21 Sept 2017
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General Info: Uses and Effects
Singulair contains an active substance called Montelukast.
Singulair is a selective, oral leukotriene receptor antagonist that specifically inhibits cysteinyl leukotriene CysLT1 receptor. This leads to blockage of the leukotriene effect and reduced bronchi sensitivity to allergens.
Singulair is useful as an additional drug in preventing and permanently treating asthma, especially in those patients in whom corticosteroids and other bronchodilators cannot fully control asthma symptoms. Montelukast is particularly useful in patients who suffer from so-called allergic asthma, as well as in the prevention of asthma attacks resulting from physical efforts. The drug can also be used to prevent seasonal allergic rhinitis.
As Singulair is a relatively new drug, the risk of its using in pregnancy and breastfeeding is not fully determined, but caution is advised when used in this population. During clinical trials it was established that Montelukast is well-tolerated and rarely causes severe adverse effects.
Contraindications: Important to Know
The only known absolute contraindication to the use of Singulair is hypersensitivity (allergy) to its active substance Montelukast. If you are not sure whether you are allergic to it, please consult your doctor.
Most common symptoms of an allergic reaction include swelling of the lips, swelling of the throat, difficulty breathing and anaphylactic shock. If you notice any symptoms of an allergic reaction, you must call your physician immediately.
Rare cases of systemic eosinophilia have been reported. Systemic eosinophilia is characterized with severely decreased number of leukocytes in the blood which will significantly impair the ability of your immune system to fight against infections. Therefore, even weak bacteria or mild infection may cause severe complications and may be fatal in certain circumstances. Therefore, you must inform your doctor at once if you notice any flu-like symptoms.
Rare cases of cardiovascular toxicity induced by Singulair have also been reported. If you notice palpitations, chest pain, rapid heartbeat or hypertension, you should inform your doctor. In these cases, your physician may decide to switch you to other drug.
There are no sufficient clinical data to confirm its efficacy and safety in pregnant and breastfeeding women. Therefore, you should always consult your doctor about Montelukast use during pregnancy or breastfeeding.
The recommended dosage for adults aged 15 years or older, who suffer from asthma, or seasonal allergic rhinitis, is one tablet of Singulair (10mg) daily, taken in the evening.
The therapeutic effect of Montelukast usually occurs after only one day. Singulair can be taken with or without food, because food has insignificant effects on its absorption.
Patients should be advised to continue taking Singulair even when their asthma symptoms are under control. The drug should not be used concomitantly with other medicinal products that have the same active ingredient called Montelukast.
It is not necessary to adjust the dose neither in elderly patients, nor in patients with renal insufficiency or mild to moderate hepatic insufficiency. There are no data whether this drug is sage to be administered in patients with severe liver failure. The dose is not different in male and female patients.
Singulair can be used as an additional therapy to an already existing patient treatment protocol. It can be used as an additional therapy when inhaled corticosteroids and short-acting beta-agonists do not provide adequate control of asthma. Montelukast should not be rapidly introduced as a replacement for inhaled corticosteroids.
It also exists in the form of chewable tablets (5mg) that are intended for pediatric patients aged 6 to 14 years.
Singulair Montelukast may cause following side effects:
- Infections of the upper respiratory tract (affects more than 1% of patients);
- Bleeding disorders (affects less than 0.01% of patients);
- Allergic reactions including rash, swelling of the lips, swelling of the tongue and/or throat and difficulty breathing (affects less than 0.01% of patients);
- Behavioral changes and mood swings (affects 0.01-0.1% of patients);
- Sleep disorders (affects 0.01-0.1% of patients);
- Psychomotor disorders;
- Aggressive behavior;
- Depression (occurs in 1% of patients);
- Tremor (occurs in 0.1% of patients);
- Suicidal thoughts and behavior (affects less than 0.01% of patients);
- Bleeding gums;
- Nosebleeds (affects 0.1% of patients);
- Vomiting (occurs in 1-10% of patients);
- Dry mouth;
- Stomach upset (affects 0.1-1% of patients);
- Hepatitis (inflammation of the liver);
- Skin rash;
- Easy bruising;
- Itchy skin;
- Severe skin reactions (erythema multiforme), which can occur suddenly;
- Pain in the joints or muscles;
- Muscle cramps;
- Fever (occurs in more than 1% of patients);
- General weakness.
Inform your doctor if you notice any side effects, including those not listed above.
Interactions with Other Drugs
There are 84 drugs known to enter moderate interactions with Singulair. Therefore, you should not use Montelukast concomitantly with following medicines:
- Abiraterone (Zytiga) - a drug used to treat prostate cancer. The drug increases plasma levels of Singulair, thus leading to increased risk of side effects (irritability, restlessness, depression, tremor, insomnia, aggressive behavior, and memory impairment).
- Apalutamide - a drug used to treat non-metastatic prostate carcinoma. It may decrease the plasma levels of Singulair making it less effective in asthma treatment.
- Somatropin - a growth hormone used to treat growth failure in children. The medicine reduces blood levels of Singulair making it less effective.
- Zafirlukast (Accolate) - a drug used to prevent asthma. The concomitant use increases risk of side effects, such as bad dreams, depression, suicidal ideas, fever, headache, hallucinations, sleepwalking, and tremor.
- Butalbital, amobarbital, phenobarbital - drugs used to treat epilepsy. They reduce effectiveness of Singulair in treating asthma.
- Amiodarone - a drug used to treat irregular heartbeat. It increases blood levels of Singulair, thus leading to increased risk of side effects.
- Bosentan - a drug used to treat high blood pressure in lungs. Bosentant reduces efficacy of Singulair in the treatment of asthma.
- Deferasirox - a drug used to treat beta-thalassemia.
- Dabrafenib - drug used to treat metastatic melanoma. This drug reduces efficacy of Singulair and concomitant use must be avoided.
- Carbamazepine - drug used to treat epilepsy. This drug reduce efficacy of Singulair in treating asthma.
- Delavirdine - drug used to treat human immunodeficiency virus infection. This drug increases blood levels of Singulair, thus increasing risk of toxicity.
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