Montelukast
Mechanism :
Montelukast is a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene CysLT1 receptor.
Indication :
- Asthma prophylaxis - add on therapy
- Exercise induced asthma
- Allergic rhinitis
Contraindications :
Contraindicated in patients with any previous sensitivity to montelukast. Not used to treat acute asthma attacks and cannot substitute inhaled or oral corticosteroids. Monitor for eosinophilia, vasculitic rash, worsening of pulmonary symptoms, cardiac complications and neuropathy.
Dosing :
Asthma, Perennial/seasonal allergic rhinitis:
Oral: Once daily in the evening
1-6 years: 4 mg
6-15 years: 5 mg
>15 years: 10 mg
Exercise induced bronchospasm:
6-15 years: 5 mg orally, 2 hours before exercise.
>15 years: 10 mg orally, 2 hours before exercise.
Adverse Effect :
Fever, headache, rash, influenza, nausea, diarrhoea, dyspepsia.
Interaction :
Phenytoin, Phenobarbital and Rifampicin: co-administered with CYP 3A4 inducers; plasma levels of montelukast may be decreased.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Not dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.