Accolate

Ac·co·late (k-lt)

A trademark for the drug zafirkulast.

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Zafirlukast (Accolate)

An inhibitor that prevents leukotrienes from binding to cell receptors; taken over time, zafirlukast can help reduce or prevent asthma symptoms.

Mentioned in: Leukotriene Inhibitors

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zafirlukast

Accolate

Pharmacologic class: Leukotriene receptor antagonist

Therapeutic class: Antiasthmatic, bronchodilator

Pregnancy risk category B

Action

Antagonizes activity of three leukotrienes at specific receptor sites in airway smooth muscle, inhibiting inflammation

Availability

Tablets (coated): 10 mg, 20 mg

⊘Indications and dosages

➣ Prophylaxis and long-term treatment of asthma

Adults and children ages 12 and older: 20 mg P.O. b.i.d.

Children ages 5 to 11: 10 mg P.O. b.i.d.

Dosage adjustment

• Hepatic impairment

Off-label uses

• Exercise-induced bronchospasm
• Chronic urticaria

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• hepatic disease, acute asthma attacks
• patients older than age 55
• pregnant patients
• breastfeeding patients (use not recommended)
• children younger than age 7 (safety not established).

Administration

• Give at least 1 hour before or 2 hours after a meal.

Route	Onset	Peak	Duration
P.O.	30 min	3.5 hr	12 hr

Adverse reactions

CNS: headache, dizziness, asthenia

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia

Musculoskeletal: joint or back pain, myalgia

Other: fever, infection, pain

Interactions

Drug-drug. Aspirin: increased zafirlukast blood level

Erythromycin, theophylline: decreased zafirlukast blood level

Warfarin: increased warfarin effects, greater risk of bleeding

Drug-food. Any food: decreased rate and extent of zafirlukast absorption

Patient monitoring

• Assess patient's respiratory status to help evaluate drug efficacy.

Patient teaching

• Tell patient to take at least 1 hour before or 2 hours after a meal.
• Advise patient to take exactly as prescribed, even if he's symptom-free.
☞ Tell patient to immediately report asthma attack. Advise him not to use drug for rapid relief of bronchospasm.
• Instruct patient to continue taking other asthma drugs unless prescriber directs otherwise.
• Instruct female patient to consult prescriber if she plans to breastfeed.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and foods mentioned above.

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Accolate® Zafirkulast, see there