Description
Indications
Montelukast Sodium is indicated for:
- Prophylaxis and chronic treatment of asthma
- Acute prevention of Exercise-Induced Bronchoconstriction (EIB)
- Relief of symptoms of Allergic Rhinitis (AR): Seasonal & Perennial Allergic Rhinitis
Pharmacology
Montelukast is a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor (CysLT1). The cysteinyl leukotrienes (LTC4, LTD4, LTE4) are products of arachidonic acid metabolism and are released from various cells, including mast cells and eosinophils. Cysteinyl leukotrienes and leukotriene receptor occupation have been correlated with the pathophysiology of asthma & allergic rhinitis, including airway edema, smooth muscle contraction, and altered cellular activity associated with the inflammatory process, which contributes to the signs and symptoms of asthma.
Administration & Dosage
Adults & adolescents (15 years & older)-
- Asthma & Allergic Rhinitis: 10 mg/day
- Exercise-Induced Bronchoconstriction: 10 mg/day
Pediatric patients (6 to 14 years)-
- Asthma & Allergic Rhinitis: 5 mg/day
- Exercise-Induced Bronchoconstriction: 5 mg/day
Pediatric patients (6 months to 5 years)-
- Asthma & Allergic Rhinitis: 4 mg/day
- Exercise-Induced Bronchoconstriction: Not recommended
Patients with both asthma and allergic rhinitis should take only one dose daily in the evening. For prevention of Acute prevention of Exercise-Induced Bronchoconstriction, a single dose should be taken at least 2 hours before exercise.
Interaction
With medicine: No dose adjustment is needed when montelukast is co-administered with theophylline, prednisone, prednisolone, terfenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative-hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, oral contraceptives, and Cytochrome P450 (CYP) enzyme inducers. With food and others: Bioavailability and other conditions were not significantly observed with food & other conditions.
Contraindications
Escitalopram is not recommended for patients who have a known hypersensitivity to Escitalopram, Citalopram, or any of the drug’s inactive ingredients. It’s not a good idea to take escitalopram and monoamine oxidase/pimozide at the same time.
Side Effects
Common: Diarrhoea, fever, gastrointestinal discomfort, headache, nausea, vomiting, skin reactions, upper respiratory tract infection.
Uncommon: Akathisia, anxiety, arthralgia, asthenia, abnormal behavior, depression, dizziness, drowsiness, dry mouth, hemorrhage, irritability, malaise, muscle complaints, edema, seizure, abnormal sensation, sleep disorders.
Rare: Angioedema, concentration impaired, disorientation, eosinophilic granulomatosis with polyangiitis, erythema nodosum, hallucination, hepatic disorders, memory loss, palpitations, pulmonary eosinophilia, suicidal tendencies, tremor.
Pregnancy & Lactation
The risks and benefits of treating a pregnant woman with Escitalopram during the third trimester should be carefully considered by the physician. It’s passed through human breast milk. The risk of citalopram exposure for the infant and the benefits of Escitalopram treatment should be considered when deciding whether to continue or stop nursing or Escitalopram therapy.
Precautions & Warnings
In patients with epilepsy (avoid if poorly controlled, discontinue if convulsions develop), concurrent electroconvulsive therapy (prolonged seizures reported with fluoxetine), history of mania, cardiac disease, diabetes mellitus, angle-closure glaucoma, concomitant use of drugs that increase bleeding risk, and history of bleeding disorders, SSRIs should be used with caution.
Therapeutic Class
Leukotriene receptor antagonists
Storage Conditions
Protect from light and moisture by storing below 30°C. Keep the medicine out of children’s reach.
