What it does
Montelukast is a medication that helps prevent asthma symptoms and relieve allergy symptoms.
Commonly used for: asthma, seasonal allergies (hay fever), exercise-induced bronchoconstriction
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Source: Pharmacy and Poisons Board · fetched 2026-01-28 21:38:19 · updated 2026-07-20 11:12:40
About this medicine
Montelukast is a medication that helps prevent asthma symptoms and relieve allergy symptoms.
What it treats
- asthma
- seasonal allergies (hay fever)
- exercise-induced bronchoconstriction
How it works
Montelukast works by blocking substances in the body that cause inflammation and allergic reactions.
Who it's for
Montelukast is for people with asthma or allergies, including children and adults.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: montelucast
Montelukast is a selective leukotriene receptor antagonist used primarily for the management of asthma and allergic rhinitis. It works by blocking the action of leukotrienes, which are inflammatory mediators involved in the pathophysiology of asthma and allergic reactions. This action helps to reduce bronchoconstriction, mucus secretion, and airway edema, thus alleviating symptoms associated with asthma and allergies.
Indications
- Asthma management in adults and children
- Prevention of exercise-induced bronchoconstriction
- Seasonal and perennial allergic rhinitis
Dosage
Children: Refer to the BNF for Children for specific dosing information.
Adults: Refer to the BNF for specific dosing information.
Mechanism of action
Montelukast functions by specifically inhibiting the cysteinyl leukotriene receptor (CysLT1). By blocking this receptor, montelukast prevents leukotriene D4 from binding and exerting its bronchoconstrictive and pro-inflammatory effects, leading to enhanced airway patency and reduced inflammation in the respiratory system.
Pharmacodynamics
Montelukast exhibits its pharmacological effects through the inhibition of leukotriene-induced bronchoconstriction, inflammation, and mucus secretion. It improves pulmonary function and reduces the frequency of asthma attacks. The onset of action generally occurs within a few hours after oral administration and can provide sustained effects lasting for 24 hours.
Pharmacokinetics
Montelukast is well-absorbed following oral administration, with peak plasma concentrations occurring within 3 to 4 hours. It is highly protein-bound (approximately 99%) and has a half-life of about 2.7 to 5.5 hours. The drug is primarily metabolized by the liver via cytochrome P450 enzymes, particularly CYP2C8 and CYP3A4, and its metabolites are excreted predominantly in the feces. Renal impairment does not significantly affect the pharmacokinetics of montelukast.
Contra-indications
- Hypersensitivity to montelukast or any of its components
Adverse effects
- Headache
- Gastrointestinal disturbances (e.g., nausea, diarrhea)
- Fatigue
- Dizziness
- Mood changes (e.g., agitation, aggressive behavior, depression)
- Skin reactions (e.g., rash)
Interactions
- May interact with phenobarbital, which can decrease montelukast levels
- Caution with other medications that affect liver enzymes
Precautions
- Use with caution in patients with a history of mood disorders
- Monitor for changes in behavior or mood in patients during treatment
- Not intended for the treatment of acute asthma attacks
Pregnancy
Montelukast is classified as category B. Limited data suggests no risk to the fetus, but it should be used only if clearly needed.
Breast-feeding
Montelukast is excreted in breast milk. Caution is advised, but it is generally considered compatible with breastfeeding.
Storage
Store at room temperature, away from moisture and heat. Keep out of reach of children.
Formulations
- Tablets (10 mg)
- Chewable tablets (4 mg, 5 mg)
- Granules (4 mg)
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.