section name header

Pronunciation

mon-te-LOO-kast

Classifications

Therapeutic Classification: allergy, cold and cough remedies, bronchodilators

Pharmacologic Classification: leukotriene antagonists

Indications

REMS


Action

  • Antagonizes the effects of leukotrienes, which mediate the following:
    • Airway edema,
    • Smooth muscle constriction,
    • Altered cellular activity.
  • Result is decreased inflammatory process, which is part of asthma and allergic rhinitis.
Therapeutic effects:
  • Decreased frequency and severity of acute asthma attacks.
  • Decreased severity of allergic rhinitis.
  • Decreased attacks of exercise-induced bronchoconstriction.

Pharmacokinetics

Absorption: Rapidly absorbed (63–73%) following oral administration.

Distribution: Minimally distributed to tissues.

Protein Binding: 99%.

Metabolism/Excretion: Mostly metabolized by the liver by the CYP3A4 and CYP2C9 isoenzymes; metabolites eliminated in feces via bile; negligible renal excretion.

Half-Life: 2.7–5.5 hr.

Time/Action Profile

(improved symptoms of asthma)

ROUTEONSETPEAKDURATION
PO (swallow)within 24 hr3–4 hr24 hr
PO (chew)within 24 hr2–2.5 hr24 hr



Plasma concentrations.



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Derm: rash, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS

EENT: epistaxis, otitis (children), rhinorrhea, sinusitis (children)

GI: liver enzymes, abdominal pain, diarrhea (children), dyspepsia, nausea (children)

Neuro: aggression, agitation, anxiety, attention disturbance, depression, disorientation, dream abnormalities, fatigue, hallucinations, headache, insomnia, irritability, memory impairment, obsessive-compulsive symptoms, restlessness, sleep walking, stuttering, SUICIDAL BEHAVIORS/THOUGHTS, tics, tremor, weakness

Resp: cough

Misc: EOSINOPHILIC CONDITIONS (INCLUDING CHURG-STRAUSS SYNDROME), fever

Interactions

Drug-drug:

Route/Dosage

Asthma

Exercise-Induced Bronchoconstriction

Allergic Rhinitis

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Singulair

Pill Image

montelukastsodium_195-8762.jpg