Singulair


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montelukast sodium

Singulair

Pharmacologic class: Leukotriene receptor antagonist

Therapeutic class: Antiasthmatic

Pregnancy risk category B

Action

Blocks action of leukotrienes, decreasing smooth muscle contractions and edema in bronchial airways and preventing inflammation and bronchospasm

Availability

Oral granules: 4-mg base/packet

Tablets: 10 mg

Tablets (chewable): 4 mg, 5 mg

Indications and dosages

Long-term asthma management

Adults and children ages 15 and older: 10-mg tablet P.O. daily in evening

Children ages 6 to 14: 5-mg chewable tablet P.O. daily in evening

Children ages 2 to 5: 4-mg chewable tablet or one 4-mg packet oral granules P.O. daily in evening

Children ages 12 to 23 months: 4-mg packet oral granules P.O. daily in evening

Prevention of exercise-induced bronchoconstriction (EIB)

Adults and children ages 15 and older: Single-dose, 10-mg tablet P.O. at least 2 hours before exercise; additional dose shouldn't be taken within 24 hours. Patients already taking 1 tablet daily for another indication shouldn't take an additional dose.

Children ages 6 to 14: 5-mg chewable tablet P.O. at least 2 hours before exercise; additional dose shouldn't be taken within 24 hours. Patients already taking 1 tablet daily for another indication shouldn't take an additional dose.

Seasonal allergic rhinitis

Adults: 10 mg P.O. daily

Children ages 2 to 5: 4 mg P.O. daily either as either chewable tablet or packet of oral granules

Perennial allergic rhinitis

Adults and children ages 15 and older: 10 mg tablet P. O. daily

Children ages 6 to 14: 5 mg P.O. daily as chewable tablet

Children ages 2 to 5: 4 mg P.O. daily as either chewable tablet or one 4-mg packet of oral granules

Children ages 6 to 23 months: 1 packet (4 mg) oral granules P.O. daily

Off-label use

• Chronic urticaria

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• acute asthma attack, hepatic impairment, phenylketonuria
• pregnant or breastfeeding patients
• children younger than age 6 when used for EIB prevention (safety not established)
• children younger than age 2 when used for seasonal allergy (safety not established)
• children younger than age 1 when used for asthma (safety not established)
• children younger than age 6 months when used for perennial allergy (safety not established).

Administration

• Give with or without food.
• Administer oral granules either directly in mouth, dissolved in 1 teaspoon (5 mL) cold or room temperature baby formula or breast milk, or mixed with spoonful of cold or room temperature soft foods (applesauce, carrots, rice, or ice cream only). Don't open packet until ready to use. After opening packet, administer full dose (with or without mixing with baby formula, breast milk, or food); dose must be given within 15 minutes. If granules have been mixed with baby formula, breast milk, or food, don't store for future use.
• Ensure that patient taking drug for prevention of EIB has short-acting beta-agonist available for rescue.

Adverse reactions

CNS: fatigue, headache, dizziness, asthenia, agitation, aggressive behavior or hostility, anxiousness, depression, disorientation, dream abnormalities, hallucinations, insomnia, irritability, restlessness, somnambulism, tremor, suicidal thinking and behavior (including suicide)

EENT: nasal congestion, otitis and sinusitis (in children)

GI: abdominal pain; nausea and diarrhea (in children); dyspepsia; infectious gastroenteritis

Respiratory: cough

Skin: rash

Other: dental pain, influenza, fever

Interactions

Drug-drug.CYP450 inducers (such as phenobarbital, rifampin): decreased montelukast effects

Drug-diagnostic tests.Alanine aminotransferase, aspartate aminotransferase, eosinophils: increased levels

Patient monitoring

• Assess eosinophil count.
• Monitor temperature. Watch for fever and other signs and symptoms of infection.

Monitor patient for change in mood or behavior, including suicidal ideation.

Patient teaching

• Advise patient (or caregiver) who has asthma or asthma and rhinitis to take drug in evening.
• Instruct patient (or caregiver) who has EIB not to take another dose within 24 hours of previous dose.
• Inform patient (or caregiver) that he may sprinkle granules onto soft foods (applesauce, carrots, rice, or ice cream only) and take immediately. Drug isn't intended to be dissolved in any liquid other than breast milk or baby formula. Don't store drug that has been mixed with food or liquids for future use.
• Instruct patient or caregiver that after opening packet of oral granules, dose must be taken within 15 minutes.

Tell patient or caregiver that drug is for preventive use only, not for treatment of acute asthma attacks and that appropriate rescue medication should be available.

Instruct patient or caregiver to notify prescriber if mood or behavior changes.
• Caution patient to avoid driving and other hazardous activities, because drug causes dizziness.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

Singulair

(sĭng′gyə-lâr′)
A trademark for the drug montelukast.

Singulair®

Montelukast, see there.

Singulair

A brand name for MONTELUKAST.

Montelukast (Singulair)

An inhibitor that prevents leukotrienes from binding to cell receptors; taken over time, montelukast can reduce or prevent symptoms of asthma and allergies.
References in periodicals archive ?
A dip in sales caused by the Singulair patent expiry in 2013, as well as the patent expiry of the best-selling ICS/LABA FDCs, GSK's Advair and AstraZeneca's Symbicort, will be offset by eight pipeline product launches, seven of which are targeted biologics.
in April is expected to not only bolster its internal pipeline productivity but also offset its anticipated losses from the expiry of its Singulair patent, which garnered sales of $5.
After a thorough review of the data from the controlled clinical trials of SINGULAIR, and a careful assessment of post-marketing adverse events, Merck believes that the data support the continued use of SINGULAIR in appropriate patients with asthma and allergic rhinitis.
Singulair granules, which can be given to children as young as six months, is the first medicine of its kind to be introduced in the UK.
Another study of 600 slightly older children aged between two and five found Singulair granules could cut asthma attacks by almost 30pc.
Singulair granules can be given to children as young as six months and can be taken directly or mixed with soft food such as mashed potato or ice cream.
Five key products - VIOXX, ZOCOR, FOSAMAX, SINGULAIR and COZAAR/HYZAAR - led Merck's growth, and now account for more than 50% of Merck's worldwide human health sales.
However, Accolate and the recently introduced Singulair, along with several other existing products such as long acting bronchodilators, may well be useful as treatments additional to inhaled steroids in those whose asthma is not well controlled on inhaled steroids alone.
Full-Year and Fourth-Quarter Double-Digit Global Sales Growth for JANUVIA, JANUMET, GARDASIL, VICTRELIS and ZOSTAVAX Offset the Decline in SINGULAIR Sales Following Patent Expiry in the United States
a subsidiary of Ajanta Pharma Limited, announced today the launch of Montelukast Sodium Oral Granules (4mg), a bioequivalent generic version of SINGULAIR Granules, in the US market.
for generic versions of asthma and allergies treatment Singulair in adults and children.
Merck makes the osteoporosis medication Fosamax, the allergy and asthma drug Singulair and the Gardasil vaccine for the human papillomavirus.