Montelukast 1 A Pharma (Montelukast)

Montelukast is indicated for conditions involving leukotriene‑mediated airway inflammation.

• Asthma: improves control of chronic asthma symptoms and reduces exacerbations.
• Allergic rhinitis: alleviates nasal congestion, sneezing and itching caused by seasonal allergies.
• Exercise‑induced bronchoconstriction: prevents airway narrowing triggered by physical activity.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1, preventing leukotriene D4 and related mediators from binding. This inhibition reduces leukotriene‑induced bronchoconstriction, vascular permeability, and inflammatory cell recruitment in the respiratory tract, thereby improving airway function and decreasing allergic inflammation.

Montelukast may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Headache: mild to moderate pain often reported during early treatment.
• Abdominal pain: discomfort or cramping in the stomach region.
• Cough: transient irritation of the airway.
• Nausea: feeling of queasiness that may precede vomiting.

Serious or Rare Side Effects

• Allergic reactions: rash, angioedema, or anaphylaxis requiring immediate medical attention.
• Mood changes: depression, suicidal thoughts, or other neuropsychiatric events.
• Liver injury: elevated liver enzymes or hepatitis, monitored through laboratory tests.

When prescribing Montelukast, clinicians should consider several safety precautions.

• Neuropsychiatric monitoring: observe patients for mood alterations or suicidal ideation.
• Hepatic caution: use with care in patients with liver impairment and monitor liver function tests.
• Acute asthma: not indicated for immediate relief of acute bronchospasm; provide rescue inhaler.
• Hypersensitivity: assess for prior allergic reactions to Montelukast or formulation components.
• Store below 25°C: keep in the original pack, protect from moisture.

Montelukast can interact with other medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Rifampin: induces metabolism, markedly reducing Montelukast exposure.
• Phenobarbital: decreases plasma concentrations through enzyme induction.
• Carbamazepine: lowers Montelukast levels via hepatic enzyme activation.
• Ketoconazole: may increase Montelukast exposure, raising risk of adverse effects.

Moderate Interactions (Monitor Closely)

• Fluconazole: modestly raises Montelukast plasma levels.
• Erythromycin: can slightly increase exposure, requiring observation.
• Warfarin: monitor INR as Montelukast may affect anticoagulant control.