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Bronchodilator

Montelukast

Brand names: Singulair

Montelukast is an oral leukotriene receptor antagonist used as add-on preventer therapy in asthma and for exercise-induced bronchoconstriction and allergic rhinitis. It is taken once daily, usually in the evening.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It selectively blocks the cysteinyl leukotriene receptor, reducing leukotriene-mediated airway inflammation, bronchoconstriction and mucus secretion.

Prescribing in practice

  • Warn patients and carers about neuropsychiatric reactions including sleep disturbance, mood change, agitation and suicidal thoughts, which are the subject of an MHRA warning, and stop if they occur.
  • It is a preventer and does not relieve acute attacks, so reliever therapy must continue.
  • Reassess benefit periodically and stop if there is no clear improvement in asthma control.

Monitoring

Monitor asthma control and remain alert for any new or worsening behavioural, mood or sleep changes throughout treatment.

Counselling the patient

  • Stop the tablet and seek advice if you or your child notice changes in mood, sleep or behaviour.
  • Take it every evening as a preventer, not for sudden symptoms.
  • Keep using your other asthma inhalers as prescribed.

Evidence & guidelines

UK guidance supports montelukast as an add-on option in asthma, with an MHRA reminder about neuropsychiatric adverse effects.

Reference: NICE NG80 Asthma; MHRA Montelukast Safety Alert 2022; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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