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Singulair
Singulair (generic name: montelukast) is a prescription medication used to prevent and treat symptoms of asthma, exercise-induced bronchoconstriction (EIB), and allergic rhinitis (seasonal or year-round allergies). It belongs to a class of drugs known as leukotriene receptor antagonists, which work by blocking the action of certain chemicals (leukotrienes) that cause inflammation in the airways. By reducing inflammation, Singulair helps prevent asthma attacks and alleviate allergy symptoms such as sneezing, runny nose, and itchy eyes. Singulair is generally taken once daily, and it is effective in both children and adults.
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Frequently Asked Questions
How long does it take for Singulair to work?
Singulair starts working within a few days, but it may take up to 2 weeks to achieve the full benefit for asthma and allergy symptoms.
Can Singulair be taken with other asthma medications?
Yes, Singulair is often prescribed along with other asthma medications, such as inhaled corticosteroids and bronchodilators. It should not replace a rescue inhaler for acute asthma attacks.
Can I stop taking Singulair once my asthma is under control?
No, Singulair is a maintenance medication, and it should be taken daily even when your asthma or allergies are under control. Consult your doctor before making any changes to your treatment plan.
Is Singulair safe for children?
Yes, Singulair is approved for use in children as young as 6 months for allergic rhinitis and 12 months for asthma. The dosage is adjusted based on the child's age and condition.
Can Singulair be used for exercise-induced bronchoconstriction?
Yes, Singulair can be taken 2 hours before exercise to help prevent symptoms of exercise-induced bronchoconstriction in children aged 6 years and older and adults.
Comprehensive Drug Guide
How Does Singulair Work?
Singulair works by blocking the activity of leukotrienes, inflammatory chemicals produced by the body that contribute to asthma symptoms and allergic reactions. Leukotrienes cause swelling and constriction of the airways, as well as increased mucus production. By blocking these chemicals, Singulair helps prevent asthma attacks, reduces inflammation in the lungs, and alleviates symptoms of allergic rhinitis.
Common Dosages
- 10 mg tablets (for adults and adolescents aged 15 years and older)
- 5 mg chewable tablets (for children aged 6 to 14 years)
- 4 mg chewable tablets and oral granules (for children aged 12 months to 5 years)
Typical Dosing
- For asthma: The recommended dose for adults and adolescents aged 15 years and older is 10 mg once daily, taken in the evening. For children, the dose depends on age and is typically 4 mg or 5 mg once daily in the evening.
- For exercise-induced bronchoconstriction: A single dose of 10 mg for adults and adolescents (or 5 mg for children aged 6 to 14 years) is taken 2 hours before exercise to prevent bronchoconstriction.
- For allergic rhinitis: The typical dose is 10 mg once daily for adults and adolescents aged 15 years and older. Children receive lower doses based on their age.
Typical Dosing
FDA Approved Indications
- Chronic asthma in adults and children aged 12 months and older
- Exercise-induced bronchoconstriction (EIB) in adults and children aged 6 years and older
- Seasonal allergic rhinitis (hay fever) in adults and children aged 2 years and older
- Perennial allergic rhinitis (year-round allergies) in adults and children aged 6 months and older
Who Shouldn't Take Singulair?
- Known hypersensitivity or allergic reaction to montelukast or any component of the formulation.
Advice From The Pharmacist
- Singulair should be taken once daily, at the same time each day, even if you are feeling well or not experiencing asthma symptoms.
- For asthma, take Singulair in the evening, as it may provide better control of nighttime symptoms.
- Singulair is not a rescue medication and should not be used to treat an acute asthma attack. Always have a quick-relief inhaler (such as albuterol) available for sudden asthma symptoms.
- The chewable tablet should be chewed thoroughly before swallowing. Oral granules can be given directly into the mouth or mixed with a spoonful of soft food such as applesauce or yogurt.
- If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Side Effects of Singulair
Common Side Effects
- Headache
- Stomach pain or upset
- Diarrhea
- Sore throat
- Cough
- Fever (in children)
Uncommon/Severe Side Effects
- Mood or behavior changes, such as agitation, aggression, or suicidal thoughts
- Allergic reactions, such as rash, swelling, or difficulty breathing
- Liver problems, with symptoms such as yellowing of the skin or eyes (jaundice)
Risks and Warnings of Singulair
- Neuropsychiatric Events: Singulair has been associated with mood changes, depression, and suicidal thoughts. Patients, especially children and adolescents, should be closely monitored for any behavioral changes. If such symptoms occur, contact your healthcare provider immediately.
- Allergic Reactions: In rare cases, Singulair can cause allergic reactions, including angioedema (swelling of the face, lips, or tongue). Discontinue the medication and seek medical attention if this occurs.
- Eosinophilic Conditions: Some patients taking Singulair for asthma may develop an increase in certain white blood cells (eosinophils), which can lead to inflammation and worsening of lung or heart problems.
Interactions with Singulair
Common Drug Interactions
- Phenobarbital and rifampin: These drugs can decrease the effectiveness of Singulair by increasing the breakdown of montelukast in the liver.
- Corticosteroids: There are no known interactions with inhaled or oral corticosteroids, and these medications are often used together for asthma control.
Alternatives to Singulair
- Zafirlukast (Accolate): Another leukotriene receptor antagonist used to manage asthma symptoms.
- Inhaled corticosteroids (e.g., fluticasone, budesonide): These are often used as a first-line treatment for asthma and provide long-term control by reducing inflammation in the lungs.
- Antihistamines (e.g., loratadine, cetirizine): These are commonly used to treat allergic rhinitis and may be used in conjunction with Singulair for better symptom control.
