Montelukast Abz (Montelukast Sodium)

Montelukast, a leukotriene receptor antagonist, is used to treat several respiratory conditions that involve leukotriene‑driven inflammation and airway hyper‑responsiveness.

• Asthma: helps achieve better symptom control and lowers the frequency of asthma attacks.
• Allergic rhinitis: reduces nasal congestion, sneezing, itching and watery discharge associated with seasonal allergies.
• Exercise‑induced bronchoconstriction: prevents narrowing of airways during or after physical activity.
• Pediatric asthma maintenance: supports long‑term control of asthma symptoms in children.

• Montelukast selectively blocks the cysteinyl leukotriene receptor type 1 (CysLT1) on airway smooth‑muscle cells, mast cells and eosinophils. By preventing leukotriene D4 and related mediators from binding, it inhibits the cascade that leads to bronchoconstriction, mucus secretion, vascular permeability and inflammatory cell recruitment, thereby reducing airway narrowing and inflammation. The antagonism is dose‑dependent and contributes to improved pulmonary function over time.

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

Common Side Effects

• Headache: mild to moderate headache that may be intermittent or persistent.
• Upper respiratory tract infection: symptoms resembling a common cold or flu, such as sore throat, nasal congestion and mild fever.
• Stomach pain: abdominal discomfort, dyspepsia or nausea that can occur after taking the medication.
• Cough: a non‑productive cough that may be transient during the initial treatment period.

Serious or Rare Side Effects

• Allergic reactions: rash, swelling, hives, or in rare cases anaphylaxis requiring immediate medical attention.
• Mood changes: depression, anxiety, suicidal thoughts or behavior that should be reported to a healthcare professional promptly.
• Liver enzyme elevation: increased transaminases indicating possible hepatitis or jaundice, warranting liver function monitoring.

When prescribing Montelukast, several precautions should be considered to ensure safe use.

• Assess asthma control: confirm that patient’s asthma is not uncontrolled before initiating therapy.
• Monitor for neuropsychiatric events: watch for depression, mood swings or suicidal thoughts.
• Evaluate liver function: consider baseline liver enzymes in patients with hepatic disease.
• Use with caution in the elderly: adjust monitoring due to higher risk of adverse reactions.
• Avoid in patients with known hypersensitivity to montelukast or any tablet excipients.
• Store at ambient temperature: keep below 25°C in the original packaging, protect from moisture.

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

Major Interactions (Avoid)

• Phenobarbital: enzyme induction may reduce montelukast plasma levels.
• Rifampin: strong CYP inducers can markedly lower drug exposure.
• St. John’s wort: herbal CYP inducer may decrease therapeutic effect.

Moderate Interactions (Monitor Closely)

• Antidepressants (SSRIs, SNRIs): may increase risk of neuropsychiatric side effects.
• Warfarin: occasional reports of altered INR; monitor coagulation parameters.
• Beta‑agonists: additive bronchodilation effect; assess clinical response.