Montelukast Tarbis Farma (Montelukast)

Montelukast acts on the leukotriene pathway to reduce airway inflammation and bronchoconstriction.

• Asthma prophylaxis: helps prevent chronic asthma symptoms and reduces the frequency of attacks.
• Exercise‑induced bronchoconstriction: lessens airway narrowing that occurs during or after physical activity.
• Allergic rhinitis: alleviates nasal congestion, sneezing and itching caused by seasonal or perennial allergies.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1, preventing leukotrienes from binding and triggering bronchoconstriction, mucus secretion, and inflammatory cell recruitment in the respiratory tract. By inhibiting this pathway, it reduces airway edema and hyper‑responsiveness associated with asthma and allergic conditions.

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

Common Side Effects

• Headache: mild to moderate pain in the head.
• Upper respiratory tract infection: symptoms such as sore throat or nasal congestion.
• Abdominal pain: discomfort or cramps in the stomach area.
• Cough: persistent dry cough.
• Diarrhoea: loose stools.
• Rash: mild skin irritation or redness.

Serious or Rare Side Effects

• Mood changes: depression, anxiety, or suicidal thoughts.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Allergic reactions: angioedema, urticaria, or anaphylaxis.
• Stevens‑Johnson syndrome: severe skin blistering.
• Blood dyscrasias: neutropenia or eosinophilia.
• Cardiovascular events: rare cases of chest pain or palpitations.

Before prescribing Montelukast, clinicians should consider several safety aspects.

• Pregnancy: evaluate risk‑benefit as safety data are limited.
• Breastfeeding: assess potential exposure to the infant.
• Hepatic impairment: monitor liver function in patients with existing liver disease.
• Psychiatric history: watch for mood alterations, especially in adolescents.
• Concomitant asthma therapy: ensure patients continue rescue inhalers for acute symptoms.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Montelukast may interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Phenobarbital: may decrease montelukast plasma concentrations.
• Rifampin: induces metabolism leading to lower drug exposure.

Moderate Interactions (Monitor Closely)

• Antidepressants (e.g., fluoxetine): potential for additive neuropsychiatric effects.
• Antihistamines: may increase sedation when combined with sedating antihistamines.
• CYP2C9 inhibitors (e.g., fluconazole): could modestly raise montelukast levels.
• Warfarin: monitor INR as occasional reports suggest altered anticoagulation.
• Vaccines: observe for atypical immune responses when administered concurrently.