Side effects of montelukast – NHS

Like all medicines, montelukast can cause side effects, although not everyone gets them.

Common side effects

These common side effects of montelukast happen in more than 1 in 100 people. There are things you can do to help cope with them:

Diarrhoea

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

High temperature

Paracetamol will help to bring the temperature down. Drink plenty of fluids. See your doctor if it lasts for more than a few days.

Headaches

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches should usually go away after the first week of taking montelukast. Talk to your doctor if headaches last longer than a week or are severe.

Stomach pain

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help.

If you’re in a lot of pain, speak to your pharmacist or doctor.

Feeling or being sick

Stick to simple meals and do not eat rich or spicy food. If you’re being sick, try small frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark strong-smelling pee.

If you take contraceptive pills and you’re being sick your contraception may not protect you from pregnancy. Check the pill packet for advice.

A mild rash

It may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is right for you.

If the rash gets worse, speak to your doctor.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Call your doctor or contact 111 immediately if:

• you notice mood changes and you become depressed, aggressive or you’re thinking of harming yourself
• you see things which are not there (hallucinations)
• you’re finding it harder than usual to concentrate or remember things
• your speech changes or you start stuttering
• you have shaking or trembling in any part of your body
• you have an unusual or fast heartbeat
• you develop a combination of symptoms such as a flu-like illness, pins and needles or numbness of arms or legs, worsening of asthma symptoms, or a rash
• the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems

Serious allergic reaction

It is possible to have a serious allergic reaction (anaphylaxis) to montelukast.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of montelukast. For a full list see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 14 March 2023

Next review due: 14 March 2026

How and when to take montelukast

Always follow your doctor’s instructions about how and when to take montelukast.

Dosage

Montelukast comes as 10mg non-chewable tablets, chewable tablets in strengths of 5mg or 4mg, and granules in sachets of 4mg.

The usual dose for adults and children aged 15 years old and over is one 10mg tablet once a day.

The usual dose for children aged 6 to 14 years old is one 5mg chewable tablet once a day.

The usual dose for children from 6 months to 5 years old is 4mg once a day. This can be taken as granules, or a chewable tablet for children over 2 years old.

How to take it

Most people take montelukast once a day in the evening to prevent symptoms of asthma or allergies. However, if exercise makes your asthma worse, your doctor might tell you to take montelukast 2 hours before you exercise.

Never take more than 1 dose a day.

How to take non-chewable tablets

You can take montelukast non-chewable tablets with or without food.

Swallow the tablets whole with water, juice or milk. Do not chew these tablets.

How to take chewable tablets

It’s important to take chewable tablets at least 1 hour before food, or 2 hours after food. This is so the medicine is absorbed into your body properly.

Chewable tablets can be chewed or sucked. You or your child can have a drink of water or squash afterwards.

How to give granules to a child

Montelukast granules come in a sachet with 4mg of granules inside (one dose). You can put them directly on your child’s tongue. You can also mix the granules with a spoonful of cold, soft food, such as yoghurt or ice-cream.

Make sure your child takes the whole dose immediately (or within 15 minutes).

It’s important not to dissolve the granules in a drink. You can give your child a drink afterwards.

How long to take it for

Take montelukast for as long as your doctor recommends it. It will only keep working while you’re taking it.

Do not stop taking montelukast without speaking to your doctor first, because your symptoms may get worse.

If you forget to take it

If you or your child miss a dose of montelukast, skip the missed dose and take your next dose the following day at the usual time.

Do not take 2 doses to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Urgent advice: Contact 111 for advice if:

• you take more than your prescribed dose of montelukast

Go to 111.nhs.uk or call 111. Call 111 if you’re asking about a child under the age of 5 years.

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the montelukast packet or leaflet inside it, plus any remaining medicine with you.

Page last reviewed: 14 March 2023

Next review due: 14 March 2026

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Many people with asthma find they have effective asthma control if they have irregular symptoms and use their inhaler less frequently. In reality, this may mean that the asthma treatment program is not effective enough or that you are not following the prescribed recommendations to the right extent. Often this behavior is associated with side effects from taking medications (for example, an unpleasant aftertaste in the back of the throat).

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DISCLAIMER.
The information on this website is for reference only and should not be used as a substitute for advice from a therapist.

FOOTNOTES:
[1] Newman S. P., et al. Improvement of pressurized aerosol deposition with Nebuhaler spacer device. Thorax, 1984, 39(12), 935–41.

[2] Asthma.org.uk. Advice/inhalersmedicines.treatments/inhalers-and-spacers. Accessed January 2016

[3] Asthma.org.uk. Advice/manage-your-asthma. Accessed January 2016

[4] Gardenhire D., Arzu A., Dean H., Myers T. A guide to aerosol delivery devices for respiratory therapists 3rd edition, American Association for Respiratory Care, 2013.

[5] Compared to previous Aeroneb Go.

[6] When using 2.