Montelukast Teva (Montelukast Sodium)

Montelukast Teva is a leukotriene receptor antagonist used in the management of respiratory allergic conditions.

• Asthma (maintenance therapy): reduces frequency of exacerbations and improves lung function in chronic asthma.
• Allergic rhinitis: alleviates nasal congestion, sneezing and itching associated with seasonal or perennial allergic rhinitis.
• Exercise‑induced bronchoconstriction: prevents airway narrowing triggered by physical activity in susceptible individuals.

• Montelukast selectively antagonizes the cysteinyl leukotriene receptor CysLT1, blocking the actions of leukotrienes D4, C4 and E4. By inhibiting these mediators, it reduces bronchial smooth‑muscle contraction, vascular permeability, mucus secretion and inflammatory cell recruitment, thereby improving airway patency and decreasing allergic inflammation. The drug is absorbed orally, reaches peak plasma concentrations within 3‑4 hours, and exhibits a high affinity for the receptor with a long half‑life supporting once‑daily dosing.

Montelukast may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Headache: mild to moderate headache reported in many patients.
• Abdominal pain: occasional stomach discomfort or cramps.
• Nausea: feeling of queasiness without vomiting.
• Cough: transient dry cough.

Serious or Rare Side Effects

• Allergic reactions: rash, angioedema or anaphylaxis requiring immediate medical attention.
• Neuropsychiatric events: mood changes, depression, or suicidal thoughts.
• Hepatic injury: signs of liver dysfunction such as jaundice or elevated enzymes.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.

When prescribing Montelukast, clinicians should consider several precautionary measures to ensure safe use.

• Liver function: monitor hepatic enzymes in patients with existing liver disease.
• Neuropsychiatric monitoring: observe for mood alterations, depression or suicidal ideation.
• Renal impairment: use with caution in severe renal dysfunction as clearance may be reduced.
• Hypersensitivity: avoid in individuals with known allergy to montelukast or any tablet excipients.
• Acute asthma: not indicated for relief of acute bronchospasm; use rescue inhalers instead.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Montelukast can interact with other medicines, affecting its plasma levels or therapeutic outcomes.

Major Interactions (Avoid)

• Phenobarbital: enzyme induction may markedly reduce montelukast concentrations.
• Rifampin: strong CYP inducer that can lower drug exposure.
• Ketoconazole: potent CYP3A4 inhibitor potentially increasing montelukast levels.

Moderate Interactions (Monitor Closely)

• Warfarin: may enhance anticoagulant effect; monitor INR.
• Oral contraceptives: possible reduction in efficacy; advise alternative contraception.
• Fluconazole: moderate CYP inhibition may raise montelukast plasma levels.
• Carbamazepine: enzyme induction could decrease effectiveness.