Side effects and precautions when using Montelukast

This is an automatically translated article.

The article was written by Pharmacist Huynh Xuan Loc - Faculty of Pharmacy - Vinmec Central Park International General Hospital

1. How does Montelukast work?

Montelukast with the common brand name Singulair is a medicine used to prevent and treat bronchial asthma (asthma). Medications to help reduce airway constriction caused by inflammation and is usually indicated in the mild phase, to help prevent daytime and nighttime asthma symptoms as well as shortness of breath during exercise or physical activity. exertion.
Montelukast also helps relieve seasonal allergy symptoms such as sneezing, itchy, stuffy or runny nose. However, drugs are not the first choice of treatment in this condition.

2. How to use montelukast correctly?

Montelukast can be used on children 6 months of age and older. Common drugs are in the form of oral nuggets, chewable tablets for children and oral tablets for people 15 years of age and older.
The medicinal forms of montelukast can be taken with or without food. Oral nuggets can be put directly into the child's mouth or mixed with cold or room-temperature drinks such as apple juice, formula, breast milk or food such as rice, carrot puree, ice cream. The nuggets also need to be used within 15 minutes after being mixed and not preserved for future use.
Chewable tablets need to be chewed or sucked until dissolved before swallowing for proper absorption. After chewing, children can drink water or rinse their mouth to clean. The usual dose of montelukast is calculated according to age, in which:
People from 15 years old take 10mg/day oral tablet; Children from 6 to 14 years old use chewable tablets 5mg/day; Children from 6 months to 5 years old use chewable tablets or oral nuggets 4mg/day.

To control asthma, the drug should be taken in the evening every day for the entire duration of treatment, even in the absence of symptoms. The drug can be taken 2 hours before physical activity or strenuous sports as considered and prescribed by the doctor.
If you miss a dose, skip it and take another dose the next day. Do not take a double dose to make up for a lost dose.

3. The side effects of montelukast

Montelukast, like other medicines, can cause harmful effects. The drug rarely causes serious side effects such as:
Allergic reactions such as skin rash, urticaria, rash with or without fever; wheezing, chest tightness or trouble breathing, trouble swallowing or talking, hoarseness; or swelling of the lips, face, tongue, or throat; Or more serious allergic reactions such as redness, swelling, peeling of the skin, irritation, redness of the eyes, sores in the mouth, throat or nose; Or fever, flu-like symptoms, facial sinus pain, ear pain, burning or stinging sensation. If you experience any of the above side effects, the patient should immediately go to the nearest medical facility for timely support.
Other side effects such as headache, stomach upset or diarrhea, cough... are also common. If these symptoms do not go away and persist, the patient should stop taking the drug and talk to the treating doctor for appropriate treatment.

Recently, a number of pharmaceutical agencies around the world have also begun to warn about the risk of neuropsychiatric side effects of montelukast and recommend limiting its use to conditions other than asthma such as allergic rhinitis. Neuropsychiatric undesirable effects include suicidal ideation, agitation, aggression, depression, sleep disturbances, hallucinations, sleepwalking, tremors, etc. Therefore, the patient or caregiver It is important to be aware of these unusual symptoms and talk to your doctor to make the right choice.

4. What should be noted when taking the drug?

Montelukast is a prescription medication and should only be taken as directed by your doctor.
The drug has no bronchodilator effect and does not help relieve acute asthma attacks. Always take it with other forms of inhaler, inhaler, or medication for effective disease control.
Talk to your doctor or go to medical facilities right away if you experience any unusual symptoms while taking the drug such as allergic reactions, difficulty breathing ... or neuropsychiatric symptoms such as hallucinations , changes in personality or behavior, feeling unusually depressed or aggressive, especially the appearance of suicidal thoughts or a desire to harm yourself.
Discuss with your doctor the benefits of the drug and the possible side effects if montelukast is indicated for the treatment of allergic rhinitis or other conditions other than bronchial asthma. Your doctor can consider and explain medication use on a case-by-case basis.
Store the medicine at room temperature, away from direct light. Store in a dry place and in the original packaging of the medicine, out of the reach of children.
Avoid using or consult your doctor before taking montelukast concomitantly with drugs that can aggravate asthma such as aspirin or non-steroidal anti-inflammatory drugs.

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References: Uptodate.com, mayoclinic.org