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Singulair (monteleukast) is a leukotriene receptor antagonist used to to reduce the frequency and severity of asthma attacks and alleviate symptoms of allergies. In blocking leukotriene, the medication reduces constriction and inflammation in the airways.

Singulair is not a steroid and may prove beneficial in those seeking extra control of asthma or allergies who are unable to take or averse to steroids. It can also be used along with steroids.

This product is suitable for ages 2 and up, though dosage modification will be required and the formula through which it is administered may vary. The majority of patients take tablets, but young children may be more inclined to consume Singulair in chewable tablets or oral granules, which dissolve in the mouth or can be mixed with fluids or soft foods.

Managing Allergies & Asthma

The first thing patients should know about Singulair is that it is for preventative purposes only; rescue inhalers, such as albuterol, should be kept on-hand and used as needed for asthma attacks. With regular daily use Singulair should reduce the frequency and severity of attacks, but when they do occur the medication will provide little benefit.

Singulair should be used daily over the long term for best results. Tablets are typically taken once per day, with or without food as desired. Standard dosing is as follows:

• Patients 15 years and up: 10 mg once per day.
• Patients 6 to 14 years old: 5 mg once per day.
• Patients 2 to 5 years old: 4 mg once per day.
• Patients under 2 years old: consult a doctor.

The above dosing guidelines apply to using Singulair for both asthma and allergies. It may take a couple weeks of regular use for maximum benefit to be seen, though most patients notice improvements with the first dose.

In some cases, such as seasonal allergies, brief exposure to allergens, or in treating exercise-induced asthma, the medication can be used on a more as-needed basis, rather than taking it daily. If preparing for seasonal allergies, treatment should start a few days before anticipated allergen exposure and continue---one tablet per day---throughout the season. Those anticipating brief allergen exposure---such as visiting a friend who has allergy-inducing pets---or those anticipating exercise-induced asthma should take a tablet 2 hours prior to exposure or exercise.

Note that many people suffer from more than one ailment; a patient may have both asthma and seasonal allergies. In these cases, patients should take care to not exceed 10 mg per day; do not take one tablet for allergies and another for asthma. No additional benefit is to be had and the odds of experiencing serious side effects go up significantly.

Adverse Reactions

Though most patients take Singulair without any adverse effects, a percentage of patients will experience such effects ranging from mild to severe. Most commonly reported are:

• Stomach upset
• Diarrhea
• Mild fever
• Headache
• Loss of bladder control in children
• Cold-like symptoms; stuffy nose, cough, sore throat, etc.

The above are not cause for concern unless severe. In most cases, if the medication is being taken long-term, side effects will stop occurring after the first week or two of treatment.

Less commonly more serious side effects develop, which call for medical attention:

• Changes in mood or behavior
• Ear pain, warmth, or swelling
• Severe rash
• Unexplained bruising
• Muscle weakness
• Tingling in extremities
• Numbness in extremities

Mood changes, including suicidal thoughts or attempts, are debated with this product. Trials---some of which were held specifically to monitor for mood changes---have yet to show Singulair does in fact produce mood changes; it is entirely based on post-marketing reports. If there is any truth to this claim, it effects a very small percentage of the population. However, that is little consolation to those who have affected loved ones; mood changes should be watched for and brought to the attention of a doctor if noticed, particularly in young patients or those with a history of suicidal ideation.