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What Is the Role of Singulair (Monteleukast) in Asthma?

Can Singulair Help My Asthma?

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Updated April 23, 2014

Singulair (monteleukast) and other leukotriene modifiers can be used as an alternative therapy for the treatment of mild persistent asthma and adjuntive therapy in combination with inhaled steroids. Singulair (monteleukast) and other leukotriene modifiers can also be used for the prevention of exercise-induced asthma, and in the treatment of allergic rhinitis and atopic dermatitis.

How Do Singulair (Monteleukast) and Other Leukotriene Modifiers Work?

Leukotrienes are released from mast cells, eosinophils, and basophils and lead to increased inflammation, secretions and airway narrowing that causes symptoms such as:

How Effective Are Singulair (Monteleukast) and Other Leukotriene Modifiers?

Because Singulair (monteleukast) and other leukotriene modifiers are not as effective as inhaled steroids, they are not considered a first-line treatment for asthma. However, Singulair (monteleukast) and other leukotriene modifiers can be useful if inhaled steroids alone do not control your asthma symptoms.

Singulair (monteleukast) and other leukotriene modifiers are also one potential option if you don't want to or cannot take inhaled steroids. One potential advantage of Singulair (monteleukast) and other leukotriene modifiers is that they are an oral medication and may be much easier for you to take. Singulair (monteleukast) and other leukotriene modifiers:

In clinical studies, Singulair (monteleukast) and other leukotriene modifiers:

  • Provide clinical benefit when added to an inhaled steroid
  • Have allowed for a lower dose of an inhaled steroid
  • Improve FEV1
  • Decrease nocturnal asthma symptoms
  • Improved quality of life

However, there is some evidence that long acting beta agonists may provide more clinical benefits when added to an inhaled steroid compared to Singulair (monteleukast) and other leukotriene modifiers. Talk with your doctor about what "add on" therapy is best for you.

Currently Available Leukotriene Modifiers

The currently available leukotriene modifiers are:

  • Singulair (montelukast sodium)
  • Accolate (zafilukast)
  • Zyflo (zileuton)

Dosages and availability for use in children will vary. You can learn more about these and other asthma medications in our Drug Finder.

Side Effects of Monteleukast and Other Leukotriene Modifiers

While Singulair (monteleukast) and other leukotriene modifiers are generally well tolerated, potential side effects include:

  • Stomach upset
  • Headaches
  • Liver test abnormalities
  • Skin rashes
  • Rarely, Churg Strauss syndrome

Additionally, Singulair (monteleukast) and other leukotriene modifiers have changed their labeling to make providers and parients aware of potential mental health side effects noted with this class of drugs.

Sources:

Wenzel, Sally E. Antileukotriene Therapy in Asthma in Middleton's Allergy: Principles and Practice, 7th ed. Mosby 2008.

National Heart, Lung, and Blood Institute. Accessed: September 7, 2009. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

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