizine?

Montelukast and Cetirizine are different types of medications. Montelukast is a leukotriene receptor antagonist used to manage asthma and allergies, while Cetirizine is an antihistamine used for allergy relief. They work on different pathways in the body to alleviate allergy symptoms.

5. How Montelukast Works?

Montelukast works by blocking leukotrienes, which are substances in the body that contribute to asthma and allergic reactions. By inhibiting leukotrienes, it helps reduce airway constriction and inflammation, making it easier to breathe and relieving allergy symptoms.

6. Is it okay to take montelukast every day?

Yes, montelukast is typically taken daily for asthma or allergic conditions as prescribed by your doctor. It helps to control symptoms and prevent flare-ups when used regularly.

7. Can Montelukast be used for a cold?

No, montelukast is not used to treat common colds. It works specifically on inflammation and airway constriction caused by allergies or asthma, not viral infections like the common cold.

8. Why should montelukast be taken at night?

Montelukast is usually taken in the evening because it can help prevent asthma symptoms that tend to worsen at night or early in the morning. Taking it at night ensures that it's effective when you need protection from asthma triggers.

9. Is Montelukast good for the lungs?

Montelukast is beneficial for lung health in conditions like asthma. It helps by reducing inflammation, relaxing airway muscles, and preventing the release of substances that cause breathing problems. However, it's important to use it as prescribed and in conjunction with other asthma management strategies.

10. Who should not use Montelukast?

Montelukast may not be suitable for everyone. People with a known allergy to montelukast or its ingredients should avoid it. Additionally, individuals with certain medical conditions, such as liver problems or a history of neuropsychiatric events, should use montelukast with caution or under medical supervision. Always consult your doctor before starting montelukast to ensure it's safe and appropriate for you.

References:

https://www.webmd.com/drugs/2/drug-6478-8277/Montelukast-oral/Montelukast-oral/details https://medlineplus.gov/druginfo/meds/a600014.html
https://go.drugbank.com/drugs/DB00471

Disclaimer: The information provided here is not meant to substitute an advice from a healthcare professional. The information is not intended to cover all the possible uses, side-effects, precautions, and drug interactions. This information is not intended to suggest that using a specific drug is suitable, safe, or efficient for you or anyone else. The absence of any information or warning regarding the drug should not be interpreted as an implicit guarantee from the organisation. We strongly advise you to consult a doctor if you have any concerns about the drug and never use the medication without a doctor’s prescription.