Montelukast: Price, Dosage & Where to Buy

Montelukast is a leukotriene receptor antagonist prescribed to prevent and manage asthma, to prevent exercise-induced bronchoconstriction, and to relieve symptoms of seasonal and perennial allergic rhinitis in patients 15 years of age and older. It has been available as a generic medicine since August 2012. In the United Kingdom, montelukast requires a prescription.

Montelukast is a leukotriene receptor antagonist. Leukotrienes are substances released by the body during allergic and inflammatory responses. They cause the airways to narrow, increase mucus production, and contribute to inflammation in the lungs and nasal passages.

Montelukast works by blocking the action of leukotrienes at their receptors, which helps to keep the airways open, reduce inflammation, and decrease mucus production. This mechanism makes breathing easier for people with asthma, helps prevent bronchoconstriction triggered by exercise, and reduces the nasal congestion, sneezing, and other symptoms associated with allergic rhinitis.

Montelukast is used for the prophylaxis and chronic treatment of asthma in adults and adolescents 15 years of age and older. It is also prescribed for the prevention of exercise-induced bronchoconstriction in patients 15 years of age and older. Additionally, montelukast relieves symptoms of seasonal allergic rhinitis and perennial allergic rhinitis in patients 15 years of age and older.

For allergic rhinitis, the medicine is reserved for patients who have an inadequate response or intolerance to alternative therapies. Montelukast is not indicated for the treatment of an acute asthma attack.

The label lists 4 mg oral granules, 4 mg and 5 mg chewable tablets, and 10 mg tablets in several forms including film-coated tablets. For asthma in adults and adolescents 15 years of age and older, the usual dose is one 10 mg tablet once daily in the evening. For prevention of exercise-induced bronchoconstriction in adults and adolescents 15 years of age and older, the label lists a single dose of one 10 mg tablet at least 2 hours before exercise.

An additional dose should not be taken within 24 hours of a previous dose. For seasonal allergic rhinitis and perennial allergic rhinitis in adults and adolescents 15 years of age and older, the usual dose is one 10 mg tablet once daily.

Patients with both asthma and allergic rhinitis should receive only one dose daily in the evening. Patients who miss a dose should resume at their regular time and should not double the dose.

The label lists storage at 20° to 25°C (68° to 77°F), with excursions permitted to 15° to 30°C (59° to 86°F). The medicine should be protected from moisture and light and stored in the original package to maintain quality. When a bulk bottle is subdivided for dispensing, the medicine should be repackaged into a well-closed, light-resistant container.

If a dose is missed, the label advises that the next dose should be taken at the regular scheduled time. Two doses should not be taken at the same time to make up for a missed dose.

For patients using montelukast for asthma or allergic rhinitis, continuing with the regular once-daily schedule is appropriate. For patients using montelukast to prevent exercise-induced bronchoconstriction, the single-dose timing before exercise remains important, but an additional dose should not be taken within 24 hours of a previous dose.

Published data from prospective and retrospective cohort studies over decades with montelukast use in pregnant women have not established a drug-associated risk of major birth defects. Animal reproduction studies in rats and rabbits at doses approximately 100 and 110 times the maximum recommended human daily oral dose showed no adverse developmental effects. Poorly or moderately controlled asthma in pregnancy increases the maternal risk of perinatal adverse outcomes such as preeclampsia and infant prematurity, low birth weight, and small for gestational age.

A published clinical lactation study reports the presence of montelukast in human milk, but available data do not suggest a significant risk of adverse reactions from exposure through breast milk. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for montelukast.