Montelukast: Uses, How It Works, Medicines
Also in: हिन्दी தமிழ் मराठी తెలుగు ಕನ್ನಡ বাংলা ગુજરાતી മലയാളം
Montelukast is a leukotriene receptor antagonist, a medicine taken by mouth to help prevent asthma symptoms and relieve allergy symptoms. It is used as an add-on to prevent asthma symptoms, to prevent narrowing of the airways caused by exercise, and to relieve allergic rhinitis. It does not relieve a sudden asthma attack. It carries a warning about mood and behaviour changes, and in India it is a prescription medicine.
Also known as: Montelukast sodium, Montelukast tablet, Montelukast 10 mg, Montelukast IP, Montelukast 4 mg, Montelukast 5 mg, Montelukast sodium IP, Montelucast
Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.
How does Montelukast work?
Montelukast blocks the CysLT1 receptor in the airways and nose, so cysteinyl leukotrienes released during an allergic reaction cannot tighten the airways, cause swelling or increase mucus. It reaches its highest level in the blood about 3 to 4 hours after a tablet and is broken down by the liver.
How to take Montelukast
Follow the label or your doctor's advice. Montelukast is taken once a day, usually in the evening for asthma, with or without food. Tablets, chewable tablets and granules are made for different age groups, so use only the form and strength a doctor chooses, and do not take more than one dose a day.
Side effects of Montelukast
Most people take montelukast without trouble, but it can cause mood and behaviour changes, which need prompt attention. Other effects are usually mild.
Uncommon or mild
- Headache
- Tummy pain
- Cough, sore throat or cold-like symptoms
- Diarrhoea or feeling sick
- Tiredness or restlessness
- Fever, especially in children
Rare but serious: get medical help
- Mood or behaviour changes such as agitation, aggression, anxiety, low mood or depression, trouble sleeping, nightmares, or seeing or hearing things that are not there; tell a doctor straight away
- Any thoughts of self-harm or suicide; get medical help immediately
- Signs of a severe allergic reaction: swelling of the face, lips or throat, difficulty breathing, or a sudden widespread rash
- Yellowing of the skin or eyes, dark urine or severe tiredness, which can be signs of liver problems
- Pins and needles or numbness, a rash with swelling, or worsening breathlessness, which can rarely occur with a condition involving inflamed blood vessels
- Unusual bruising or bleeding
Who should be careful
Montelukast carries a boxed warning about serious mood and behaviour changes, so anyone taking it, or caring for a child who does, should watch for these changes and tell a doctor.
- Mood and behaviour changes can happen in adults and children, with or without past mental health problems; tell a doctor if they appear
- History of depression, anxiety, sleep problems or other mental health conditions: tell your doctor before starting
- It does not treat a sudden asthma attack; keep using the reliever inhaler a doctor prescribed
- Do not suddenly stop or reduce inhaled or oral steroids unless your doctor tells you to
- Liver disease: tell your doctor
- Phenylketonuria: chewable tablets may contain phenylalanine
- Pregnancy or breastfeeding: use only if a doctor advises it
- Children: use only the form and dose a doctor gives
Medicines and things that interact with Montelukast
Montelukast has few interactions, but some medicines change how much of it stays in the blood. Tell your doctor or pharmacist about everything you take.
- Phenobarbital and rifampicin: can lower montelukast levels
- Gemfibrozil (for cholesterol): can raise montelukast levels
- Other asthma or allergy medicines: do not stop or swap them without a doctor's advice
- Other products containing montelukast under another brand: taking two together doubles the dose
If someone takes too much
Taking too much montelukast is a medical matter even if the person feels fine. Reports include tummy pain, sleepiness, thirst, headache, vomiting and restlessness. Call 112 or go to the nearest hospital and take the medicine pack with you.
Regulatory status in India
Approved for sale in India and sold as a prescription medicine, in tablets, chewable tablets and granules. Single-ingredient montelukast is not on the CDSCO list of banned medicines, but some combinations, such as with acebrophylline or with etofylline and theophylline, were banned. Check the ingredient list on the pack.
Type of medicine
Montelukast belongs to this type of medicine.
Medicines that contain Montelukast
These medicines sold in India contain Montelukast. They are listed A to Z, not ranked.
- Montair LC · 10 mg tablet
What is Montelukast used for?
Combination medicines that contain Montelukast are used for these conditions.
Common questions
What is the montelukast mental health warning?
In 2020 the US FDA added a boxed warning that montelukast can cause serious mood and behaviour changes, including agitation, depression, sleep problems and suicidal thoughts. These can happen in adults and children, with or without past mental illness. The label advises stopping it and contacting a doctor straight away if such changes appear.
When is montelukast usually taken?
It is taken once a day. For asthma the label says to take it in the evening; for allergic rhinitis the time can suit the person. It can be taken with or without food. Follow your doctor's advice or the label, and do not take more than one dose a day.
Can montelukast be used for an asthma attack?
No. Montelukast helps prevent symptoms over time and does not open the airways quickly. Keep using the reliever inhaler your doctor prescribed for attacks, and do not stop or reduce inhaled or oral steroids unless your doctor tells you to.
Is Montair LC the same as montelukast?
No. Montair LC is a tablet that contains montelukast 10 mg together with levocetirizine 5 mg, so it is a combination for allergic rhinitis. Plain montelukast tablets contain only montelukast. Check the ingredients and strength printed on the pack.
Can montelukast be taken by children?
Montelukast comes in child-friendly chewable tablets and granules, but a doctor must choose the form and dose by age. The mood and behaviour warning applies to children too, so parents should tell the doctor about any change in sleep, mood or behaviour.
Can I drink alcohol while taking montelukast?
The labels used here do not list a direct interaction with alcohol, but alcohol can worsen low mood and sleep problems, which montelukast can also affect. It can also irritate allergies and asthma. Ask your doctor if you are unsure.
Is montelukast safe in pregnancy or while breastfeeding?
Ask your doctor. Labels say to use it in pregnancy only if clearly needed. Small amounts pass into breast milk. Do not start or stop montelukast on your own during pregnancy or breastfeeding, and keep using your prescribed asthma plan.
What is the difference between montelukast and levocetirizine?
They work differently. Montelukast blocks leukotrienes, which tighten airways and cause nasal swelling, while levocetirizine blocks histamine, which causes sneezing and itching. Doctors sometimes combine them for allergic rhinitis. Which is suitable is a decision for your doctor.
Sources
- SINGULAIR (montelukast sodium) tablets, chewable tablets and oral granules: full prescribing information (revised 6/2021). Organon, US FDA-approved labeling
- FDA requires Boxed Warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair); advises restricting use for allergic rhinitis (Drug Safety Communication, 4 March 2020). US Food and Drug Administration
- Singulair 10 mg film-coated tablets: Summary of Product Characteristics. electronic medicines compendium (emc), UK
- Montelukast. StatPearls, National Center for Biotechnology Information (NCBI), US National Library of Medicine
- How and when to take montelukast. NHS (UK)