Montelukast Mylan (Montelukast)

Montelukast is a leukotriene receptor antagonist that helps control airway inflammation and bronchoconstriction in several respiratory conditions.

• Asthma: improves symptom control and reduces the frequency of exacerbations.
• Exercise‑induced bronchoconstriction: prevents airway narrowing triggered by physical activity.
• Allergic rhinitis: alleviates nasal congestion, sneezing and itching caused by allergens.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1 on airway smooth‑muscle cells, mast cells and eosinophils. By antagonising this receptor, it inhibits leukotriene‑mediated bronchoconstriction, mucus secretion and inflammatory cell recruitment, thereby reducing airway hyper‑responsiveness and allergic inflammation.

Adverse reactions may occur with Montelukast use. Patients should be aware of both common and less frequent but serious events.

Common Side Effects

• Headache: mild to moderate intensity.
• Upper respiratory tract infection: transient symptoms.
• Abdominal pain or dyspepsia.
• Cough: dry or productive.
• Fatigue or somnolence.
• Rash or mild skin irritation.

Serious or Rare Side Effects

• Mood changes or suicidal thoughts.
• Allergic reactions such as angioedema or anaphylaxis.
• Hepatic enzyme elevations.
• Severe skin reactions (e.g., Stevens‑Johnson syndrome).
• Blood dyscrasias (e.g., eosinophilia).

Before initiating therapy, consider the following safety measures.

• Pregnancy: discuss potential risks with a healthcare professional; data are limited.
• Breastfeeding: evaluate benefit‑risk balance; drug may pass into milk.
• Liver impairment: use with caution; monitor hepatic function if clinically indicated.
• Concomitant asthma therapy: do not replace inhaled corticosteroids or bronchodilators.
• Age considerations: pediatric dosing is determined by the prescriber based on weight and age.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Montelukast may interact with other medicines; awareness of interaction severity helps guide monitoring.

Major Interactions (Avoid)

• Phenobarbital or rifampin: may reduce montelukast plasma concentrations, compromising efficacy.
• Strong CYP3A4 inducers: can lower drug exposure.

Moderate Interactions (Monitor Closely)

• Warfarin: occasional reports of altered INR; monitor coagulation parameters.
• Beta‑agonists: additive bronchodilatory effect may increase risk of tachycardia.
• Antidepressants (e.g., fluoxetine): monitor for neuropsychiatric symptoms.