What is the treatment for Montelukast (Singulair)?

From the Guidelines

Singulair (montelukast) is an effective treatment for asthma and allergic rhinitis, typically prescribed as a 10mg tablet taken once daily in the evening for adults and adolescents over 15 years old. Children aged 6-14 typically receive 5mg chewable tablets, while those 2-5 years old take 4mg chewable tablets or oral granules 1. Singulair works by blocking leukotriene receptors, which reduces inflammation in the airways and helps prevent asthma symptoms and allergic responses. It's particularly useful for exercise-induced asthma and can be taken alongside inhaled corticosteroids for better asthma control 1. Patients should take Singulair consistently even when symptom-free, as it works best with regular use. Side effects are generally mild but may include headache, gastrointestinal discomfort, and rarely, mood changes or behavioral issues. Unlike rescue inhalers, Singulair is not for immediate symptom relief but rather for long-term management and prevention of symptoms. The dosage and administration of Singulair may vary depending on the patient's age and response to treatment, and it is essential to monitor the patient's response to therapy closely 1. In some cases, Singulair may be used in combination with other medications, such as inhaled corticosteroids, to achieve better asthma control 1.

Some key points to consider when prescribing Singulair include:

• The patient's age and dosage requirements
• The potential for side effects and interactions with other medications
• The importance of consistent use, even when symptoms are not present
• The need for regular monitoring of the patient's response to therapy
• The potential for combination therapy with other medications to achieve better asthma control.

Overall, Singulair is a valuable treatment option for patients with asthma and allergic rhinitis, and its use should be tailored to the individual patient's needs and response to therapy.

From the FDA Drug Label

SINGULAIR is prescribed for the treatment of asthma, the prevention of exercise-induced asthma, and allergic rhinitis: Asthma. SINGULAIR should be used for the long-term management of asthma in adults and children ages 12 months and older. Prevention of exercise-induced asthma. SINGULAIR is used for the prevention of exercise-induced asthma in patients 15 years of age and older. Allergic Rhinitis. SINGULAIR is used to help control the symptoms of allergic rhinitis (sneezing, stuffy nose, runny nose, itching of the nose)

The treatment for Montelukast (Singulair) is:

• For asthma: once a day in the evening for long-term management in adults and children 12 months and older
• For prevention of exercise-induced asthma: at least 2 hours before exercise in patients 15 years of age and older
• For allergic rhinitis: once a day, at about the same time each day, to help control symptoms in adults and children 2 years and older (seasonal) or 6 months and older (perennial) 2

From the Research

Treatment Overview

• Montelukast is a cysteinyl leukotriene receptor antagonist used to treat persistent asthma in patients aged ≥ 6 years 3.
• The recommended dose for adults is 10 mg/day, and for children aged 6-14 years, it is 5 mg/day 4.

Efficacy

• Montelukast has been shown to improve lung function, reduce symptoms, and decrease the need for beta2-agonist use in patients with persistent asthma 3, 5.
• The addition of montelukast to low-dose budesonide has been compared to the addition of formoterol, with formoterol showing better asthma control in patients with moderately persistent asthma 5.
• Montelukast has also been used to treat chronic cough in children, with 68% of patients experiencing cessation of cough during the third week of treatment 6.

Safety and Tolerability

• Montelukast has been shown to be well-tolerated, with a safety profile similar to placebo in both short-term and long-term administration 7.
• The frequency of adverse events in montelukast-treated patients was similar to that in placebo recipients, with no dose-related adverse effects observed 7.

Patient Selection

• Patients with increased levels of serum eosinophil cationic protein (ECP) and absolute eosinophil blood counts may be more likely to benefit from treatment with montelukast 6.
• Montelukast may be useful as monotherapy in patients with mild persistent asthma or as an adjunct to inhaled corticosteroids in patients with more severe asthma 3.