Overview and context

Montelukast is a leukotriene receptor antagonist most widely known by the brand name Singulair. Generic montelukast is available and works by blocking leukotrienes, substances that can cause airway inflammation and bronchospasm. It is prescribed mainly for ongoing control of asthma and for treatment of some allergic rhinitis symptoms.

This agent is intended for daily maintenance therapy and should not be used as an immediate rescue treatment during an acute asthma attack. Keep a fast-acting rescue inhaler on hand and follow a personalized asthma action plan. Please refer to the a section of the text. How to correctly take montelukast for dosing notes and Safety Assurance and Continuous monitoring for follow-up advice.

  • Active moiety: montelukast sodium
  • Most common uses: chronic asthma control, prevention of exercise-induced bronchoconstriction, and treatment of allergic symptoms
  • Common presentations: film-coated tablets, chewable tablets, and oral granules

Visible signs and Typical Uses

Clinicians may prescribe montelukast in these settings:

  • Daily control of asthma symptoms in patients who respond to leukotriene pathway inhibition
  • Prevention of exercise-induced bronchospasm when taken before exercise
  • Management of seasonal or perennial allergic rhinitis in selected patients

Because montelukast has an FDA boxed warning for neuropsychiatric events, many prescribers reserve it for patients who cannot use or do not tolerate first-line options for allergic rhinitis. See Safety and Juridical Notes in the USA for regulatory details.

Dose Formats and Strength Levels

Montelukast is produced in several formats so the dose can be tailored by age and clinical need:

  • 10 mg film-coated tablet for most adolescents and adults
  • 5 mg chewable tablet for children
  • 4 mg chewable tablet and 4 mg oral granules for younger children

Your prescriber will pick the appropriate formulation and dosing regimen based on age in addition to the medical condition being treated. For administration tips, refer to How to take a sip this montelukast medication.

Before you begin the task

Discuss these points with your healthcare provider prior to starting montelukast:

  • Any history of liver disease or abnormal liver tests
  • Current or prior psychiatric, mood, or behavioral conditions
  • Allergic reactions to montelukast or any inactive ingredients
  • Pregnancy intentions, pregnancy, or breastfeeding status
  • Phenylketonuria (chewable tablets may contain phenylalanine)

For pediatric patients, confirm the correct pediatric dose, how to give granules, and a continuous oversight plan with the child’s clinician.

Montelukast dosing guide

  • Follow the prescription label merged with the clinician's instructions as written.
  • Take montelukast once daily at about the same time each day to maintain stable blood levels.
  • Swallow 10 mg film-coated tablets whole; do not split, crush, or chew them.
  • Chewable tablets should be chewed completely before swallowing.
  • Oral granules may be taken directly in the mouth or mixed with a spoonful of soft food (for example applesauce); take immediately after opening the packet.
  • Continue daily therapy even if you feel better, unless your prescriber tells you to stop.

In case of suspected overdosing, get emergency medical help or contact the US Poison Help line at 1-800-222-1222.

For quick reference on storing and emergency measures, see Storage systems and Disposal Guidelines and Safety Protocols and Continuous Environmental monitoring.

Dose was not delivered Help and Instructions

Should you skip a dose, take the i missed the medication dose as soon as you remember. If it is nearly time for your next scheduled dose, skip the i missed the medication dose; do not double up doses to catch up. For routine timing, return to Montelukast administration tips.

Drug Interaction Risks and Safety

Certain medications and supplements can change how montelukast works or how it is metabolized. Examples include:

  • Rifampin and rifabutin, which can lower montelukast levels
  • Enzyme-inducing antiepileptic drugs such as phenobarbital, carbamazepine, or phenytoin
  • Some antidiabetic medicines in specific clinical situations
  • Certain chemotherapy agents in particular treatment settings
  • Herbal inducers like St. John's wort

This listing is incomplete. Always give your prescriber and pharmacist a comprehensive list of all prescription medicines, over-the-counter products, vitamins, and herbal supplements. Also discuss alcohol and tobacco use as they may affect overall asthma control.

Safety Guidelines and Real-time monitoring

  • Plan regular follow-up visits to evaluate symptom control and adjust therapy as needed.
  • Do not use montelukast as a replacement for a short-acting rescue inhaler during an acute attack.
  • Report any new or worsening mood changes, anxiety, depression, agitation, or suicidal thoughts immediately.
  • Watch for signs that may indicate liver problems such as dark urine, jaundice, persistent nausea, or abdominal pain and notify your clinician.

For details on the FDA boxed warning and communications, see United States Legal and Safety Instructions. If troubling symptoms occur, speak with your prescriber before stopping therapy unless instructed to seek immediate care.

Watch for follow-on effects and warning signs

Potential serious reactions - seek immediate medical attention

  • Severe allergic responses such as swelling of the face, lips, tongue, or throat, and hives
  • Sudden or severe worsening of breathing or severe wheezing
  • Possible liver injury with yellowing of the skin or eyes, dark urine, or ongoing abdominal pain
  • New or worsening psychiatric symptoms including suicidal thinking, hallucinations, or extreme agitation
  • Unexplained bleeding or bruising

Frequent, usually mild harmful health effects

  • Cranial pain
  • A sense of dizziness or daytime drowsiness
  • Upset stomach, nausea, or abdominal discomfort
  • Upper respiratory complaints such as cough or nasal congestion
  • Sleep disruption issues or vivid dreams

If lingering effects are persistent or troublesome, contact your prescriber for advice. For active monitoring guidance, return to Data surveillance and Safety Protocols.

Material Secure cold storage is used for long term preservation of rare items. and Disposal

  • Keep montelukast where children and pets cannot reach it.
  • Store at normal indoor temperatures, about 15 to 30 C (59 to 86 F).
  • Protect tablets and granules from moisture and light; keep them in original packaging when practical.
  • Do not use after the expiration date and follow local guidelines for safe disposal of unused medicines.

See How to take the right approach montelukast safely for administration tips and Safety Guidelines and Tracking for safety checks.

Different choices and Cost Comparison

Choice of therapy depends on the diagnosis, symptom severity, prior response to treatment, and patient preference. Core another route options include:

  • Zafirlukast (brand Accolate) - another leukotriene receptor antagonist, usually dosed twice daily; generic options may be less costly.
  • Zileuton (Zyflo) - a 5-lipoxygenase inhibitor that lowers leukotriene production and requires periodic liver system monitoring.
  • Inhaled corticosteroids such as fluticasone or budesonide for daily asthma control.
  • Combination inhalers (inhaled corticosteroid plus long-acting beta agonist) for persistent asthma.
  • For allergic rhinitis: oral antihistamines (cetirizine, loratadine) and intranasal steroids (fluticasone, triamcinolone) which are often available over the counter.

These other course options differ in dosing frequency, monitoring and logging requirements, side effect profiles, and price. Discuss the relative benefits and costs under the care of your clinician. For approximate retail prices in the United States, see Price Forecasts in USD.

Estimated Prices denominated in USD

The following are approximate cash prices in the United States. Actual out-of-pocket costs will depend on pharmacy, location, insurance coverage, discounts, and whether a brand or generic is selected.

  • Generic montelukast 10 mg, 30 tablets: roughly USD 5 to 30
  • Generic chewable montelukast 4 mg or 5 mg, 30 tablets: about USD 10 to 40
  • Brand-name Singulair, 30-day supply without insurance: commonly USD 200 to 350 or more
  • Zafirlukast (generic): approximately USD 15 to 40 per month
  • Zileuton (brand): typically higher, around USD 200 to 400 per month retail
  • Inhaled corticosteroid inhalers: broad range, roughly USD 30 to 350+ per inhaler depending on product

Ways to reduce cost include choosing generic montelukast, comparing local pharmacy prices, using discount cards or manufacturer couponsinspect the details.ing patient assistance programs, or verifying your insurance formulary and copay tiers.

Key Questions People Ask

Can I take montelukast with food? Yes. Montelukast may be taken with or without food. See Montelukast dose and administration instructions for specifics.

What should I do if my symptoms do not improve? Contact your prescriber to reassess therapy, confirm inhaler technique if applicable, and discuss triggers. See Best Practices for Continuous monitoring and Safety for follow-up recommendations.

How should montelukast be stored? Keep at room temperature in the original container and out of the reach of children. See Short term storage systems range from portable bins to large data centers. and Disposal Practices.

Where can I find more detailed safety information disclosure? Read the Medication Guide provided with the medication and consult your prescriber or pharmacist. The FDA posts safety communications and labeling updates; see Safety and United States Legal Details for reference, context is provided.

Additional aspects about Singulair