Montelukast Rivopharm Uk (Montelukast)

Montelukast is a leukotriene receptor antagonist used to treat conditions mediated by cysteinyl leukotrienes.

• Asthma: helps control chronic airway inflammation, improves lung function, and reduces the frequency and severity of asthma attacks.
• Allergic rhinitis: relieves nasal congestion, sneezing, runny nose, and itchy eyes caused by seasonal or perennial allergens, improving overall nasal symptoms.
• Exercise‑induced bronchoconstriction: prevents narrowing of the airways that can occur during or after physical exertion, allowing better tolerance of exercise.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1, preventing leukotriene D4 from binding. By inhibiting this receptor, the drug reduces leukotriene‑mediated bronchoconstriction, vascular permeability, and inflammatory cell recruitment in the airways, thereby mitigating the pathophysiological processes underlying asthma and allergic rhinitis. This antagonism also leads to decreased airway edema and mucus secretion.

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

Common Side Effects

• Headache: mild to moderate pain often occurring early in therapy.
• Abdominal pain: discomfort or cramps in the stomach region.
• Cough: occasional dry or productive cough.
• Nausea: feeling of queasiness, sometimes with mild vomiting.

Serious or Rare Side Effects

• Neuropsychiatric events: agitation, depression, suicidal thoughts, or behavioral changes.
• Allergic reactions: rash, urticaria, angioedema, or anaphylaxis.
• Hepatic enzyme elevation: increased liver transaminases indicating possible liver stress.

Before initiating therapy, consider the following precautions.

• Assess liver function: monitor transaminases in patients with hepatic disease.
• Avoid in hypersensitivity: discontinue if any allergic reaction to montelukast occurs.
• Psychiatric history: use caution in patients with depression, anxiety, or suicidal ideation.
• Drug interaction review: evaluate concomitant medications that affect CYP3A4 or CYP2C9 metabolism.
• Pregnancy and lactation: discuss potential risks with the prescriber; safety data are limited.
• Store at ambient temperature: keep below 25°C, retain in original container, protect from moisture and light.

Montelukast can interact with other medicines; awareness of the interaction level helps manage risk.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase montelukast exposure.
• CYP inducers such as phenobarbital or rifampin: may reduce therapeutic effect.

Moderate Interactions (Monitor Closely)

• Warfarin: potential alteration of INR, requiring closer coagulation monitoring.
• Theophylline: additive bronchodilator effect may require dose adjustment.
• Beta‑agonists: generally safe but monitor overall respiratory response.