Indications
Montair is prescribed for:
- Prophylaxis and Chronic Management of Asthma
- Acute Prevention of Exercise-Induced Bronchoconstriction (EIB)
- Relief from Allergic Rhinitis Symptoms: Effective for both seasonal and perennial allergic rhinitis.
Pharmacology
Montelukast acts as a selective, orally active leukotriene receptor antagonist, specifically targeting the cysteinyl leukotriene receptor (CysLT1). Cysteinyl leukotrienes (LTC4, LTD4, LTE4) are derived from arachidonic acid metabolism and are released by various cells, including mast cells and eosinophils. The involvement of cysteinyl leukotrienes in asthma and allergic rhinitis is linked to airway edema, smooth muscle contraction, and changes in cellular activity due to inflammation, which contribute to the symptoms of asthma.
Dosage & Administration
For Adults and Adolescents (15 years and older):
- Dosage: 10 mg tablet once daily.
For Pediatric Patients:
- Ages 6 to 14 years: 5 mg tablet once daily.
- Ages 2 to 5 years: 4 mg tablet once daily.
- Ages 6 months to 5 years: 4 mg oral granules once daily, which can be taken directly or mixed with a spoonful of cold water or soft food at room temperature.
Elderly and Patients with Liver or Kidney Issues:
- No dosage adjustments are necessary for elderly patients or those with mild to moderate hepatic or renal insufficiency.
Always consult a registered healthcare professional before use.
Interactions
Montair has been safely administered alongside other standard asthma therapies without a significant increase in adverse effects. In drug interaction studies, Montair did not notably affect the pharmacokinetics of medications such as theophylline, prednisone, oral contraceptives, and others. While there were no additional specific studies on interactions, clinical evidence supports its concurrent use with a wide range of commonly prescribed medications. However, phenobarbital, a hepatic enzyme inducer, reduced the AUC of Montair by approximately 40%. Careful clinical monitoring is recommended when Montair is used with potent cytochrome P450 enzyme inducers.
Contraindications
Montelukast should not be used by individuals who have a known hypersensitivity to any of its components.
Side Effects
Common Side Effects: Diarrhea, fever, gastrointestinal discomfort, headache, nausea, vomiting, skin reactions, upper respiratory infections.
Less Common Side Effects: Akathisia, anxiety, joint pain, fatigue, abnormal behavior, depression, dizziness, dry mouth, irritability, malaise, muscle pain, edema, seizures, abnormal sensations, sleep disturbances.
Rare Side Effects: Angioedema, impaired concentration, disorientation, eosinophilic granulomatosis with polyangiitis, hallucinations, liver disorders, memory loss, palpitations, pulmonary eosinophilia, suicidal tendencies, tremors.
Pregnancy & Lactation
Montelukast crosses the placenta in animal studies, but adequate human studies are lacking. It should only be used during pregnancy when clearly needed. Due to the potential for excretion in breast milk, caution is advised when administering Montelukast to nursing mothers.
Precautions & Warnings
Montair is not intended for the immediate relief of acute asthma attacks. Patients should keep rescue medication on hand. While Montair can be continued during asthma exacerbations, it should not replace inhaled or oral corticosteroids without proper medical supervision. Montair is not suitable as a standalone treatment for exercise-induced bronchospasm. Patients with known aspirin sensitivity should continue to avoid aspirin and NSAIDs while using Montair, as it does not eliminate bronchoconstrictor responses in these individuals.
Overdose Effects
Most reports of overdose did not result in significant adverse effects. Common symptoms included abdominal pain, drowsiness, thirst, headache, vomiting, and increased activity levels. In case of overdose, supportive measures should be employed, such as gastrointestinal decontamination and clinical monitoring.
Therapeutic Class
Leukotriene receptor antagonists.
Storage Conditions
Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of reach of children.
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