Montelukast for Paediatric Patients From 6 To 14 Years Accord Healthcare (Montelukast)

• Montelukast acts on the leukotriene pathway to control airway inflammation and bronchoconstriction.
• Asthma: improves long‑term control and reduces frequency of symptoms in children.
• Exercise‑induced bronchoconstriction: prevents airway narrowing during physical activity.
• Allergic rhinitis: relieves nasal congestion, sneezing and itching associated with seasonal allergies.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1 on airway smooth‑muscle cells, mast cells and eosinophils. By antagonising the actions of leukotrienes C4, D4 and E4, it inhibits the cascade that leads to bronchoconstriction, mucus secretion and inflammatory cell recruitment, thereby stabilising airway tone and reducing inflammation. The effect is dose‑dependent and contributes to improved respiratory function over time. It does not affect beta‑adrenergic pathways.

Montelukast may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Headache: mild to moderate intensity.
• Abdominal pain: occasional discomfort.
• Cough: transient irritation.
• Nausea: occasional upset stomach.

Serious or Rare Side Effects

• Allergic reactions: rash, angioedema, or anaphylaxis.
• Mood changes: agitation, depression, or suicidal thoughts.
• Hepatic enzyme elevation: rare liver function abnormalities.

• When prescribing Montelukast for children, clinicians should consider several precautionary measures to ensure safe use.
• Assess asthma control: confirm that the patient’s asthma is stable before initiating therapy.
• Monitor neuropsychiatric events: observe for mood changes, agitation or depressive symptoms during treatment.
• Use caution in hepatic impairment: adjust use if the child has significant liver disease.
• Avoid in known hypersensitivity: discontinue if allergic reaction to Montelukast occurs.
• Store at room temperature: keep in the original packaging, protect from moisture and heat.

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

Major Interactions (Avoid)

• Strong CYP3A4 inducers: agents such as rifampicin may markedly reduce Montelukast exposure.
• Phenobarbital: may lower plasma concentrations, diminishing therapeutic effect.
• Concurrent leukotriene modifiers: using zafirlukast or pranlukast together can increase risk of adverse reactions.

Moderate Interactions (Monitor Closely)

• Antidepressants (SSRIs, SNRIs): may heighten risk of neuropsychiatric side effects.
• Antihistamines: additive sedation may occur when combined with sedating antihistamines.
• Theophylline: Montelukast may modestly affect theophylline metabolism, requiring monitoring.