Montelukast functions as a leukotriene receptor antagonist (cysteinyl leukotriene receptors). It works by blocking the action of leukotriene D4 in the lungs resulting in decreased inflammation and relaxation of smooth muscle.

Montelukast is effective in treating the overall symptoms of allergic rhinitis when compared against placebo. It is also effective in treating the night-time symptoms of allergic rhinitis when compared against oral antihistamines.

Montelukast is proposed to potentiate its effects through two probable mechanisms:

1. Its effect in preventing the cytokine storm by modulating the immune response.
2. The direct effect on the virus which is explored using the computational docking.

Therapeutic Fields​

Allergic rhinitis (perennial or seasonal)

Asthma, persistent (maintenance therapy)

Bronchoconstriction, exercise-induced (prevention)

It is estimated that the number of people with Asthma will grow from

300 million to more than 400 million

worldwide by 2025 – a 100 million increase.
Dosing

Pediatric 6-15 years: 5 mg once daily

Adult and Adolescents ≥15 years: 10 mg once daily

Renal Impairment

No adjustment necessary.

Hepatic Impairment

Mild to moderate impairment: No dosage adjustment necessary.

Severe impairment: has not been studied.

Administration

May administer without regard to food or meals.

Missed dose: The missed dose should be skipped and therapy resumed at next scheduled doses; two doses should not be administered at the same time to catch up.

Cautions

• Serious neuropsychiatric (NP) events: have been reported with the use of montelukast. If changes in behavior are observed, or if new NP symptoms or suicidal thoughts and/or behavior occur, advise patients to discontinue montelukast and contact a health care provider immediately.
• Acute asthma/bronchospasm: Montelukast is not FDA approved for use in the reversal of bronchospasm in acute asthma attacks, including status asthmaticus.
• Chewable tablet(5mg): Contains phenylalanine. Avoid use in phenylketonuria

Eosinophilia and vasculitis

Contraindications

• Hypersensitivity to montelukast or any component of the formulation
• 5mg chewable tablet contain phenylalanine, avoid use in phenylketonuria

Pregnancy

An increased risk of teratogenic effects has not been observed with montelukast use in pregnancy. Montelukast should not be withheld during pregnancy when clinically indicated

Breast-feeding

• Montelukast is present in breast milk, the decision to breastfeed during therapy should consider the risk and benefits.