Is 7.5 ml of Montair LC Kids an Overdose in a 17 kg Child?
No, 7.5 ml of Montair LC Kids (containing montelukast and levocetirizine) is NOT an overdose in a 17 kg child, as this dose falls within the safe therapeutic range for both components. However, the appropriateness depends on the specific formulation concentration and the child's age.
Dosing Analysis by Component
Montelukast Safety Profile
- Montelukast has an extremely wide safety margin. Single oral doses up to 5000 mg/kg in animal studies showed no mortality, with exposures 210-335 times higher than maximum recommended pediatric doses 1
- In clinical studies, adult patients received doses up to 900 mg/day for one week without clinically significant adverse events 1
- Acute overdoses up to 1000 mg in children have been reported with minimal adverse effects, most commonly abdominal pain, somnolence, thirst, headache, and psychomotor hyperactivity 1
- Standard pediatric dosing for montelukast is 4-5 mg once daily for children 2-14 years old 2, 3
Levocetirizine Safety Profile
- Levocetirizine is approved for children ≥6 months at 5 mg daily dosing 2
- The medication has a favorable safety profile with sedation rates of only 8% at therapeutic doses 2
- Second-generation antihistamines like levocetirizine have significantly lower CNS penetration and adverse effects compared to first-generation agents 2
Typical Montair LC Kids Formulation
Most combination formulations contain:
- Montelukast 4 mg + Levocetirizine 2.5 mg per 5 ml suspension
For a 17 kg child receiving 7.5 ml:
- Montelukast dose: ~6 mg (slightly above standard 4-5 mg pediatric dose but well within safety margin)
- Levocetirizine dose: ~3.75 mg (below the standard 5 mg pediatric dose)
Clinical Evidence for Combination Therapy
- The fixed-dose combination of montelukast 5 mg + levocetirizine 5 mg has been studied extensively in children aged 6-14 years with excellent safety profiles 3
- Combination therapy showed superior efficacy for allergic rhinitis symptoms compared to montelukast alone, with fewer adverse events and higher patient satisfaction 3
- The combination has been used safely in children as young as 2-6 years for otitis media with effusion at doses of montelukast 4 mg + levocetirizine 2.5 mg 4
Important Caveats
Age Considerations
- Verify the child's age: Levocetirizine is approved for children ≥6 months, while montelukast granules are approved down to 1 year old 2
- For children 2-6 years, montelukast 4 mg chewable tablets are the standard formulation 2
Monitoring Recommendations
- Observe for common adverse effects including somnolence, headache, abdominal pain, or behavioral changes 1, 3
- No specific antidote exists for overdose; management is supportive with removal of unabsorbed material if recent ingestion 1
- Neither drug is significantly removed by dialysis 1
When to Seek Medical Attention
- Excessive somnolence or difficulty arousing the child
- Severe abdominal pain or persistent vomiting
- Behavioral changes including significant psychomotor hyperactivity or agitation
- Any signs of allergic reaction to the medication itself
Bottom Line
A 7.5 ml dose represents approximately 1.5 times the typical pediatric dose but remains far below toxic levels for both components. The child should be monitored for mild adverse effects, but serious toxicity is extremely unlikely given the wide therapeutic index of both medications 1, 3.