What Is Montelukast Used For? Uses, Benefits, and Safety Precautions

Uses, benefits, safety precautions and considerations.

Montelukast (Singulair) is a prescription drug prescribed to prevent and manage asthma symptoms, to prevent exercise-induced breathing problems, to treat allergic rhinitis.

Montelukast helps manage the symptoms by blocking a substance (leukotrienes) that contributes to airways' narrowing and inflammation.

Montelukast provides symptom relief but cannot be used as a rescue therapy to treat sudden asthma attacks.

Physicians may prescribe montelukast to address asthma that cannot be managed by other means, as well as for the treatment of allergic conditions that have not responded satisfactorily to another medication. However, FDA warns that montelukast is associated with serious mental disorders development and therefore its benefits must be carefully assessed against risks.

What Is Montelukast For?

Montelukast uses include management of persistent asthma symptoms, treatment of exercise-induced bronchoconstriction and prevention of allergic rhinitis.

As stated by MedlinePlus, montelukast is approved for asthma prevention and treatment for patients aged one year old and older. Moreover, montelukast is approved to prevent exercise-induced bronchoconstriction in patients aged six years and older.

Moreover, montelukast may be used to reduce sneezing, rhinorrhea, nasal itchiness and nasal congestion.

However, FDA warns that montelukast is intended for the treatment of allergic rhinitis as a second-line option and must be used only for patients with allergic rhinitis when other treatments are less effective or unsuitable.

Montelukast 10 mg uses include those purposes indicated for adults and adolescents aged 15 years and older. Lower-strength formulations of montelukast are suitable for younger children.

For patients asking what is montelukast 10 mg used to treat, the prescribed indications may include asthma management, exercise-induced bronchoconstriction prevention, and allergic rhinitis when other suitable treatments are ineffective or cannot be tolerated.

Main Montelukast Uses

Montelukast helps to control conditions associated with allergic inflammation and airways' narrowing.

Montelukast for Asthma Prevention and Long-Term Treatment

Physicians prescribe montelukast in order to control asthma by preventing its symptoms such as wheezing, coughing, chest tightness and difficulty in breathing.

Montelukast for asthma is used as a preventive or long-term control treatment rather than a medicine for immediate relief during an asthma attack.

Asthma is the disease associated with airways' inflammation and makes them prone to irritation by some factors (e.g., pollen, smoke, dust, temperature changes).

Montelukast blocks chemicals causing asthma's inflammation and airways' narrowing.

Sometimes physicians prescribe montelukast as an adjunctive asthma control medication for patients with poor symptom management.

Inhaled steroids are usually prescribed to most asthmatic patients as primary medications in order to manage inflammation.

Inhaled steroids are considered as preferable drugs for asthma management. Montelukast cannot be used as a substitute of rescue inhaler.

You should follow your asthma action plan if an attack is experienced. Montelukast cannot be used for treating acute attacks.

Montelukast for Exercise-Induced Bronchoconstriction

Some people might be prone to developing breathing problems during or after physical exercise.

The condition is called exercise-induced bronchoconstriction and can manifest in symptoms like wheezing, coughing and tightness of chest.

Montelukast prevents airways' narrowing related to exercise.

The use of montelukast for exercise induced asthma refers to preventing exercise-related airway narrowing when this treatment has been prescribed.

DailyMed recommends to use prescribed montelukast dose at least two hours before exercise in case when it is prescribed for that purpose.

If you are already using montelukast daily, you shouldn't take an additional dose prior to exercise.

You should use montelukast for exercise-induced asthma attack prevention, not as a rescue therapy.

Montelukast for Allergic Rhinitis (Seasonal and Year-Round Allergies)

Montelukast for allergic rhinitis may be used to manage symptoms related to exposure to allergen.

The use of montelukast for allergies is generally considered when other appropriate allergy treatments have not provided satisfactory relief or cannot be used.

Seasonal allergic rhinitis develops in certain seasons due to exposure to allergen like pollen, whereas year-round allergic rhinitis develops due to exposure to allergens present all the time (like mold, animal dander).

Montelukast prevents nasal inflammation by blocking leukotrienes' activity.

However, FDA states that montelukast must be reserved only for patients with allergies whose symptoms could not be satisfactorily treated by other medications.

This recommendation is required due to potential mental side effects associated with montelukast therapy.

For patients wondering why is montelukast prescribed for allergic rhinitis, doctors may consider it when symptoms remain inadequately controlled with other appropriate treatments or those treatments are unsuitable.

How Does Montelukast Work?

Montelukast belongs to leukotriene receptor antagonists.

Leukotrienes are the substances secreted by the body during allergic and inflammatory reactions. They contribute to airways' narrowing and swelling.

Montelukast blocks those receptors that respond to leukotrienes. In this way it decreases airways' inflammation and narrowing that may be associated with asthma and allergic reactions.

If you wonder how does montelukast work for asthma and allergies then it blocks one of the pathways that can produce these conditions.

It cannot open airways quickly like rescue inhaler.

That's why montelukast is used for preventive and chronic treatment only.

How Long Does Montelukast Take To Work?

Montelukast starts acting after the administration, however, time needed to notice the effect may vary.

How Quickly Does Montelukast Work For Asthma?

According to the NHS recommendations, montelukast can start helping with asthma symptoms in about one day.

However, some patients may need a more time to assess the effectiveness of this drug.

NHS advises to discuss other medications with your physician if montelukast hasn't helped during 4–8 weeks.

You shouldn't wait that long if your asthma becomes worse or your rescue inhaler is used more frequently.

How Long Does Montelukast Take To Work For Allergies?

Some patients notice improvement in allergic symptoms after first day of treatment.

However, some patients need several days to find out whether their symptoms are satisfactorily controlled.

The response depends on the severity of symptoms and continuous exposure to allergens.

If you want to know how long montelukast works for allergies you need to understand that this drug might be ineffective in controlling every symptom of allergy.

Patients searching how long does montelukast take to work for allergies should understand that the response varies and symptom relief may not be noticeable immediately.

Chronic congestion, sneezing and nose irritation should be discussed with your physician.

How Long Before Exercise Should Montelukast Be Taken?

If montelukast was prescribed specifically for exercise-induced bronchoconstriction, then it should be taken at least two hours prior to exercise.

More than one montelukast dose shouldn't be taken within 24 hours.

Those patients using montelukast daily shouldn't take montelukast for exercise-related symptoms.

How Should You Take Montelukast?

Montelukast is usually prescribed for once-a-day usage but depending on the condition the dosage schedule might be different.

Best Time To Take Montelukast

To prevent and manage asthma symptoms, montelukast should be taken regularly in the evening.

If montelukast is used for allergic rhinitis then the schedule of the drug usage depends on the physician's recommendations.

If you have asthma and allergic rhinitis then evening usage is recommended.

Always follow your prescribed schedule.

Montelukast Forms Available

Montelukast is available in forms as follows:

• 10 mg regular tablets – usually prescribed for adults and adolescents aged 15 years and older.
• 5 mg chewable tablets – usually prescribed for children aged 6–14 years.
• 4 mg chewable tablets – prescribed for children aged 2–5 years.
• 4 mg oral granules – available for younger children.

Regular tablets should be taken in their whole. Chewable tablets should be chewed prior to swallowing.

Food consumption instructions are provided by the packaging.

Oral granules can be administered alone or mixed with approved soft foods or liquids according to the manufacturer's directions. After granules container opening, administration should be done within 15 minutes.

Which formulation should be used depends on the age of your child and the condition requiring treatment.

What Should You Do If You Skip a Dose?

If you forget to take montelukast dose then it should be skipped and next dose should be used at regular time.

Never double doses.

According to MedlinePlus, more than one montelukast dose shouldn't be taken in 24 hours.

What Are the Common Side Effects of Montelukast?

As many other prescription medications, montelukast can cause side effects.

The common adverse effects that can occur include:

• Headache
• Abdominal pain
• Bloating and heartburn
• Diarrhea
• Fatigue
• Fever or upper respiratory tract symptoms in some patients

Not all of these side effects will appear.

However, you should always discuss persistent or developing complications with your healthcare provider.

Montelukast also requires special caution due to its mental side effects.

When considering montelukast benefits and side effects, patients should discuss both the expected symptom control and the possibility of serious neuropsychiatric reactions with their healthcare professional.

Important Warning: Montelukast And Neuropsychiatric Side Effects

FDA warns about the potential mental side effects of montelukast requiring a black box warning since suicidal thoughts or behavior was noted among those taking the drug and after its discontinuation in some patients.

Can Montelukast Cause Mood or Behavior Changes?

Yes. Montelukast can cause changes in patient's mood and behavior, sleep patterns and so on.

Possible side effects of the drug can be:

• Anxiety, irritation, agitation
• Nightmares or strange dreams
• Sleep problems (insomnia and others)
• Depression or rapid mood changes
• Sudden aggressive or unusual behavior
• Delirium and hallucinations
• Suicidal thoughts or behavior

These symptoms might develop even in people with no history of mental problems.

Exact risk of these events in one individual patient is hard to predict.

What Should You Do If You Experience Neuropsychiatric Symptoms?

Stop using montelukast and consult your healthcare professional as soon as possible if you or your child experienced unusual changes in sleep or mood.

Your family members should also pay attention to unusual symptoms in children unable to explain what they feel.

Contact your physician immediately in case of suicidal thoughts or danger to your life or health.

In case when montelukast was prescribed for asthma and neuropsychiatric symptoms appeared, you should immediately discuss another medication with your prescriber.

Who Should Know About These Risk Prior to Montelukast Treatment?

Any person prescribed montelukast should know about this important information.

Tell your healthcare provider about the presence of any current or previous mental problems.

However, absence of such conditions doesn't make you protected from developing side effects.

For allergic rhinitis, FDA also recommends taking into account other treatment options prior to montelukast prescription.

Can Children Use Montelukast?

Yes. Montelukast may be prescribed to children but only for certain conditions and depending on their age.

Under U.S. prescribing information, approved age ranges for the following conditions are as follows:

• Asthma prevention and treatment – children aged 12 months and older;
• Exercise-induced bronchoconstriction – children aged six years and older;
• Seasonal allergic rhinitis – children aged two years and older;
• Year-round allergic rhinitis – children aged six months and older.

Children need age-specific formulation and dosage of montelukast.

Parents should pay attention to montelukast administration and monitor appearance of any side effects.

Unusual behavior, insomnia, nightmares, strange irritability and mood change should be reported as soon as possible, and montelukast should be stopped according to FDA warning.

Montelukast vs. Other Asthma and Allergy Drugs

Montelukast acts in a different way compared to several other prescription asthma and allergy treatments.

Montelukast vs. Antihistamines For Allergies

Cetirizine and loratadine are examples of antihistamines.

These drugs reduce symptoms of allergic reaction by blocking the effects of substance (histamine) that is responsible for inflammation during allergic reactions.

Montelukast blocks leukotrienes' activity and has no effect on histamine.

Both approaches can relieve allergic reaction, however antihistamines and nasal corticosteroid sprays are more preferable for allergic rhinitis. Montelukast is considered when other therapies are ineffective or not applicable.

Montelukast vs. Inhalers For Asthma

Montelukast is used orally while asthma inhalers contain medicine that goes directly into lungs.

Inhaled corticosteroids help to manage airways' inflammation and are usually recommended for the vast majority of asthmatic patients.

Reliever inhalers can provide fast relief when asthma exacerbation is developing.

Montelukast may be additionally prescribed but cannot substitute your reliever inhaler.

You should never decrease or stop any of asthma inhalers without medical recommendation.

When You Should Talk with Your Physician Regarding Montelukast?

Regular consultations with your physician will help to define the efficiency of montelukast use for your condition.

You should contact your doctor if:

• Your asthma symptoms get worse or develop more frequently
• You need to use reliever inhaler more often
• The symptoms of allergic rhinitis persist despite using montelukast
• You experience persistent or troublesome side effects
• You want to discuss interaction between medications and/or suitability of this treatment.

Neuropsychiatric symptoms should be immediately reported to your physician and montelukast therapy should be discontinued.

In case of developing of serious breathing problems, swelling of face and neck or any signs of allergic reaction requiring emergency treatment contact healthcare professionals right away.

Inform your pharmacist about all medications you are currently taking as some of them (like rifampin and some antiseizure drugs) may affect the amount of montelukast absorbed.

Frequently Asked Questions About Montelukast

Is montelukast used for cough?

Montelukast can be used for coughing that is associated with asthma or allergic reaction. This drug is not a general cough suppressant and doesn't help to relieve any type of cough. Cough requires proper diagnosis.

The use of montelukast for cough depends on whether the coughing is associated with a condition for which montelukast has been prescribed.

Does montelukast help with allergies and sinus?

Montelukast may be used to control sneezing, nasal congestion and other symptoms of allergic rhinitis. However, this drug can't be used for treatment of sinus infection.

Due to the risk of development of neuropsychiatric complications, other medications for allergies are preferred.

For people asking can montelukast be used for cough and congestion, the answer depends on the underlying cause, since montelukast is not a general cough suppressant or a treatment for every cause of nasal congestion.

Can montelukast be used during asthma attack?

No. Montelukast cannot help in emergency situation of asthma attack. Use the prescribed rescue inhaler.

Is montelukast a steroid or antihistamine?

Neither of them. Montelukast is a leukotriene receptor antagonist.

This drug doesn't act as steroid or antihistamine, rather blocks the effects of leukotrienes.

Why is montelukast used at night?

Evening administration is recommended for asthma patients under U.S. prescribing information.

Most clinical trials performed to obtain approval for the use of montelukast in asthma had evening dosing. However, this doesn't mean that it works only at night.

Can montelukast be taken every day?

Yes, if montelukast is prescribed for ongoing management of asthma symptoms or treatment of allergic rhinitis.

However, therapy using montelukast should be periodically reviewed by your physician in order to estimate the risks and benefits of this treatment.

For patients asking what are the benefits and risks of taking montelukast daily, the potential benefit is ongoing symptom control, while the risks include common adverse effects and serious possible changes in mood, sleep, or behavior.

Can montelukast be taken with cetirizine?

Montelukast and cetirizine can sometimes be prescribed simultaneously due to different mechanism of actions of the drugs.

However, don't start using montelukast with allergies unless it is allowed by the prescriber as it requires FDA black box warning.

How long should you take montelukast?

Duration of treatment depends on the condition, its severity and response to the therapy. Some patients need long-term treatment due to persistent asthma, some – for a short period of time.

Your physician should review treatment periodicity in order to decide on further actions regarding the treatment.

What will happen if you suddenly discontinue montelukast?

After the discontinuation asthma or allergy symptoms might appear again or develop as montelukast cannot cure the condition.

Usually, you should discontinue montelukast only with consultation of your healthcare professional.

The exception is neuropsychiatric symptoms when treatment should be stopped right after the appearance of these symptoms. Contact your physician in case when you decide to discontinue montelukast therapy.

Final Thought: Main Montelukast Uses

Montelukast is used to prevent and manage asthma symptoms, prevent exercise-induced bronchoconstriction and to treat allergic rhinitis.

Its main mechanism of action consists in prevention of inflammation caused by leukotrienes.

However, montelukast cannot be used for treating acute asthma exacerbation and is not usually used for treatment of mild allergies.

Black box warning related to risk of neuropsychiatric complications of montelukast is the most important information regarding its use.

If you have been prescribed montelukast or montelukast 10 mg, use the formulation as recommended, monitor symptoms and have consultations with your healthcare professional.

 

Medical Sources

1. FDA – Montelukast Drug Safety Communication. Boxed warning concerning serious mental health side effects and recommendations restricting use for allergic rhinitis.
   https://www.fda.gov/drugs/drug-safety-communications/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug
2. DailyMed – SINGULAIR (Montelukast Sodium) Prescribing Information. Official labeling covering approved indications, age-specific dosages, exercise-related dosing, contraindications, and safety warnings.
   https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=482dcc92-b47f-4ea6-854a-f5ac2aea7842
3. MedlinePlus – Montelukast Drug Information. Patient guidance on medication uses, administration, missed doses, side effects, and mental health precautions.
   https://medlineplus.gov/druginfo/meds/a600014.html
4. NHS – How and When to Take Montelukast. Guidance on timing, available formulations, dosing, administration, and missed doses.
   https://www.nhs.uk/medicines/montelukast/how-and-when-to-take-montelukast/
5. NHS – Common Questions About Montelukast. Information about its mechanism, expected onset of benefit, asthma treatment, and exercise-related use.
   https://www.nhs.uk/medicines/montelukast/common-questions-about-montelukast/