Montelukast, sold under the brand name Singulair, is a leukotriene receptor antagonist used mainly to help control asthma over the long term. It works by blocking the action of leukotriene D4 in the lungs, which reduces inflammation and relaxes smooth muscle in the airways. Beyond asthma it treats allergic rhinitis and chronic hives, though it is considered inferior to inhaled corticosteroids for asthma control and does not treat sudden attacks. The FDA approved montelukast in 1998, and it is now available generically, ranking as the twentieth most prescribed drug in the United States by 2023 with more than twenty five million prescriptions a year.
Facts
Drug ClassLeukotriene receptor antagonist 1 Mechanism of ActionBlocks the action of leukotriene D4 in the lungs, decreasing inflammation and relaxing smooth muscle 1 Approved UseMaintenance treatment of asthma; also allergic rhinitis and chronic hives 1 First Approved / Isolated Year Significant RiskNeuropsychiatric effects (behavioural changes, depression, suicidality) with black box warning 1 Classification
Approval Status ATC ClassSourced to the subject's own account Route of Administration Sources
1. Montelukast (Wikipedia)
Infobox, class
Leukotriene receptor antagonist
Pharmacology
It works by blocking the action of leukotriene D4 in the lungs
Lead section, paragraph 1
used in the maintenance treatment of asthma
Lead section, paragraph 3
approved for medical use in the United States in 1998
Lead section, paragraph 2
black box warning in the United Kingdom for behavioural changes, depression, and suicidality
https://en.wikipedia.org/wiki/Montelukast, lead section
of asthma. It is generally less preferred for this use than inhaled corticosteroids. It is not useful for acute asthma attacks. Other uses include allergic rhinitis and hives of long duration. For allergic rhinitis it is a second-line treatment.
- Regulatory approval status
View the Source2. Anatomical Therapeutic Chemical Classification System (Wikipedia)
WikipediaFirst-level anatomical group codes, Code RQuote, First-level anatomical group codes, Code R
Respiratory system
3. Wikipedia
Wikipedia contributors, Wikimedia Foundation
Frequently Asked Questions
Why does montelukast carry a warning about mood and behaviour?
Neuropsychiatric effects including behavioural changes and depression prompted a black box warning.
Sources on montelukast record neuropsychiatric effects, meaning behavioural changes, depression and suicidal thinking, and note that the United Kingdom attached a black box warning for them. This is a recorded regulatory finding about the drug, not medical advice; anyone taking it should raise concerns with a prescriber.
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