Montelukast Sodium
| (mahn-teh-LOO-kast) |
| Singulair |
| Tablets: 10 mg |
| Tablets, chewable: 4 mg |
| Tablets, chewable: 5 mg |
| Class: Leukotriene receptor antagonist |
Action Blocks the effects of specific leukotrienes in the respiratory airways, thereby reducing bronchoconstriction, edema, and inflammation.
Indications Prophylaxis and chronic treatment of asthma.
Contraindications Standard considerations.
Route/DosageAdults and children at least 15 yr: PO 10 mg once daily in the evening.
Children 6 to 14 yr: PO 5 mg chewable tablet once daily in the evening.
Children 2 to 5 yr: PO 4 mg chewable tablet once daily in the evening.
Children 12 to 23 mo: PO 1 packet of 4 mg granules daily in the evening.
InteractionsPhenobarbital, rifampin:
Decreased montelukast levels.
Lab Test Interferences None well documented.
Adverse ReactionsCNS: Dizziness; headache. DERMATOLOGIC: Rash; urticaria. EENT: Dental pain; pharyngitis; laryngitis; nasal congestion; sinusitis; otitis; cough; ear pain; sneezing. GI: Dyspepsia; gastroenteritis; nausea; diarrhea; abdominal pain. HEPATIC: Increased AST and ALT. RESPIRATORY: Bronchitis. OTHER: Asthenia; fatigue; viral infection; influenza; pyuria; fever; leg pain; thirst.
PrecautionsPregnancy: Category B. Lactation: Undetermined. CHILDREN: Safety and efficacy in children less than 12 mo not established. Acute asthma attacks: Do not use for the reversal of bronchospasm in acute asthma attacks, including status asthmaticus.
| PATIENT CARE CONSIDERATIONS |
|
Administration/Storage- Administer in the evening.
- Store tablets at room temperature. Protect from light and moisture.
Assessment/Interventions- Review patient history, including drug history.
- If potent cytochrome P450 enzyme inducers, such as phenobarbital, are prescribed, employ appropriate clinical monitoring.
- Review history and laboratory tests for signs of decreased severe hepatic function.
- Do not administer alone for acute attacks. This drug is for prophylaxis only. Have short-acting inhaled beta-agonists available for respiratory emergencies.
- Monitor patients appropriately.
- Monitor patient for effective prophylaxis and lessening of asthma symptoms.
Patient/Family Education- Provide patient information pamphlet.
- Advise patient to take montelukast daily in the evening as prescribed, even when asymptomatic, as well as during periods of worsening asthma.
- Advise patient that oral tablets of montelukast are not for treatment of acute asthma attack but for prophylaxis purposes.
- Advise patient to have short-acting inhaled beta-agonists available for respiratory emergencies to treat asthma exacerbations.
- Instruct patient to seek medical attention if short-acting inhaled bronchodilators are needed more often than usual or respiratory difficulties are present.
- Inform patient with phenylketonuria that the 4 and 5 mg chewable tablets contain phenylalanine.
- Instruct patient who has exacerbations of asthma after exercise to use the usual treatment of inhaled beta-agonists for prophylaxis as prescribed.
- Caution patient with known aspirin sensitivity to avoid aspirin or NSAIDs while taking montelukast.
- Instruct patient not to decrease the dose or stop taking any other anti-asthma medication unless instructed by a health care provider.
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