Adult Dosing
Asthma
- 10 mg PO qd in the evening
Exercise-Induced Bronchoconstriction (EIB)
- 10 mg PO qd, at least 2 hrs before exercise. Max: 10 mg/24 hrs
- Do not take an additional dose if already on daily montelukast therapy for another indication
Allergic Rhinitis
Seasonal and Perennial Allergic Rhinitis
Pediatric Dosing
Asthma
- 12-23 months: 4-mg oral granules PO qd in the evening
- 2-5 yrs of age: 4-mg chewable tablet or 4-mg oral granules PO qd in the evening
- 6-14 yrs: 5-mg chewable tablet PO qd in the evening
15 yrs: 10 mg PO qd in the evening
Note: Safety and effectiveness in pediatric patients <12 months of age with asthma have not been established
Exercise-Induced Bronchoconstriction (EIB)
- 15 yrs: 10 mg PO qd, at least 2 hrs before exercise. Max: 10 mg/24 hrs
- Do not take an additional dose if already on daily montelukast therapy for another indication
Note: Safety and effectiveness in pediatric patients <15 yrs of age have not been established
Allergic Rhinitis
Seasonal Allergic Rhinitis
- 2-5 yrs of age: 4-mg chewable tablet or 4-mg oral granules PO qd
- 6-14 yrs: 5-mg chewable tablet PO qd
- 15 yrs: 10 mg PO qd
Note: Safety and effectiveness in pediatric patients <24 months of age have not been established
Perennial Allergic Rhinitis
- 6-23 months: One packet of 4-mg oral granules PO qd
- 2-5 yrs of age: 4-mg chewable tablet or 4-mg oral granules PO qd
- 6-14 yrs: 5-mg chewable tablet PO qd
- 15 yrs: 10 mg PO qd
Note: Safety and effectiveness in pediatric patients <6 months of age have not been established in perennial allergic rhinitis
[Outline]
See Supplemental Patient Information
- Do not use for reversal of bronchospasm in acute asthma attacks, including status asthmaticus. Patients should have appropriate rescue medications available
- Abrupt substitution of oral/inhaled corticosteroids with montelukast should not be done; gradually reduce the dose of inhaled corticosteroids during concomitant administration
- Patients with known aspirin sensitivity should avoid use of aspirin or NSAIDs during treatment with montelukast
- Neuropsychiatric events like agitation, aggressive behavior or hostility, anxiousness, depression, disorientation, dream abnormalities, hallucinations, insomnia, irritability, restlessness, somnambulism, suicidal thinking and behavior (including suicide), and tremor have been reported in adult, adolescent and pediatric patients taking montelukast in post-marketing reports. Carefully evaluate the risks and benefits of continuing treatment if these events occur
- Systemic eosinophilia, sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome may occur during therapy in patients with asthma. Physicians should be alert to eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients
- Inform phenylketonuric patients that montelukast chewable tablets contain phenylalanine
Cautions: Use cautiously in
Supplemental Patient Information
- Inform patients that oral montelukast is not recommended for treating acute asthma attacks
- Advise patients to have short-acting inhaled beta-agonist medication readily available to treat asthma exacerbations
Pregnancy Category:B
Breastfeeding: No published data exist on the use of montelukast during lactation; an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Montelukast is approved for use in children as young as 6 months of age. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 5 April 2011). Manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Singulair 4 MG CHEW [Bottle] (MERCK SHARP & DOHME)
30 mg = $166.91
90 mg = $466.48 - Singulair 5 MG CHEW [Bottle] (MERCK SHARP & DOHME)
30 mg = $166.99
90 mg = $463.96 - Singulair 10 MG TABS [Bottle] (MERCK SHARP & DOHME)
30 mg = $167.99
90 mg = $487.95 - Singulair 4 MG PACK [Packet] (MERCK SHARP & DOHME)
30 mg = $169.05
90 mg = $490.01
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
