How are Montelukast (Singulair) packets mixed?

Mixing Montelukast Granule Packets

Montelukast 4-mg oral granules should be mixed with one teaspoonful (5 mL) of cold or room temperature baby formula, breast milk, or a spoonful of soft food such as applesauce, mashed carrots, rice, or ice cream. 1

Proper Mixing Instructions

The FDA-approved instructions for mixing montelukast granule packets are very specific:

1. Do not open the packet until ready to use

2. The 4-mg oral granules can be given in one of three ways:

   • Directly in the mouth
   • Dissolved in 1 teaspoonful (5 mL) of cold or room temperature baby formula or breast milk
   • Mixed with a spoonful of one of these soft foods at cold or room temperature:
     • Applesauce
     • Mashed carrots
     • Rice
     • Ice cream

3. Important administration guidelines:

   • Ensure the entire dose is mixed with the food, baby formula, or breast milk
   • Give the entire spoonful of the mixture to the child immediately (within 15 minutes)
   • Never store any oral granules mixed with food, baby formula, or breast milk for later use
   • Throw away any unused portion

Important Cautions

• Do not put montelukast oral granules in any liquid drink other than baby formula or breast milk 1
• The child may drink liquids after swallowing the montelukast oral granules 1
• Never store the mixture for future use - it must be consumed within 15 minutes of preparation 1

Age-Appropriate Dosing

Montelukast granule packets (4 mg) are indicated for:

• Children 12-23 months of age with asthma
• Children 2-5 years of age with asthma or seasonal allergic rhinitis
• Children 6 months to 5 years of age with perennial allergic rhinitis 1

Clinical Context

Montelukast is a leukotriene receptor antagonist (LTRA) used as a second-line alternative for mild persistent asthma 2. It can be used as adjunctive therapy with inhaled corticosteroids, although adding long-acting beta-agonists is generally preferred for patients 12 years and older 2.

For young children who have difficulty with other medication forms, the granule formulation provides an important alternative delivery method, allowing for better medication adherence in the pediatric population.