What are the uses of Singulair. How should Singulair be taken. What are the potential side effects of Singulair. How does Singulair work in managing asthma and allergies. When should you seek medical help while taking Singulair. What precautions should be taken while using Singulair. How does Singulair interact with other medications.

Understanding Singulair: Montelukast for Asthma and Allergy Management

Singulair, also known by its generic name montelukast, is a medication primarily used to control and prevent symptoms associated with asthma and allergies. This oral medication has gained significant attention in the medical community for its effectiveness in managing respiratory conditions. But what exactly is Singulair, and how does it work?

Singulair belongs to a class of drugs called leukotriene receptor antagonists. It works by blocking certain natural substances in the body called leukotrienes, which are responsible for causing inflammation in the airways. By inhibiting these substances, Singulair helps to reduce swelling and constriction in the airways, making breathing easier for individuals with asthma and allergies.

Key Functions of Singulair

• Controls and prevents asthma symptoms
• Prevents exercise-induced bronchospasm
• Relieves symptoms of hay fever and allergic rhinitis
• Reduces the frequency of quick-relief inhaler use

Is Singulair a quick-relief medication for sudden asthma attacks? No, Singulair is not designed for immediate relief of asthma symptoms. It is a long-term control medication that must be taken regularly to be effective. For sudden asthma attacks or acute breathing difficulties, patients should use their prescribed quick-relief inhalers.

Proper Usage and Dosing Guidelines for Singulair

Taking Singulair correctly is crucial for its effectiveness. The medication is available in various forms, including tablets, chewable tablets, and oral granules. The dosage and timing of Singulair depend on several factors, including the patient’s age, medical condition, and the specific symptoms being treated.

General Dosing Instructions

1. Take Singulair orally, with or without food
2. Maintain a consistent dosing schedule
3. For asthma or combined asthma and allergy treatment, take in the evening
4. For allergy treatment only, take either in the morning or evening
5. For exercise-induced bronchospasm, take at least 2 hours before physical activity

Can Singulair be taken more than once a day? No, Singulair should not be taken more than once in a 24-hour period. Taking multiple doses within a day can increase the risk of side effects without providing additional benefits.

For children using chewable tablets, it’s important to ensure they chew the tablet thoroughly before swallowing. If a child cannot safely chew and swallow the tablet, parents should consult with their healthcare provider for alternative options or administration methods.

Potential Side Effects and Safety Considerations of Singulair

While Singulair is generally well-tolerated, like all medications, it can cause side effects in some individuals. It’s crucial for patients and caregivers to be aware of potential adverse reactions and to report any concerning symptoms to their healthcare provider promptly.

Common Side Effects

• Headache
• Stomach pain
• Nausea
• Diarrhea
• Fatigue
• Cough
• Fever

Do the side effects of Singulair typically persist? Most side effects of Singulair are mild and tend to diminish over time as the body adjusts to the medication. However, if side effects persist or worsen, it’s important to consult with a healthcare provider.

Serious Side Effects Requiring Immediate Medical Attention

• Mental/mood changes (e.g., agitation, anxiety, depression, hallucinations)
• Suicidal thoughts or behaviors
• Numbness or tingling in arms or legs
• Severe sinus pain or swelling
• Muscle weakness or uncontrolled movements
• Stuttering

What should you do if you experience serious side effects while taking Singulair? If you or someone you care for experiences serious side effects, it’s crucial to seek medical help immediately. These effects may occur even after discontinuing the medication, so vigilance is important.

Singulair’s Role in Asthma Management

Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways. Singulair plays a significant role in long-term asthma management by helping to control inflammation and prevent asthma symptoms.

Benefits of Singulair in Asthma Treatment

• Reduces frequency and severity of asthma attacks
• Decreases reliance on quick-relief inhalers
• Improves lung function
• Enhances overall quality of life for asthma patients

How does Singulair complement other asthma medications? Singulair is often used in conjunction with other asthma medications, such as inhaled corticosteroids. It provides an additional layer of control by targeting a different aspect of the inflammatory process in asthma. This complementary action can lead to better overall asthma management and reduced symptoms.

It’s important to note that while Singulair is effective for many patients, it may not be suitable for everyone. Healthcare providers will consider individual patient factors, including the severity of asthma, other medical conditions, and potential drug interactions when prescribing Singulair.

Singulair for Allergy Relief: Effectiveness and Considerations

Beyond its use in asthma management, Singulair is also prescribed for the treatment of allergic rhinitis, commonly known as hay fever. This condition causes symptoms such as sneezing, nasal congestion, runny nose, and itchy eyes, which can significantly impact quality of life.

Singulair’s Action in Allergic Rhinitis

• Blocks leukotrienes involved in allergic reactions
• Reduces nasal congestion and inflammation
• Alleviates sneezing and itching
• Provides 24-hour relief with once-daily dosing

Is Singulair as effective as antihistamines for allergy relief? While Singulair can be effective for allergy symptoms, it works differently from antihistamines. Some patients may find greater relief with Singulair, while others may respond better to antihistamines. In some cases, a combination of both may be recommended for optimal symptom control.

It’s worth noting that due to potential safety concerns, Singulair is typically prescribed for allergic rhinitis only when other allergy medications have proven ineffective or are not well-tolerated. Healthcare providers carefully weigh the benefits against potential risks when considering Singulair for allergy treatment.

Precautions and Warnings: Ensuring Safe Use of Singulair

While Singulair can be an effective medication for many patients, there are important precautions and warnings to consider. Understanding these can help ensure safe and appropriate use of the medication.

Key Warnings for Singulair Use

• Risk of mental health side effects
• Potential for allergic reactions
• Interactions with other medications
• Special considerations for pregnant or breastfeeding individuals

What should patients tell their healthcare provider before starting Singulair? Patients should inform their healthcare provider about all medical conditions, especially liver problems, and any medications they are taking, including over-the-counter drugs and supplements. It’s also crucial to discuss any history of mental health issues.

The FDA has issued a boxed warning for Singulair regarding the risk of serious mental health side effects. These can include agitation, depression, sleep problems, and suicidal thoughts or actions. Patients and caregivers should be vigilant for any changes in behavior or mood and report them immediately to a healthcare provider.

Special Populations and Singulair Use

• Pregnancy: Limited data available; discuss risks and benefits with healthcare provider
• Breastfeeding: Montelukast may pass into breast milk; consult with healthcare provider
• Children: Approved for use in certain age groups; dosing differs from adults
• Elderly: May be more sensitive to side effects; careful monitoring required

Can Singulair be stopped abruptly? It’s generally not recommended to stop taking Singulair suddenly, especially if it’s being used for asthma control. Abrupt discontinuation may lead to worsening of asthma symptoms. Any changes in medication regimen should be discussed with and supervised by a healthcare provider.

Drug Interactions and Considerations with Singulair

Understanding potential drug interactions is crucial for patients taking Singulair. While montelukast has fewer drug interactions compared to some other medications, there are still important considerations to keep in mind.

Common Medications That May Interact with Singulair

• Phenobarbital
• Rifampin
• Phenytoin
• Certain antifungal medications

How do these medications interact with Singulair? Some medications, particularly those that affect liver enzymes, can alter the metabolism of montelukast. This can potentially decrease the effectiveness of Singulair or increase the risk of side effects.

It’s important to note that while these interactions are possible, they are not exhaustive. Patients should always provide their healthcare provider with a complete list of all medications, including over-the-counter drugs, herbal supplements, and vitamins.

Singulair and Other Asthma Medications

Singulair is often used in combination with other asthma medications. Generally, it does not interact negatively with most asthma drugs, including:

• Inhaled corticosteroids
• Long-acting beta-agonists
• Short-acting beta-agonists (rescue inhalers)

Can Singulair replace other asthma medications? No, Singulair is not intended to replace quick-relief inhalers or other prescribed asthma medications. It’s designed to work alongside these treatments as part of a comprehensive asthma management plan.

Patients should never adjust their medication regimen without consulting their healthcare provider. Changes in asthma symptoms or the frequency of quick-relief inhaler use should be reported promptly to ensure optimal management of the condition.

Long-Term Use of Singulair: Benefits and Considerations

For many patients with chronic asthma or persistent allergies, long-term use of Singulair may be recommended. Understanding the potential benefits and considerations of extended use is important for patients and healthcare providers alike.

Potential Benefits of Long-Term Singulair Use

• Sustained control of asthma symptoms
• Reduced frequency of asthma exacerbations
• Improved quality of life for individuals with chronic allergies
• Potential reduction in overall medication burden

Does long-term use of Singulair lead to tolerance or decreased effectiveness? Current evidence suggests that Singulair remains effective with long-term use. Unlike some medications, patients typically do not develop tolerance to montelukast, meaning its effectiveness should not diminish over time when used as prescribed.

Considerations for Extended Singulair Use

• Regular monitoring for side effects
• Periodic reassessment of asthma control and medication needs
• Vigilance for potential mental health effects
• Consideration of bone health in long-term users

How often should patients on long-term Singulair therapy be evaluated? Patients using Singulair long-term should have regular follow-ups with their healthcare provider. The frequency of these evaluations may vary based on individual factors but typically occur at least annually. These check-ups allow for assessment of the medication’s ongoing effectiveness and monitoring for any potential side effects.

It’s worth noting that while Singulair is generally well-tolerated in long-term use, individual responses can vary. Some patients may experience changes in their condition or develop new symptoms over time. Open communication with healthcare providers is essential to ensure that the treatment plan remains optimal for each patient’s needs.

Singulair Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

This medication may rarely cause serious mental/mood changes. These effects may occur even after the medication has been stopped. Tell your doctor right away if you or a caregiver/family member notice symptoms such as agitation, anxiety, abnormal dreams, depression, memory/attention problems, hallucinations, trouble sleeping, or changes in behavior (such as aggression, hostility, restlessness, sleepwalking, suicidal thoughts/attempts). Talk to your doctor about the risks and benefits of this medication.

Warnings:

This medication may rarely cause serious mental/mood changes. These effects may occur even after the medication has been stopped. Tell your doctor right away if you or a caregiver/family member notice symptoms such as agitation, anxiety, abnormal dreams, depression, memory/attention problems, hallucinations, trouble sleeping, or changes in behavior (such as aggression, hostility, restlessness, sleepwalking, suicidal thoughts/attempts). Talk to your doctor about the risks and benefits of this medication.

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Uses

Montelukast is used to control and prevent symptoms caused by asthma (such as wheezing and shortness of breath). It is also used before exercise to prevent breathing problems during exercise (bronchospasm). This medication can help decrease the number of times you need to use your quick relief inhaler.Montelukast is also used to relieve symptoms of hay fever and allergic rhinitis (such as sneezing, stuffy/runny/itchy nose). Since there are other allergy medications that may be safer (see also Warning section), this medication should be used for this condition only when you cannot take other allergy medications or they do not work well.This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden asthma attacks or breathing problems. If an asthma attack or sudden shortness of breath occurs, use your quick-relief inhaler as prescribed. This drug works by blocking certain natural substances (leukotrienes) that may cause or worsen asthma and allergies. It helps make breathing easier by reducing swelling (inflammation) in the airways.

How to use Singulair oral

Read the Medication Guide provided by your pharmacist before you start taking montelukast and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor. The dosage is based on your age and medical condition.

If you are using the chewable tablets, chew them thoroughly before swallowing. If your child cannot safely chew and swallow them, consult the doctor or pharmacist for advice.

Take this medication at the same time each day. If you are taking this medication for asthma or for both asthma and allergies, take your dose in the evening. If you are taking montelukast to prevent only allergies, take your dose either in the morning or the evening.

If you are taking this medication to prevent breathing problems during exercise, take your dose at least 2 hours before exercise. Do not take more than one dose in 24 hours. Do not take a dose before exercise if you are already taking this medication daily for asthma or allergies. Doing so may increase the risk of side effects.

Do not increase or decrease your dose or stop using this medication without consulting your doctor. Continue to use this medication regularly to keep your asthma under control, even during sudden asthma attacks or periods when you have no asthma symptoms. Continue to also take other medications for asthma as directed by your doctor. This medication works over time and is not meant to relieve sudden attacks of asthma. If an asthma attack or other breathing problem occurs, use your quick-relief inhaler as prescribed. You should always have a quick-relief inhaler with you. Consult your doctor or pharmacist for more details.

Get medical help right away if your asthma symptoms worsen and your quick-relief inhaler is not helping. Tell your doctor promptly if asthma symptoms, breathing problems, allergy symptoms, number of times you use your rescue inhaler last or get worse.

Side Effects

See also Warning section.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: numbness/tingling/shooting pain in the arms or legs, sinus pain/swelling, muscle weakness, uncontrolled muscle movements, stuttering.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking montelukast, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this drug, tell your doctor or pharmacist your medical history, especially of: liver disease, mental/mood problems (such as anxiety, depression, thoughts of suicide).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

The chewable tablets may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Does Singulair oral interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: thirst, drowsiness, inability to keep still, vomiting, or severe stomach pain.

Do not share this medication with others.

Lab and/or medical tests (such as lung function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up. Do not take more than 1 dose in 24 hours.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Singulair 5 mg chewable tablet

Color: pinkShape: roundImprint: MSD 275 SINGULAIR

This medicine is a pink, round, cherry, chewable tablet imprinted with “MSD 275” and “SINGULAIR”.

Singulair 10 mg tablet

Color: beigeShape: square (rounded corners)Imprint: MSD 117 SINGULAIR

This medicine is a pink, round, cherry, chewable tablet imprinted with “MSD 275” and “SINGULAIR”.

Singulair 5 mg chewable tablet

Color: pinkShape: roundImprint: SINGULAIR MRK 275

This medicine is a pink, round, cherry, chewable tablet imprinted with “MSD 275” and “SINGULAIR”.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Singulair (Montelukast) – Side Effects, Interactions, Uses, Dosage, Warnings

uses

What is Singulair (Montelukast) used for?

• Allergic Rhinitis
• Asthma — Maintenance
• Bronchospasm Prophylaxis

warnings

What is the most important information I should know about Singulair (Montelukast)?

You should not use montelukast if you are allergic to it.

Tell your doctor if you have ever had:

• mental illness or psychosis; or
• asthma, or a history of severe allergic reaction (sneezing, runny or stuffy nose, wheezing, shortness of breath) after taking aspirin or another NSAID.

The chewable tablet may contain phenylalanine and could be harmful if you have phenylketonuria (PKU).

Tell your doctor if you are pregnant or breastfeeding.

Do not give this medicine to a child without a doctor’s advice.

User Reviews & Rating

Overall rating for Singulair (Montelukast)

2.9

out of  5

Side Effects

Easy to Use

Effectiveness

Read Singulair (Montelukast) Reviews

Side Effects

What are the side effects of Singulair (Montelukast)?

Get emergency medical help if you have signs of an allergic reaction: hives, blisters, severe itching; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor right away if you have signs of blood vessel inflammation: flu-like symptoms, severe sinus pain, a skin rash, numbness or a “pins and needles” feeling in your arms or legs.

Some people using montelukast have had new or worsening mental problems. Stop taking this medicine and call your doctor right away if you have unusual changes in mood or behavior, such as:

• agitation, aggression, feeling restless or irritable;
• anxiety, depression, confusion, problems with memory or attention;
• stuttering, tremors, uncontrolled muscle movements;
• suicidal thoughts or actions;
• hallucinations, sleep problems, vivid, dreams, sleep-walking; or
• compulsive or repetitive behaviors.

Common side effects may include:

• stomach pain, diarrhea;
• fever or other flu symptoms;
• ear pain or full feeling, trouble hearing;
• headache; or
• cold symptoms such as runny or stuffy nose, sinus pain, cough, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Singulair (Montelukast) if I’m pregnant or breastfeeding?

Tell your doctor if you are pregnant or breastfeeding.

Interactions

What drugs and food should I avoid while taking Singulair (Montelukast)?

Avoid situations or activities that may trigger an asthma attack.

If your asthma symptoms get worse when you take aspirin, avoid taking aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Dosage Guidelines & Tips

How to take Singulair (Montelukast)?

Use Singulair (Montelukast) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Singulair (Montelukast)?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Overdose Signs

What happens if I overdose on Singulair (Montelukast)?

If you think you or someone else may have overdosed on: Singulair (Montelukast),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Singulair (Montelukast), call 911

911

What to Expect

Montelukast starts to lower leukotriene levels in your body right away, but it may take about a week before you notice the full benefits.

You can safely use this medicine for a long period of time. It will only work while you’re taking it.

Secondary Uses

Singulair is sometimes prescribed “off-label” to treat other medical conditions, such as hives or chronic obstructive pulmonary disorder (COPD).

Images

SINGULAIR, MSD 117

Color: brown

Shape: square

Imprint: SINGULAIR, MSD 117

54 157

Color: brown

Shape: round

Imprint: 54 157

54 144

Color: pink

Shape: oval

Imprint: 54 144

Singular 10 mg n14 tablets

Indications

Prevention and long-term treatment of bronchial asthma in adults and children aged 6 years and older, including:

– prevention of daytime and nighttime symptoms of the disease;

– treatment of bronchial asthma in patients with hypersensitivity to acetylsalicylic acid;

– prevention of exercise-induced bronchospasm.

Relief of day and night symptoms of seasonal allergic rhinitis (in adults and children aged 6 years and over) and persistent allergic rhinitis (in adults and children aged 6 years and over).

Pharmacological action

Leukotriene receptor antagonist. Montelukast inhibits cysteinyl leukotriene receptors in the epithelium of the respiratory tract, while simultaneously showing the ability to inhibit bronchospasm caused by inhalation of cysteinyl leukotriene LTD ₄ in patients with bronchial asthma. Doses of 5 mg are sufficient to relieve bronchospasm induced by LTD ₄ . The use of montelukast in doses exceeding 10 mg / day. 1 time / day, does not increase the effectiveness of the drug.

Montelukast causes bronchodilation within 2 hours of oral administration and may supplement bronchodilation induced by beta ₂ beta-agonists.

Pharmacokinetics

Absorption

After oral administration, montelukast is rapidly and almost completely absorbed from the gastrointestinal tract. Regular meals do not affect plasma C _max and the bioavailability of coated tablets and chewable tablets. In adults, when taken on an empty stomach, film-coated tablets at a dose of 10 mg C _max in plasma is achieved after 3 hours. Bioavailability when taken orally is 64%.

After oral administration on an empty stomach, the drug in the form of chewable tablets at a dose of 5 mg C _max in adults is achieved after 2 hours. Bioavailability is 73%.

Distribution

Binding of montelukast to plasma proteins is more than 99%. V _d averages 8-11 liters.

With a single dose of the drug in the form of coated tablets, at a dose of 10 mg 1 time / day. there is a moderate (about 14%) accumulation of the active substance in plasma.

Metabolism

Montelukast is extensively metabolized in the liver. When used in therapeutic doses, the concentration of montelukast metabolites in plasma in an equilibrium state in adults and children is not determined.

It is assumed that cytochrome P450 isoenzymes (3A4 and 2C9) are involved in the metabolism of montelukast, while at therapeutic concentrations montelukast does not inhibit cytochrome P450 isoenzymes: 3A4, 2C9, 1A2, 2A6, 2C19 and 2D6.

Elimination of

T _1/2 montelukast in young healthy adults ranges from 2.7 to 5.5 hours. Montelukast clearance in healthy adults averages 45 ml/min. After oral administration of montelukast, 86% is excreted in the feces within 5 days and less than 0.2% in the urine, which confirms that montelukast and its metabolites are excreted almost exclusively in the bile.

Pharmacokinetics in special clinical situations

The pharmacokinetics of montelukast remains almost linear after oral administration of more than 50 mg.

When taking montelukast in the morning and evening, no differences in pharmacokinetics are observed.

Pharmacokinetics of montelukast in women and men is similar.

When taken orally coated tablets at a dose of 10 mg 1 time / day. pharmacokinetic profile and bioavailability are similar in elderly and young patients.

In patients with mild to moderate hepatic insufficiency and clinical manifestations of liver cirrhosis, a slowdown in the metabolism of montelukast was noted, accompanied by an increase in AUC of approximately 41% after a single dose of the drug at a dose of 10 mg. The excretion of montelukast in these patients is slightly increased compared with healthy subjects (T _1/2 averages 7.4 hours). Dose modification of montelukast is not required in patients with mild to moderate hepatic impairment. There are no data on the nature of the pharmacokinetics of montelukast in patients with severe hepatic insufficiency (more than 9 points on the Child-Pugh scale).

Since montelukast and its metabolites are not excreted in the urine, the pharmacokinetics of montelukast have not been evaluated in patients with renal insufficiency. Dose adjustment in this category of patients is not required.

There were no differences in clinically significant pharmacokinetic effects in patients depending on race.

Instructions for use / dosage

The drug is taken orally 1 time per day. regardless of food intake. For treatment of bronchial asthma Singular should be taken in the evening. When treatment of allergic rhinitis the drug can be taken at any time of the day.

Adults and adolescents aged 15 years and older the drug is prescribed at a dose of 10 mg (1 coated tablet) per day.

For children aged 6 to 14 years, is prescribed at a dose of 5 mg (1 chewable tablet) per day. No dose adjustment is required for this age group.

The therapeutic effect of Singulair on indicators reflecting the course of bronchial asthma develops during the first day. The patient should continue to take Singular both during the period of achieving control of asthma symptoms and during the period of exacerbation of the disease.

For elderly patients, patients with renal insufficiency , patients with mild or moderate hepatic impairment , and also depending on gender, no special dose adjustment is required.

Singular can be added to treatment with bronchodilators and inhaled corticosteroids.

Side effects

Allergic reactions: anaphylaxis, angioedema, rash, itching, urticaria; very rarely – eosinophilic infiltrates of the liver.

From the side of the central nervous system: unusual vivid dreams, hallucinations, drowsiness, irritability, agitation, including aggressive behavior, fatigue, insomnia, paresthesia / hypoesthesia, headache; very rarely – convulsive seizures.

From the digestive system: nausea, vomiting, dyspepsia, diarrhea, abdominal pain.

From the musculoskeletal system: arthralgia, myalgia, including muscle cramps.

Other: tendency to increase bleeding, formation of subcutaneous hemorrhages, palpitations, edema.

In general, Singulair is well tolerated. Side effects are usually mild and usually do not require discontinuation of treatment. Overall frequency of side effects reported with Singulara comparable to placebo.

Contraindications

– hypersensitivity to the components of the drug. Use during pregnancy and lactation The benefit to the mother outweighs the potential risk to the fetus or baby.

Use in hepatic impairment

For patients with mild or moderate hepatic impairment, no special dose adjustment is required.

There are no data on the nature of the pharmacokinetics of montelukast in patients with severe hepatic insufficiency (more than 9 points on the Child-Pugh scale).

Use for impaired renal function

No special dose adjustment is required for patients with renal insufficiency.

Special instructions

Singular is not recommended for the treatment of acute attacks of bronchial asthma. In the acute course of bronchial asthma, patients should be prescribed medications for therapy that stops and prevents attacks of the disease.

The dose of inhaled GCS used simultaneously with Singular can be gradually reduced under the supervision of a physician. Should not be abruptly replaced Singular therapy with inhaled or oral corticosteroids.

Reducing the systemic dose of corticosteroids in patients receiving anti-asthma drugs, including leukotriene receptor antagonists, was accompanied in rare cases by the appearance of one or more of the following phenomena: eosinophilia, vascular rash, worsening of pulmonary symptoms, cardiac complications and / or neuropathy, sometimes diagnosed as Churg-Ostrich syndrome – systemic eosinophilic vasculitis. Although a causal relationship of these adverse events with therapy with leukotriene receptor antagonists has not been established, with a decrease in the systemic dose of GCS in patients taking Singulair , caution should be exercised and appropriate clinical monitoring should be carried out.

Age differences in the efficacy and safety profile Singulara were not found.

Influence on the ability to drive vehicles and work with mechanisms

Facts indicating that the reception of Singulara affects the ability to drive a car or moving mechanisms have not been identified.

Overdose

Symptoms of overdose Singulara in patients with chronic bronchial asthma when used at a dose exceeding 200 mg / day for 22 weeks and at a dose of 900 mg / day. – within 1 week, not detected.

There are reports of acute overdose of montelukast in children (at a dose of at least 150 mg / day). Clinical and laboratory data at the same time indicate compliance with the safety profile of Singulara in children safety profile in adults and elderly patients. The most common adverse events were thirst, drowsiness, mydriasis, hyperkinesis and abdominal pain.

Treatment: symptomatic therapy.

There are no data on the possibility of excretion of montelukast by peritoneal dialysis or hemodialysis.

Drug interaction

Singular may be given with other medicines traditionally used for the prevention and long-term treatment of asthma. Montelukast at the recommended clinical dose did not have a clinically significant effect on the pharmacokinetics of the following drugs: theophylline, prednisone, prednisolone, oral contraceptives (ethinyl estradiol / norethindrone 35/1), terfenadine, digoxin and warfarin.

In patients who simultaneously received phenobarbital, the AUC of montelukast decreased by approximately 40%. Dose selection Singulara is not required for this category of patients.

If bronchodilators are ineffective as monotherapy for bronchial asthma, Singulair can be added to the treatment. When a therapeutic effect is achieved (usually after the first dose) during therapy with Singular , the dose of bronchodilators can be gradually reduced.

Treatment Singular provides an additional therapeutic effect in patients receiving inhaled corticosteroids. Upon reaching stabilization of the patient’s condition, it is possible to reduce the dose of corticosteroids. The dose of corticosteroids should be reduced gradually, under the supervision of a physician.