Montelukast Paediatric Relonchem (Montelukast)

Montelukast acts on the leukotriene pathway to control respiratory and allergic conditions in children.

• Asthma: improves control of chronic airway inflammation and reduces frequency of exacerbations.
• Exercise‑induced bronchoconstriction: prevents narrowing of airways triggered by physical activity.
• Allergic rhinitis: alleviates nasal congestion, sneezing and itching caused by allergen exposure.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1 on airway smooth muscle and inflammatory cells. By antagonizing this receptor, it inhibits leukotriene‑mediated bronchoconstriction, mucus secretion, and vascular permeability, thereby reducing airway inflammation and hyper‑responsiveness associated with asthma and allergic rhinitis.

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

Common Side Effects

• Headache: mild to moderate pain often resolving without intervention.
• Abdominal pain: discomfort in the stomach area, usually transient.
• Cough: occasional irritation of the throat.
• Sore throat: mild irritation or scratchiness.
• Nausea: feeling of queasiness, may be brief.
• Diarrhoea: loose stools, typically self‑limiting.

Serious or Rare Side Effects

• Allergic reactions: rash, urticaria, or angioedema requiring medical attention.
• Neuropsychiatric events: mood changes, agitation, or suicidal thoughts.
• Hepatic injury: abnormal liver function tests or jaundice.
• Anaphylaxis: severe, life‑threatening hypersensitivity reaction.
• Stevens‑Johnson syndrome: rare severe skin reaction.
• Blood dyscrasias: rare cases of eosinophilia or neutropenia.

Before initiating therapy, consider the following safety measures.

• Neuropsychiatric monitoring: observe for mood changes, anxiety, or suicidal ideation.
• Hepatic function: assess liver enzymes in patients with known liver disease.
• Severe asthma: use as add‑on therapy, not as sole rescue medication.
• Drug hypersensitivity: avoid if the patient has known allergy to montelukast or any component of the formulation.
• Concomitant medications: review for potential interactions, especially with CYP3A4 modulators.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Montelukast may interact with other medicines; clinical judgment is required.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): may increase montelukast plasma concentrations.
• Other leukotriene modifiers (e.g., zafirlukast): combined use can raise risk of neuropsychiatric effects.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., phenobarbital, carbamazepine, rifampin): may reduce montelukast effectiveness.
• Warfarin: occasional alteration of INR; monitor coagulation parameters.
• Oral contraceptives: possible reduction in contraceptive efficacy; advise additional contraceptive measures.