Singulair: Targeted Leukotriene Inhibition for Asthma & Allergy Control
Singulair
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $3.33 | $100.00 (0%) | 🛒 Add to cart |
| 60 | $2.50 | $200.00 $150.00 (25%) | 🛒 Add to cart |
| 90 | $2.22 | $300.00 $200.00 (33%) | 🛒 Add to cart |
| 120 | $2.09 | $400.00 $251.00 (37%) | 🛒 Add to cart |
| 180 | $1.95 | $600.00 $351.00 (42%) | 🛒 Add to cart |
| 270 | $1.86
Best per pill | $900.00 $502.00 (44%) | 🛒 Add to cart |
| Product dosage: 4mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.40 | $42.00 (0%) | 🛒 Add to cart |
| 60 | $1.15 | $84.00 $69.00 (18%) | 🛒 Add to cart |
| 90 | $1.08 | $126.00 $97.00 (23%) | 🛒 Add to cart |
| 120 | $1.04 | $168.00 $125.00 (26%) | 🛒 Add to cart |
| 180 | $1.00 | $252.00 $180.00 (29%) | 🛒 Add to cart |
| 270 | $0.97 | $378.00 $263.00 (30%) | 🛒 Add to cart |
| 360 | $0.96
Best per pill | $504.00 $346.00 (31%) | 🛒 Add to cart |
| Product dosage: 5mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $2.37 | $71.00 (0%) | 🛒 Add to cart |
| 60 | $1.88 | $142.00 $113.00 (20%) | 🛒 Add to cart |
| 90 | $1.73 | $213.00 $156.00 (27%) | 🛒 Add to cart |
| 120 | $1.65 | $284.00 $198.00 (30%) | 🛒 Add to cart |
| 180 | $1.57 | $426.00 $283.00 (34%) | 🛒 Add to cart |
| 270 | $1.52
Best per pill | $639.00 $411.00 (36%) | 🛒 Add to cart |
Synonyms
| |||
Singulair (montelukast sodium) is a leukotriene receptor antagonist (LTRA) prescription medication specifically formulated for the prophylactic and chronic treatment of asthma, and for the relief of symptoms of allergic rhinitis. It represents a distinct class of controller medication that targets a key inflammatory pathway, offering a non-steroidal option for managing underlying inflammation and bronchoconstriction. Its mechanism provides a critical therapeutic alternative for both adult and pediatric populations, as young as 12 months for asthma and 2 years for allergic rhinitis. This profile details the essential information for healthcare professionals considering its application in a treatment regimen.
Features
- Active Ingredient: Montelukast sodium.
- Pharmacologic Class: Selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene (CysLT1) receptor.
- Available Formulations: Film-coated tablets (4mg, 5mg, 10mg), chewable tablets (4mg, 5mg), and oral granules (4mg packet).
- Dosing Regimen: Once-daily administration, typically in the evening.
- Primary Indications: Prophylaxis and chronic treatment of asthma; relief of symptoms of allergic rhinitis (seasonal and perennial).
Benefits
- Provides targeted inhibition of leukotriene-mediated inflammation, a key pathway in asthma and allergic response.
- Reduces airway eosinophilic inflammation, a hallmark of asthmatic pathology.
- Improves overall asthma control, as measured by reduced daytime symptoms, nocturnal awakenings, and beta-agonist rescue use.
- Prevents exercise-induced bronchoconstriction (EIB) when taken at least 2 hours prior to physical activity.
- Offers effective relief from allergic rhinitis symptoms, including sneezing, nasal congestion, rhinorrhea, and pruritus.
- Serves as a convenient, once-daily, oral alternative or adjunct to inhaled corticosteroid therapy.
Common use
Singulair is indicated for the chronic treatment of asthma in adults and pediatric patients 12 months of age and older. It is not indicated for the reversal of acute asthma attacks, including status asthmaticus. For asthma management, it is used to prevent symptoms and reduce the frequency of exacerbations. It is also indicated for the prophylaxis of exercise-induced bronchoconstriction (EIB) in patients 6 years of age and older. Furthermore, it is approved for the relief of symptoms of allergic rhinitis (seasonal and perennial) in adults and pediatric patients 2 years of age and older. It may be used as monotherapy or as an add-on controller medication in patients who are inadequately controlled on inhaled corticosteroids and whose symptoms are significantly attributable to the leukotriene pathway.
Dosage and direction
Administration is once daily, without regard to food. For asthma and allergic rhinitis, the dose should be taken in the evening. For exercise-induced bronchoconstriction, it should be taken at least 2 hours before exercise and not repeated within 24 hours.
- Asthma & Allergic Rhinitis:
- Adults and adolescents 15 years and older: one 10mg tablet daily.
- Pediatric patients 6 to 14 years: one 5mg chewable tablet daily.
- Pediatric patients 2 to 5 years: one 4mg chewable tablet or one 4mg packet of oral granules daily.
- Pediatric patients 12 to 23 months (for asthma only): one 4mg packet of oral granules daily.
- Exercise-Induced Bronchoconstriction (EIB):
- Patients 15 years and older: one 10mg tablet at least 2 hours before exercise.
- Patients 6 to 14 years: one 5mg chewable tablet at least 2 hours before exercise.
- An alternative daily asthma therapy should be prescribed; daily administration for EIB is not recommended.
Precautions
Patients should be advised that Singulair is not for the treatment of acute asthma attacks. They should have appropriate short-acting bronchodilator medication available. Physicians should be alert to neuropsychiatric events, as serious side effects affecting behavior and mood have been reported (see Possible Side Effects). Systemic eosinophilia, sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome, has been reported rarely and is often associated with the reduction of oral corticosteroid therapy. Patients with phenylketonuria (PKU) should be informed that the 4mg and 5mg chewable tablets contain aspartame, a source of phenylalanine. Patients should be monitored for adequate asthma control and the dose should be reevaluated if control is not achieved.
Contraindications
Singulair is contraindicated in patients with known hypersensitivity to montelukast or any other component of the formulation. Hypersensitivity reactions, including anaphylaxis, angioedema, rash, and urticaria, have been reported.
Possible side effect
The most common adverse reactions in clinical trials (≥1% and greater than placebo) for adults and adolescents included headache, influenza, abdominal pain, cough, and dyspepsia. In pediatric patients, adverse reactions also included fever, otitis media, pharyngitis, sinusitis, and rhinorrhea. Serious side effects have been reported post-marketing and include:
- Neuropsychiatric events: Agitation, aggressive behavior or hostility, anxiety, depression, disorientation, disturbance in attention, dream abnormalities, hallucinations, insomnia, irritability, memory impairment, obsessive-compulsive symptoms, restlessness, sleepwalking, suicidal thinking and behavior (suicidality), tic, tremor.
- Allergic reactions: Hypersensitivity reactions including anaphylaxis, hepatic eosinophilic infiltration.
- Other: Pulmonary eosinophilia, erythema nodosum, increased bleeding tendency.
Drug interaction
Formal drug interaction studies showed no clinically significant inhibition of cytochrome P450 enzymes. However, caution is advised when co-prescribing with potent CYP450 enzyme inducers (e.g., phenobarbital, rifampin), as they may decrease the systemic exposure of montelukast. No dosage adjustment is recommended. Singulair may be added to existing treatments, including inhaled and oral corticosteroids, and bronchodilators.
Missed dose
Patients should be instructed to take the next prescribed dose at the regular time. They should not take a double dose to make up for a missed one. Consistency in daily evening administration is important for maintaining therapeutic effect in chronic asthma and allergy management.
Overdose
Experience in marketed use is limited. In chronic asthma studies, montelukast has been administered at doses up to 200 mg/day to patients without clinically important adverse experiences. There is no specific antidote for montelukast overdose. In the event of an overdose, the patient should be treated symptomatically, and supportive measures should be instituted as required. It is not known if montelukast is removed by peritoneal or hemodialysis.
Storage
Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F). Store in the original container or blister package. Protect from moisture and light. The 4mg oral granules packet may be administered directly in the mouth, dissolved in 5mL of cold or room temperature baby formula or breast milk, or mixed with a spoonful of soft food (e.g., applesauce, carrots, rice, or ice cream). The food or formula must be cold or at room temperature and used within 15 minutes of mixing. Do not store any mixed drug/food or formula for future use. Keep all medications out of the reach of children.
Disclaimer
This information is intended for educational purposes and for review by healthcare professionals only. It is a summary and does not include all possible information about this product. It does not constitute medical advice. A healthcare professional must be consulted for a complete list of indications, warnings, precautions, adverse events, and other important information prior to prescribing any medication. The patient should always be instructed to read the accompanying FDA-approved patient labeling or Medication Guide.
Reviews
- “As an allergist, I find Singulair to be a valuable tool in my arsenal, particularly for patients with concomitant asthma and allergic rhinitis. Its once-daily dosing improves adherence, especially in pediatric populations where inhaler technique can be a barrier. I use it frequently as an add-on therapy to inhaled corticosteroids.” – Allergist/Immunologist, 15 years experience.
- “In my pediatric practice, the chewable and granule formulations are essential for young asthmatics. It provides a clear anti-inflammatory effect and is well-tolerated by most children. I always counsel families thoroughly on the potential for neuropsychiatric side effects, however, and monitor closely.” – Pediatric Pulmonologist, 10 years experience.
- “For managing exercise-induced bronchoconstriction in my adolescent athletes, Singulair offers a convenient and effective prophylactic option. It integrates easily into their pre-game routine and has demonstrated reliable efficacy in preventing symptoms during competition.” – Sports Medicine Physician, 8 years experience.
- “While effective for many, it is not a panacea. I reserve it for patients whose symptom profile suggests a strong leukotriene component. It is less potent than inhaled corticosteroids for moderate-to-severe persistent asthma but serves as an excellent steroid-sparing agent or for those who cannot tolerate ICS.” – Pulmonologist, 20 years experience.