Patients in whom leukotriene receptor antagonists (LTRAs) may be particularly effective are those with aspirin sensitivity, a large exercise induced component to the symptoms, highly atopic eczema, and rhinitis.
- Tablets 10mg (£1.10)
- Chewable tablets 4mg, 5mg (£0.89, £1.06)
- Paediatric granules 4mg (£4.85)
Indications and dose:
- Prophylaxis of asthma:
- Child 6 months–5 years: 4 mg once daily, dose to be taken in the evening.
- Child 6–14 years: 5 mg once daily, dose to be taken in the evening.
- Adults and adolescents 15 years of age and above: 10 mg once daily, dose to be taken in the evening.
- Montelukast is not indicated for treatment of an acute deterioration of asthma and should not be used to relieve an attack of acute severe asthma. Montelukast does not necessarily allow a reduction in the existing corticosteroid treatment.
- Montelukast may be considered if exercise induced asthma is a specific problem in a patient who is otherwise well controlled.
- Treatment should be trialled – if no benefit seen after 4 weeks, montelukast should be discontinued and alternative treatment options discussed with the patient
- Refer to paediatric and adult asthma guidance for further information on the use of montelukast in the management of asthmatic patients.
MHRA Drug Safety Update (September 2019): reminder
of the risk of neuropsychiatric reactions
- be alert for neuropsychiatric reactions in patients taking montelukast; events have been reported in adults, adolescents, and children
- advise patients and their caregivers to read carefully the list of neuropsychiatric reactions in the patient information leaflet and seek medical advice immediately should they occur
- evaluate carefully the risks and benefits of continuing treatment if neuropsychiatric reactions occur
- be aware of newly recognised neuropsychiatric reactions of speech impairment (stuttering) and obsessive–compulsive symptoms
3. Respiratory >
3.3 Cromoglicate and related therapy, leukotriene receptor antagonists and phosphodiesterase type-4 inhibitors >
3.3.2 Leukotriene receptor antagonists (LTRAs)
- First line
- Second line