Montelukast For Paediatric Patients From 2 To 5 Years Accord Healthcare (Montelukast)

Montelukast acts on leukotriene pathways that contribute to airway inflammation and allergic symptoms.

• Asthma (prophylaxis in children 2–5 years): reduces the frequency of asthma attacks and improves overall control.
• Allergic rhinitis (children 2–5 years): alleviates nasal congestion, sneezing and itching associated with seasonal or perennial allergies.
• Exercise‑induced bronchospasm (children 2–5 years): helps prevent bronchoconstriction triggered by physical activity.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1, preventing leukotrienes from binding and triggering bronchoconstriction, mucus secretion, and vascular permeability. By inhibiting this pathway, it reduces airway inflammation and hyper‑responsiveness, contributing to better control of asthma and allergic rhinitis symptoms.

Montelukast is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate pain often reported.
• Abdominal pain: discomfort or cramps in the stomach area.
• Cough: occasional dry or productive cough.
• Fever: low‑grade temperature elevation.
• Sore throat: irritation or pain in the throat.
• Nausea: feeling of queasiness.

Serious or Rare Side Effects

• Allergic reactions: rash, angioedema, or anaphylaxis.
• Neuropsychiatric events: mood changes, agitation, or suicidal thoughts.
• Stevens‑Johnson syndrome: severe skin reactions.
• Hepatic injury: abnormal liver function tests.
• Blood dyscrasias: rare blood cell abnormalities.
• Severe bronchospasm: paradoxical worsening of breathing.

When prescribing Montelukast, clinicians should consider several safety aspects.

• Neuropsychiatric monitoring: observe for mood changes or suicidal ideation.
• Hepatic function: assess liver enzymes in patients with pre‑existing liver disease.
• Hypersensitivity: avoid in individuals with known allergy to Montelukast or formulation excipients.
• Concomitant leukotriene modifiers: do not combine with other leukotriene receptor antagonists.
• Pediatric dosing: ensure the prescriber selects the appropriate dose for the 2‑5 year age group.
• Store at ambient temperature: keep below 25°C, retain in original packaging, protect from moisture.

Montelukast may interact with other medicines; awareness of the interaction level helps guide safe use.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): may increase Montelukast plasma concentrations.
• Potent CYP2C9 inducers (e.g., rifampicin): may reduce therapeutic effect.
• Other leukotriene receptor antagonists (e.g., zafirlukast): additive pharmacologic effect increases risk of adverse events.

Moderate Interactions (Monitor Closely)

• SSRIs or SNRIs: may heighten risk of neuropsychiatric side effects.
• Phenobarbital: moderate enzyme induction can lower drug exposure.
• Warfarin: monitor INR as Montelukast may modestly affect anticoagulation.
• Aspirin/NSAIDs: observe for potential bronchospasm in sensitive patients.