Author: Olivia Schwaller, PharmD Candidate 2016
Clinical Review: Kelly Cochran, PharmD, BCPS
When reviewing a patient’s medication list I noticed the Singulair (montelukast) prescription instructed her to take one tablet by mouth in the evening. I knew this was the proper way to take this medication because I had seen it come through the pharmacy many times, but I always wondered why it had to be taken in the evening.
What is montelukast? Montelukast is a medication that can be used for the treatment of asthma, allergic rhinitis, and exercise-induced bronchoconstriction in the pill form. It is an anti-inflammatory agent that inhibits the leukotriene pathway by blocking receptors located in the cell walls of the lungs, preventing smooth muscle contraction, respiratory inflammation, and edema.1 These leukotrienes are also released from the nasal mucosa after allergen exposure, and montelukast may inhibit symptoms associated with allergic rhinitis.1
Upon a little research I found that the prescribing information states, “There have been no clinical trials in patients with asthma to evaluate the relative efficacy of morning versus evening dosing… Efficacy has been demonstrated for asthma when montelukast was administered in the evening…”2 From this information I gathered that most of the trials that were treating asthma patients with montelukast included evening administration in their trial protocols and the efficacy morning administration has not been studied. For those that would use montelukast for seasonal allergic rhinitis or perennial allergic rhinitis, a specific time to take the dose was not recommended.
A study from 2006, Pajaron-Fernandez et al, compared the response children with exercise induce bronchoconstriction (EIB) had to a morning or evening dose of montelukast over a two week period.3 Children enrolled were between the ages of 6-14 years old and were only taking an inhaled beta-2 agonist as needed for asthma symptoms.3 Following two weeks of treatment with montelukast in the morning or evening each treatment group underwent a one week washout period where they did not take any doses of montelukast. Then the groups switched to the opposite treatment time, for example from morning previously now to evening for an additional two weeks of treatment.3 Of 48 children enrolled, 24 completed the trial and their response to therapy was analyzed The main outcome variable interpreted was the maximum percent fall in the forced expired volume in 1 second (FEV1) after 3, 5, 10, 15, and 20 minutes of exercise. The secondary outcome measured was the maximum percent fall in forced expiratory flow at 25-75% of forced vital capacity (FEF25-75%). When interpreting these variables we look to see which treatment option has the least amount of decline in FEV1 and FEF25-75%to consider them the more viable option when treating asthma. A more pronounced decrease in these variables means asthma symptoms are worse, decreasing the outflow of air from the lungs. The results showed there was not statistical significance in maximum percent decline in FEV1 or in the area under the curve of FEV1 (AUCFEV1) between montelukast either given in the morning or the evening; meaning results did not show a difference in correlation to the time of day montelukast was given. There was a difference shown in the maximum percent fall of FEF25-75% while the morning dose showed a slight decrease compared to the evening dose, but it was not statistically significant. The authors of this trial concluded that montelukast exerts an increased action at night, either because of higher plasma concentration at the moment of the challenge test, or because of anti-inflammatory effect during the first hours of the morning, or both.3 Since this study observed the effects of montelukast in children with EIB, it cannot be accurately compared to adults with asthma due to the human lungs continuing to develop throughout one’s lifetime.5
In the Rumor vs. Truth section of the Pharmacists Letter evaluating when montelukast should be dosed, they concluded asthma symptoms tend to be worse during the night and early morning hours and that montelukast has a short half-life of about 4-7 hours with blood levels peaking 3-4 hours after a dose.4 For these reasons, they concluded that this is why healthcare providers and the prescribing information for montelukast recommends taking it at night in order to match peak drug levels with symptom onset.4 A comment was added by a pharmacist from Maryland that leukotriene synthesis occurs more at night than during the day. This would argue that evening dosing would have the most significant benefit on asthma symptoms both during sleep and the next day4. No clinical data could be found supporting this comment. Since the publication from the Pharmacist Letter, there has not been any additional studies or trials conducted to compare morning versus evening dosing of montelukast.
With the question still slightly up in the air, I would still recommend the use of montelukast in the evening, despite there being no clinical evidence in comparing morning doses versus evening doses in adults with asthma. I say this because from clinical trials comparing placebo versus montelukast, montelukast was always given in the evening showing statistical significant results in reducing asthma symptoms in children and adults.2
- Montelukast for asthma
- Name of drug
- Why is it important for my child to take this medicine?
- What is montelukast available as?
- When should I give montelukast?
- How much should I give?
- How should I give montelukast?
- When should the medicine start working?
- What if my child is sick (vomits)?
- What if I forget to give it?
- What if I give too much?
- Are there any possible side-effects?
- Can other medicines be given at the same time as montelukast?
- Is there anything else I need to know about montelukast?
- General advice about medicines
- Where should I keep this medicine?
- Who to contact for more information
- How Long Does Singulair Take To Work
- Lung & Respiratory – Asthma: Does Singulair take time to work?
- how long does it take for singulair to work – MedHelp
- What Is the Role of Singulair (Montelukast) in Asthma?
- How does singulair take to work – JustAnswer
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- Singulair: How it works, uses, and side effects
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Montelukast for asthma
This leaflet is about the use of montelukast for the prevention of asthma.
This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Name of drug
Brand name: Singulair®
Why is it important for my child to take this medicine?
Montelukast blocks the effects of chemicals in the body that cause inflammation and narrowing of the airway. Taking montelukast regularly will help to stop your child from having asthma attacks.
What is montelukast available as?
- Tablets: 10 mg
- Chewable tablets: 4 mg, 5 mg; these contain small amounts of aspartame (phenylalanine)
- Granules: 4 mg per sachet
When should I give montelukast?
Montelukast is usually given once each day, this is usually in the evening.
Give the medicine at about the same time each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of montelukast (the dose) that is right for your child. The dose will be shown on the medicine label.
It is important that you follow your doctor’s instructions about how much to give.
How should I give montelukast?
Tablets should be swallowed whole, with a glass of water, juice or milk. Your child should not chew these tablets.You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing.
Chewable tablets should be chewed or sucked. Your child can have a drink afterwards. They should be taken at least 1 hour before eating or 2 hours after eating.
Granules: Sprinkle or stir the granules into a small amount of cold soft food (e.g. yogurt). Your child should then swallow the food straight away, without chewing. Make sure that they take it all.
- Do not mix the granules with warm food or liquid.
- Your child must take the granules within 15 minutes of opening the sachet. If the sachet has been open for more than 15 minutes, throw the contents away and use a new sachet.
- Do not keep granules or a granule/food mixture to give later.
When should the medicine start working?
Your child may need to take montelukast for a few weeks before it starts to prevent asthma attacks. Continue to give montelukast to your child during this time. Give their other asthma medicines as your doctor has told you to.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of montelukast give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of montelukast, you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.
What if I forget to give it?
- If you remember before your child has gone to sleep, give them the missed dose. If you remember after your child has gone to sleep, you do not need to wake them up to give the missed dose.
- You can give the missed dose in the morning, as long as this is at least 6 hours before the next evening dose will be given.
Never give a double dose of montelukast.
What if I give too much?
If you give your child too much montelukast, they may get stomach ache, feel or be sick (vomit), get a headache, feel thirsty, and they may be sleepy or more active than normal (especially younger children).
If you think you may have given your child too much montelukast, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales) or take your child to hospital.
Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine or packaging with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side-effects that you must do something about
If your child gets swelling of the face, lips or tongue, a skin rash or itching, has difficulty breathing or has a fit (seizure), take them to hospital or call for an ambulance straight away, as they may be allergic to montelukast.
If your child has flu-like symptoms (temperature above 38°C, aches, headache) and also pins and needles, numbness, a rash, and their asthma gets worse, contact your doctor straight away, as they may have a rare syndrome called Churg–Strauss syndrome. This is more likely if the dose of inhaled steroids that your child has (the brown inhaler) has been reduced.
If your child has an irregular or fast heart beat (they may say that their heart feels fluttery or is racing), contact your doctor straight away.
If your child gets a yellowish tinge to the skin or whites of the eyes, contact your doctor straight away, as there may be a problem with your child’s liver.
If your child seems to bruise more easily than usually, or a cut or graze does not stop bleeding as quickly as you would expect, contact your doctor straight away, as there may be a problem with your child’s blood.
Other side-effects you need to know about
When your child first starts taking montelukast they may have the following side-effects. Most of these wear off as your child gets used to the medicine. If they are still a problem after about 2 weeks, contact your doctor.
- They may feel or be sick (vomit) and have diarrhoea.
- They may get headache or muscle pain (myalgia).
- They may have a dry mouth or feel thirsty. Eating citrus fruits (e.g. oranges) and taking sips of water may help.
- Your child’s skin may feel itchy. Using a moisturising cream may help.
- Your child may have nightmares or problems sleeping.
- Your child may feel tense, nervous or ‘on edge’. Young children (under 5 years of age) may seem more active than usual.
- Your child may feel light headed or faint. They should try not to stand up too quickly. They should lie down for a while if they feel faint.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.
Can other medicines be given at the same time as montelukast?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Montelukast should not be given with some medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before starting montelukast.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
Is there anything else I need to know about montelukast?
- Montelukast is used to help prevent asthma attacks. It should not be used to stop an attack that has already started, as it will not help. Use your child’s reliever medicine (the blue inhaler) to help with an attack that has already started.
General advice about medicines
- Try to give the medicine at about the same time each day, to help you remember.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor for advice.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where should I keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Keep the medicine in the container it came in.
- Make sure that children cannot see or reach the medicine.
Who to contact for more information
Your child’s doctor, pharmacist or asthma practice nurse will be able to give you more information about montelukast and about other medicines used to treat asthma.
How Long Does Singulair Take To Work
- Lung & Respiratory – Asthma: Does Singulair take time to work?
- How long does Singulair take to go into effect? | Yahoo …
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- Singulair Uses, Dosage & Side Effects – Drugs.com
Lung & Respiratory – Asthma: Does Singulair take time to work?
Does Singulair take time to work? (I have Albuterol) Anyway, it’s been almost a week and I don’t feel any better and my inhaler still only works for a 1/2 hour to an hour. So I was wondering if Singulair is one of those drugs that takes a week or two to build up and start working, or if it should have started working immediately. Your child needs to take the medicine called montelukast (say: mon-te-LOO-kast). This information sheet explains what montelukast does, how to give it, and what side effects or problems your child may have when they take this medicine. How Does Singulair Work? Singulair is part of a group of medications called leukotriene modifiers. Leukotrienes are chemicals produced by the body in response to allergens or other problems. In the lungs, they cause swelling and inflammation in the airways and constriction of the muscles of the respiratory tract.
How long does Singulair take to go into effect? | Yahoo …
How long does Singulair take to go into effect? I am using it as a decongestant for severe allergies, any other suggestions? Claritin D has been the most effective medication so far, am looking for something stronger without using steroid nasal sprays. How long does it take until you know if singulair is working for you or not? This is day 2 and I am still wheezing. My chest doesn’t feel quite as tight. It’s been bad lately, I’ve been very short of breath. My PCP gave me some singulair hoping this will do it for me. I am also on 2 puffs of advair twice a day-:) Thanks!
How long does it take for Singulair to work – Answers
How long does it take for Singulair to work? Answer. Wiki User June 20, 2009 7:41PM. My doctor says Singulair takes 2-3 days to work. Related Questions . Asked in Claritin (Loratadine) Can you take singulair and Claritin together? can i take singulair and claretin togther Do not take Singulair if you are allergic to montelukast. Singulair is not a fast-acting bronchodilator and should never be used in the place of a rescue inhaler. The drugs phenobarbital and rifampin should not be used while taking Singulair. Talk with your doctor about stopping any drug treatments, including Singulair. How long does it usually take for someone to see results from accolate, vitamin E, and massage? Level II Capsular Contracture. … If So, What “Baker” Grade? How Long to Take Singular? A: Your breasts look asymmetrical and assuming that they didn’t early postop it would most likely be from a capsular contracture on the right side (the higher one).
how long does it take for singulair to work – MedHelp
hmmmm Singulair is also an allergy medication (or suppose to be) but it may not be enough for you to control hayfever. It affects a different part of the immune system than the typical antihistamines so some people it works better on, some it does not work as well. I think it does have a link because of the allergy release. Which is the same as Cholinergic Urticaria. Singulair is available only as a perscription. But it does take about two months to be in full effect. I know its hard to take something that u feel isnt working…. but i have strong hopes it will. Let me know of any progress or questions.
Singulair (Montelukast) – Side Effects, Dosage …
Your doctor may recommend that you take Singulair in the evening, but it can be taken during the daytime, as long as you take it around the same time each day. Singulair does not work immediately and should not be used to treat sudden asthma attacks or other breathing problems. Singulair Overdose It takes time to build up in your system to be effective. Benadryl is a fast-acting antihistamine used for dealing with allergic reactions more quickly, where Singulair is a preventative medication. I’ve used Singulair for Asthma since it became available, and along with Zyrtec, it keeps my Asthma symptoms to a minimum.
Singulair effectiveness – HealingWell.com
My primary did tell me to take it at night because for reasons unknown, it works better for asthma at night, and it doesn’t really matter what time you take it for allergies. I was trying to avoid going to an allergist. I take a couple of immunosupressant medications for rheumatoid arthritis so my immune system does not function properly. Montelukast controls the symptoms of asthma and allergic rhinitis but does not cure these conditions. Continue to take montelukast even if you feel well. Do not stop taking montelukast without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
How soon after taking Singulair (montelukast) will my …
In clinical trials, the effects of Singulair (montelukast) were noticed after the first dose, however, the medication can take about three to seven days to start working. Even if you experience a big reduction in your asthma attacks and symptoms or allergy symptoms, do not stop taking Singulair. How does the drug Singulair work? … How long does it take for Singulair to get out of your system? … (Singulair), a long-term control medicine,” Fine said. It helps block the chain reaction that can cause your airways to become swollen and inflamed. Long term ratings: 4/5. This is a reivew of how effective Singulair (montelukast sodium) is for Cough and for what kind of people. The study is created by eHealthMe from 11 Singulair users and is updated continuously. eHealthMe has been monitoring drugs since 2008. Our original studies have been referenced on 600+ peer-reviewed medical …
Singulair User Reviews for Allergic Rhinitis at Drugs.com
User Reviews for Singulair to treat Allergic Rhinitis. The following information is NOT intended to endorse drugs or recommend therapy. While these reviews might be helpful, they are not a substitute for the expertise, skill, knowledge and judgement of healthcare practitioners in patient care. For exercise-induced bronchoconstriction, take a single dose at least 2 hours before you exercise, and do not take another dose for at least 24 hours. Follow your doctor’s instructions. Montelukast is not a rescue medicine. It will not work fast enough to treat an asthma attack. Use only a fast acting inhalation medicine for an asthma attack.
How Quickly Does Singulair Work | Healthfully
How Quickly Does Singulair Work. Function of Singulair ; Singulair Forms and Uses ; … In order for the drug to work properly, doctors advise you to take Singulair at the same time every day 1 2. … Singulair works in the long term, helping your body breathe easier, and is not an instantaneous remedy for an asthma attack 1 2. Singulair is not anti-inflammatory, ICS’s are. Singulair treats the symptoms, whereas ICS’s treat the problem. This is why study after study proves that ICS’s are superior to Singulair, and why guidelines place ICS’s as first line treatment and Singulair as alternative. Does Singulair work? Of course Singulair works. SINGULAIR may affect how your other medicines work. How should I take SINGULAIR? … in the evening.Continue to take SINGULAIR every day for as long as your healthcare providerprescribes it, … Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
Singulair Oral : Uses, Side Effects, Interactions …
Find patient medical information for Singulair Oral on WebMD including its uses, side effects and safety, interactions, … This medication does not work right away and should not be used to treat sudden asthma attacks or other breathing problems. … Take this medication by mouth with or without food as directed by your doctor. my 15 son takes singulair but isn’t always compliant..how long does it stay in his system he had a bad emotional episode the other night After a few phone calls to local pharmacists and some online research, the best answer to give you is this: Singulair should be taken once daily as prescribed It works by stopping the action of a chemical called leukotriene, which causes your nasal passages to swell and make a lot of mucus. The same chemical is also responsible for tightening airways when you have asthma, making it harder to breathe. Singulair is a prescription medication. You take it once a day.
What Is the Role of Singulair (Montelukast) in Asthma?
Singulair (montelukast) and other leukotriene modifiers are also one potential option if you don’t want to or cannot take inhaled steroids. One potential advantage of Singulair (montelukast) and other leukotriene modifiers is that they are oral medication and may be much easier for you to take. How long does singulair stay in your system? … How long does it take for singulair to leave your system if it was taken for 4 yrs? The child is 6 years old. Show More. … GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
How does singulair take to work – JustAnswer
How long does it take for montelukast to take effect …
In clinical trials, the effects of Singulair (montelukast) were noticed after the first dose, however, the medication can take about three to seven days to start working. Even if you experience a big reduction in your asthma attacks and symptoms or allergy symptoms, do not stop taking Singulair. Singulair – how long ’til it works? tetonwoman. I am starting Singulair use with my doctor’s recommendation. How long does one usually have to take it before they notice improvements with asthma/allergy symptoms? Thanks … It could take days to a month to see changes, … How long does it take for doxycycline mono to work for acne OYes Buy Now! Best choice. Low price and best customer support! Only Quality tabs. U.S., Canada- fast shipping!
Clinical Question: When to take Singulair (montelukast …
When reviewing a patient’s medication list I noticed the Singulair (montelukast) prescription instructed her to take one tablet by mouth in the evening. I knew this was the proper way to take this medication because I had seen it come through the pharmacy many times, but I always wondered why it I take Pulmicort twice everyday as a preventative medicne, but my doctor just prescribed Singulair to help as well. It’s been 5 days since I started taking Singulair on top of the Pulmicort but I’m still having waves of breathlessness. How long does it take for Singulair to start working and making you feel better?
singulair how long does it take to work – MedHelp
Singulair how long does it take to work. Common Questions and Answers about Singulair how long does it take to work. singulair. It affects a different part of the immune system than the typical antihistamines so some people it works better on, some it does not work as well. Rated Singulair for Asthma Report . This drug really helped me with the control of asthma and hard breathing. It’s a masterpiece med. Moreover, it work within five minutes and I’m used to take it two hours before going to the gym which really makes it highly effective. Singulair (montelukast) is a leukotriene modifier. Singulair is approved for: 1. Long-term treatment of asthma for people ages 12 months and older. Prevention of exercise-induced asthma for people ages 6 years and older. Treatment of seasonal hay fever (allergic rhinitis) for people ages 2 years and older.
how long for singulair to work – ShonCase’s blog
time: 26.05.2012 AUTHOR: cefitwka how long for singulair to work Oh, and my magnesium levels are still low, and he wasn’t too happy about that either, so I’m still having to take more magnesium. Gracious, how is the question when. How Long Will It Take For Singulair To Start Working/making… Looking for singulair without prescription? No problem! BUY SINGULAIR ONLINE – CLICK HERE! time: 8.02.2012 author: newsnupthai how soon does singulair work How long does it take to work – Singulair How Quickly Does Singulair Work | eHow.com How Does Singulair Work? | eHow.com My doctor says Singulair takes 2-3…
How long before the full effects of singulair take effect …
Doctors give trusted answers on uses, effects, side-effects, and cautions: Dr. Law-Yone on how long before the full effects of singulair take effect: If you are asking how long the medication lasts, the half-life is 72 hours. If you are asking about the overall treatment of depression, it can last a lifetime. Remember to take montelukast regularly every day, even if your asthma is well controlled. Try not to miss any of your doses but if you do forget, just take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
Singulair: How it works, uses, and side effects
Singulair is a medication that people commonly use to prevent asthma attacks and allergy symptoms. It works by blocking the molecules that trigger inflammation throughout the body. However, the FDA has received complaints that Singulair causes harmful, psychological side effects. Read on to learn more. How long does Singulair take to start working? Every day at MyAsthmaCentral.com we get lots of asthma related questions. … My Humble Answer: Asthma does not cause weight gain. However, systemic corticosteroids used to treat asthma (or other ailments) can cause weight gain. How long does it take for singulair to clear out of your system completely . Topic: Singulair … How long does it take before singulair is out of the body? … it take singulair to leave the body? – Singulair how long does it last. How long does singulair stay in your body? – Singulair how long does it take to work.
Should You Use Singulair for Allergies?
Learn how Singulair, a common asthma medication, works and is sometimes used to treat allergy symptoms. Learn how Singulair, … Let’s take a closer look at Singulair, including its indications and side effects, and how its mechanism of action is unique to traditional medications for allergic rhinitis. How long till Singulair starts working? – posted in Miscellaneous: I could probably have put this elsewhere but I’m after a high traffic area and hopefully a quick response.My DS has been started on Singulair today.How long does it take before if begins to work? I’ve had shocking sleep with second hourly waking the last three nights and was … Singular is commonly prescribed to treat asthma (including exercise-induced asthma) and an itchy, stuffy, runny nose that is the result of allergies. It works by blocking leukotriene receptors, which helps minimize or prevent symptoms. Singulair is available in various forms, including tablets, granules, and chewable tablets.
Singulair Uses, Dosage & Side Effects – Drugs.com
Singulair is usually taken once daily in the evening for prevention of asthma or allergy symptoms. For exercise-induced bronchoconstriction, take a single dose at least 2 hours before you exercise, and do not take another dose for at least 24 hours. Follow your doctor’s instructions. Singulair is not a rescue medicine. It will not work fast … Looking for singulair without prescription? No problem! BUY SINGULAIR ONLINE – CLICK HERE! TIME: 14.06.2012 author: remprecam how long singulair to take effect How long does Singulair take to go into effect? How Quickly Does Singulair Work | eHow.com Best Answer: I am currently on Singulair. It will take several…
How Long Does Singulair Take To Work more
How Quickly Does Singulair Work. Function of Singulair ; Singulair Forms and Uses ; . In order for the drug to work properly, doctors advise you to take Singulair at the same time every day 1 2. . Singulair works in the long term, helping your body breathe easier, and is not an instantaneous remedy for an asthma attack 1 2. Singulair how long does it take to work. Common Questions and Answers about Singulair how long does it take to work. singulair. It affects a different part of the immune system than the typical antihistamines so some people it works better on, some it does not work as well. Learn how Singulair, a common asthma medication, works and is sometimes used to treat allergy symptoms. Learn how Singulair, . Let’s take a closer look at Singulair, including its indications and side effects, and how its mechanism of action is unique to traditional medications for allergic rhinitis. Does Singulair take time to work? (I have Albuterol) Anyway, it’s been almost a week and I don’t feel any better and my inhaler still only works for a 1/2 hour to an hour. So I was wondering if Singulair is one of those drugs that takes a week or two to build up and start working, or if it should have started working immediately. How long does it take for Singulair to work? Answer. Wiki User June 20, 2009 7:41PM. My doctor says Singulair takes 2-3 days to work. Related Questions . Asked in Claritin (Loratadine) Can you take singulair and Claritin together? can i take singulair and claretin togther In clinical trials, the effects of Singulair (montelukast) were noticed after the first dose, however, the medication can take about three to seven days to start working. Even if you experience a big reduction in your asthma attacks and symptoms or allergy symptoms, do not stop taking Singulair. Nvidia geforce experience disappeared. In clinical trials, the effects of Singulair (montelukast) were noticed after the first dose, however, the medication can take about three to seven days to start working. Even if you experience a big reduction in your asthma attacks and symptoms or allergy symptoms, do not stop taking Singulair. Hearthstone fidget spinner. Find patient medical information for Singulair Oral on WebMD including its uses, side effects and safety, interactions, . This medication does not work right away and should not be used to treat sudden asthma attacks or other breathing problems. . Take this medication by mouth with or without food as directed by your doctor. Does the state of california pay for fmla. Singulair is a medication that people commonly use to prevent asthma attacks and allergy symptoms. It works by blocking the molecules that trigger inflammation throughout the body. However, the FDA has received complaints that Singulair causes harmful, psychological side effects. Read on to learn more. Singulair is usually taken once daily in the evening for prevention of asthma or allergy symptoms. For exercise-induced bronchoconstriction, take a single dose at least 2 hours before you exercise, and do not take another dose for at least 24 hours. Follow your doctor’s instructions. Singulair is not a rescue medicine. It will not work fast . Star wars characters stormtroopers. Your doctor may recommend that you take Singulair in the evening, but it can be taken during the daytime, as long as you take it around the same time each day. Singulair does not work immediately and should not be used to treat sudden asthma attacks or other breathing problems. Singulair Overdose American football equipment manufacturers.
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What is Singulair and what is it used for?
Share on PinterestCommon side effects of taking Singulair include developing a cough or sore throat.
The most common side effects include:
- a cough
- ear infection
- sinus infection
- sore throat
- stomach pain
- upper respiratory infection
Report the following adverse effects to a doctor:
- a skin rash or hives
- pain or muscle weakness
- red or pinpoint spots under the skin
Singulair has been linked to behavior and mood changes, including:
- vivid and unpleasant dreams
- suicidal thoughts
Children and younger people using the medication are particularly at risk of these side effects.
The United States Food and Drug Administration (FDA) has received a number of complaints about the extreme emotional side effects of Singulair.
The administration noted in 2015 that they issued an early warning to manufacturers of the drug in 2008 and investigations were underway into the complaints.
The FDA cautions people not to stop taking Singulair without first discussing this with their healthcare provider.
The Therapeutic Goods Administration in Australia reported 58 cases of neuropsychiatric adverse events between 2000 and 2013.
The FDA is still gathering information about these effects, but the number of possible reactions is very small compared with the number of daily doses worldwide. It is not yet possible to establish a definite cause and effect.
However, the FDA labels now carry a warning related to these mood changes. Parents should watch for changes in behavior.
Less common side effects include a possible increase in certain white blood cells and a risk of inflamed blood vessels throughout the body.
This can lead to numbness and tingling, flu-like symptoms, a rash, and inflamed sinuses.
Report any worsening asthma symptoms to a doctor. If Singulair triggers an allergic reaction, seek immediate medical assistance.
The chewable tablets contain a component of aspartame called phenylalanine. Some people are allergic to this substance and should not use Singulair.
Singulair, or montelukast, is a drug that gradually reduces the risk of asthma flare-ups by blocking the action of leukotrienes. These are fatty signaling molecules, which the body uses during inflammation and allergic reactions.
It is available as chewable tablets, granules, and regular tablets, depending on the age of the person with inflammation or asthma.
However, the FDA warns that Singulair can lead to severe side effects, including difficulties with psychological health, especially in young people.
Can I take Singulair while using other medications?
Singulair is safe to take with most medications.
Discuss all medications you are taking with your doctor and pharmacist to ensure that Singulair is safe to take with your medications.
Dena Westphalen, PharmD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Singulair: 6 things you should know
- May be administered with or without food. Available as tablets, chewable tablets, and oral granules. The granules can be administered directly into the mouth or dissolved in a teaspoonful of breast milk or formula, or soft food such as applesauce, carrots, rice or ice cream. Once the packet is opened, the contents should be taken within 15 minutes. Discard any unused portion.
- Take once daily in the evening when used as a preventative treatment for asthma. Take Singulair daily as prescribed, even if you have no symptoms of asthma. Do not increase or decrease the dose of Singulair without your doctor’s permission and continue to take all other asthma medications as prescribed.
- Take at least two hours prior to exercise when given to prevent against exercise-induced bronchoconstriction.
- When given for allergic rhinitis, only a single dose should be taken daily but it may be dosed morning or evening depending on patient preference.
- Take exactly as prescribed when given for asthma, even if you are asymptomatic. Continue taking as prescribed even during an acute asthma attack.
- You should talk with your doctor beforehand about what to do if you have an acute asthma attack. This should include taking your short-acting bronchodilator medicine (commonly albuterol) as prescribed. Singulair is not for use during an acute attack. Talk to your doctor if you regularly need to take more of your acute asthma treatment.
- Notify your doctor if you experience any neuropsychiatric effects (such as aggression, anxiety, depression, tics, thoughts of suicide, or hallucinations) while taking Singulair. Also, tell your doctor if you develop any symptoms of an allergic reaction including a rash or breathing problems; or side effects such as an abnormal heartbeat, unusual bruising, yellowing of the skin or eye, trouble sleeping or a tingling or twitching in your fingers and toes.
- Avoid driving or operating machinery if Singulair makes you drowsy or dizzy.
- If you know you are sensitive to aspirin or other NSAIDs, continue to avoid these while taking Singulair.
- Phenylketonurics note: The 4mg and 5mg chewable tablets contain phenylalanine.
Update: Singulair And That Black Box Warning
Montelukast (Singulair)was approved by the FDA in 1998, 1 although I wasn’t prescribed it until March of 2008. At the time my doctor said it was overhyped, although he agreed to let me try it. That spring was the first time in my life I made it through pollen season without feeling miserable due to sniffles, sneezes, and wheezes.
Little did I know at the time, in September of 2008 the Associated Press reported on a 15-year-old high school football player who started taking Singulair in 2007 due to an allergy to ragweed. Within weeks his parents noted he was feeling agitated and having trouble sleeping, and 17 days after starting the medicine he committed suicide. Singulair was blamed, and the case was reported to the FDA. 2
FDA investigates Singulair and suicides
In March of 2008, the FDA announced it was performing a review of the links between Singulair and psychological events (mood and behavioral changes). Shortly thereafter there were similar reports. 1
Prior to this time, the FDA only investigated psychiatric drugs for potential suicide risks. However, these reports opened the doors for them investigating other drugs that have the potential for crossing the blood brain barrier and having an effect on the mind, and this included asthma medicines. 2
During its first ten years on the market, Singulair became the best selling drug for Merck. In 2007 alone, sales were $3.4 billion. Merck reported that none of the 11,000 participants involved in initial studies of Singulair reported psychological events.
However, just to be on the safe side, and before any further studies were conducted, the FDA issued warnings on the products so that the public — asthmatics, parents, and doctors alike — were well aware of these reports. 3-4
In September 2008, the FDA released a report of its own study of the “well-being” of 536 people taking Singulair. Of them, there were no reports of “psychiatric problems, depressive episodes, or suicide.” In fact, the study actually showed an improvement in well-being among asthmatics taking Singulair, compared to asthmatics who were not. Later, the FDA confirmed Merck’s claim that, of 40 studies of over 11,000 people taking Singulair, there were no reports of suicides. 2, 5
Despite this report, the black box warning remained, mainly because the claims could not be disproved beyond a reasonable doubt. The warning has been changed quite a few times over the past decade, and currently reads.
“SINGULAIR may cause serious side effects. Behavior and mood-related changes. Tell your healthcare provider right away if you or your child have any of these symptoms while taking SINGULAIR: agitation including aggressive behavior or hostility, attention problems, bad or vivid dreams, depression, disorientation (confusion), feeling anxious, hallucinations (seeing or hearing things that are not really there, irritability, memory problems, restlessness, sleepwalking, suicidal thoughts and actions, including suicide), tremor, trouble sleeping, uncontrolled muscle movements.”
Concerns about Singulair black box warning begin to mount
This was thought to be good in that it would make the public aware of the reports, and hopefully inspire patient-physician or parent-physician discussions. However, most doctors ignored the warnings — including my own doctor at that time, and continued prescribing the medicine anyway, usually without issuing any warnings. The main reason was because they had already prescribed the medicine to so many asthmatics with good results.4
Another concern among the medical community about the warnings was that they might scare some asthmatics (or their parents), thereby preventing some asthmatics from taking a medicine that might otherwise help them obtain improved allergy and asthma control.2
This is actually the reason I decided to write this update. My 14-year-old daughter, like me, has asthma and severe allergies. Now that my allergic asthma is relatively controlled thanks to both Advair and Singulair, I thought Singulair would help her control her allergies. So I discussed the idea of having my daughter’s pediatrician prescribe it for her. My wife was concerned due to the warnings.
My wife, my daughter, and I have had some nice discussions about Singulair. So far my daughter is managing without it. Still, there are mornings where she’s sniffling and sneezing quite a bit, so there’s a part of me that wonders if Singulair would be good for her, perhaps even improve her well-being. Perhaps she will have to end up making the decision on her own someday.
Links to psychiatric events renewed
The issue of Singulair and Psychiatric events was brought up again on September 23, 2014, at a Pediatric Advisory Committee. Addressing the concerns of a parent who addressed the committee, the members reviewed the current data and determined that, despite the previously mentioned studies, there were many reports of patients or parents reporting psychiatric events, such as the ones mentioned in the black box warning listed above. While most psychiatric events reported were “not serious,” all were reversed after cessation of the product. 1, 7
To address these concerns, the members of the committee discussed the need to communicate with physicians to raise awareness of possible psychiatric side effects, to discuss possible side effects with patients/parents, to monitor patients for signs of psychiatric events, and to discontinue the medicine if any signs of psychiatric events are observed. 1, 7
What can we conclude here?
Singulair is the most commonly prescribed leukotriene antagonist, so it’s often the one mentioned in reports of adverse side effects and involved in studies. However, to be on the safe side, the same warnings on Singulair products have also been added to other leukotriene antagonist products, including zileuton Zyflo, and zafirlukast (Accolate).
It’s also advised that if someone experiences psychiatric events while taking one antileukine antagonist, that all leukotriene antagonists be avoided. Another recommendation by the committed was further studies on this issue. However, because current labeling is quite clear, and because this is a known issue, the FDA did not agree that further changes to information to physicians nor studies were warranted at this time. 7
So, that’s where we stand today. Thoughts?
2. Case summary
A 22 years old male patient (body weight 64 kg) was suffering from allergic rhinitis and was prescribed 10 mg oral montelukast daily after food. He was symptomatically improved by the drug and continued taking it prophylactically. After 1.5 months of therapy, he experienced gradually increased abdominal fat deposition and recorded an unusual weight gain by 7 kg. At the end of 2 months, he presented in the emergency with acute abdominal pain and vomiting. The pain was gradual in onset, dull and steady, located around the epigastrium and periumbilical region, radiating toward back and associated with abdominal distension.
Physical examination revealed a generalized distressed state with a pulse rate of 96/minute and blood pressure 112/72 mm of Hg. His body weight was 73 kg. There was no evidence of jaundice or erythematous skin nodules. Abdominal examination revealed presence of striae. Abdomen was severely tender with muscle guarding. Bowel sounds were diminished. Relevant blood and other investigations done at that time are enumerated in Table 1.
Investigation results during the acute illness and recovery.
|Blood investigation reports|
|Serial nos.||Parameters detected||Detected values during acute illness||Detected values during recovery|
|1||Hemoglobin||12.8 g/dL||12.7 g/dL|
|2||Total WBC count||17800/μL||11900/μL|
|3||ESR||40 mm after 1st hour||26 mm after 1st hour|
|4||Fasting blood glucose||166 mg/dL||135 mg/dL|
|5||2 h postprandial blood glucose||211 mg/dL||152 mg/dL|
|6||Serum urea||13.9 mg/dL|
|7||Serum creatinine||0.7 ng/mL|
|8||Serum sodium||138 meq/L|
|9||Serum potassium||4.3 meq/L|
|10||Serum calcium||7.8 mg/dL||8.9 mg/dL|
|11||Serum amylase||311 U/L||81 U/L|
|12||Serum lipase||163 U/L||38 U/L|
|13||Serum lactate dehydrogenase||177 U/L|
|14||Serum lipid profile||Total cholesterol||264.9 mg/dL||183.6 mg/dL|
|LDL cholesterol||108.2 mg/dL||88.2 mg/dL|
|HDL cholesterol||44.6 mg/dL||43.4 mg/dL|
|VLDL cholesterol||112.1 mg/dL||52.0 mg/dL|
|Triglyceride||560.5 mg/dL||260.0 mg/dL|
|15||Liver function tests||Total bilirubin||0.7 mg/dL|
|Direct bilirubin||0.3 mg/dL|
|Indirect bilirubin||0.4 mg/dL|
|Serum glutamic oxaloacetic transaminase (SGOT)||64 U/L|
|Serum glutamic pyruvic transaminase (SGPT)||53 U/L|
|Alkaline phosphatase||136 IU/L|
|Other investigation reports|
|Serial nos.||Investigations||Findings during acute illness||Findings during recovery|
|1||12 lead electrocardiography||Non-specific ST changes|
|2||Straight skiagram (X-ray) of abdomen in erect posture||Presence of some air in the duodenal C-loop|
|3||Ultrasonography (USG) of whole abdomen||Edematous pancreas, with increased volume and heterogenous echo texture, presence of pancreatic head enlargement and edema along the body of pancreas. There was some peripancreatic free fluid collection. No evidence of gall bladder pathology was found||Slight edematous pancreas with heterogenous echogenicity and no peripancreatic fluid collection|
|4||Upper GI endoscopy||Within normal limits|
|5||Computed tomography (CT scan) of abdomen||Diffuse enlargement of pancreas with heterogenous enhancements and irregular margins with intraperitoneal free fluid collection, suggestive of acute pancreatitis. No evidence of pancreatic pseudocyst or abscess||Slight enlargement of pancreas with regular borders and mild edema. No intraperitoneal free fluid collection|
These clinical features coupled with blood and other investigations highly suggested it to be diagnosed as a case of severe acute pancreatitis (by Ranson’s criteria3) associated with hypercholesterolemia and severe hypertriglyceridemia.
It appears from the blood investigation reports, abdominal ultrasonography findings and computed tomography report that the patient had an acute pancreatitis, associated with hypercholesterolemia and severe hypertriglyceridemia. The ECG findings showed some non-specific ST changes which might be due to associated hypocalcemia.
The patient was never on oral montelukast therapy earlier. Before initiation of this drug, he was otherwise normal, except for symptoms of allergic rhinitis. He was non-alcoholic and dietary habit was regular and normal. He maintained a sedentary life style with moderate physical activities.
Factitious pancreatitis was ruled out. There were no evidences of any other intra-abdominal pathology like biliary tract disease, peritonitis, peptic ulcer perforation, intestinal obstruction or appendicitis. Ultrasonography of abdomen finding did not show any evidence of gallstones. There was no history of any abdominal trauma, head injury, any surgery or any operative procedure like Endoscopic Retrograde Cholangiopancreatography (ERCP).
There was no history of any concomitant medications. 3 months back, he took oral ranitidine 300 mg daily for 2 weeks for symptoms of gastritis, after which he was not on any other medications before initiating montelukast.
The patient was also not having any infections like coxsackievirus, cytomegalovirus, Epstein-Barr virus, Human Immunodeficiency Virus (HIV), echovirus or other parasites. Also there were no evidences of parotitis, sialadenitis or eating disorders. He was not an immune compromised or a transplant recipient, where cytomegalovirus induced pancreatitis is common. So, all these virological infections could be ruled out.
There was no history of hereditary pancreatitis or obesity in the family. The patient was did not have any co-morbidities like cystic fibrosis, any vasculitis, connective tissue disorders, any autoimmune disorders like Sjogren’s syndrome or hematologic disorders like thrombotic thrombocytopenic purpura (TTP). There were no evidences of carcinoma pancreas, periampullary diverticulum, pancreas division, metabolic acidosis, diabetes mellitus or renal failure.
The patient was admitted and montelukast was withdrawn immediately upon suspicion and the patient was treated conservatively with intravenous fluids, analgesics and no oral alimentations. Amoxicillin and metronidazole were used as prophylactic antibiotics. The patient’s condition started improving from the next 7 days. Pain abdomen and vomiting were relieved considerably and gradually oral feeding was commenced on the 11th day post admission. Biochemical tests and other investigations were done routinely during follow up. Clinical symptoms improved totally within 14 days and the patient was then discharged. Relevant investigation reports done during discharge are shown in Table 1.
De-challenge revealed that hypercholesterolemia, hypertriglyceridemia and acute pancreatitis was montelukast induced and no other immunological processes were possibly involved in the process. No specific immunological tests were done.
After the next 1 month the patient recorded his body weight as 66 kg. The symptoms of allergic rhinitis however returned again after 3 weeks of cessation of montelukast, for which he was started treatment with 5 mg oral levocetirizine daily with well response. Obviously, no re challenge with oral montelukast was done.
Your allergy meds could be making you fat
Allergy season is upon us, and the record pollen levels we’re experiencing this year may have you heading to the allergy relief aisle at your local drugstore. But what you take to alleviate your symptoms could have unpleasant side effects on your waistline. Researchers have suggested that allergies and weight gain go hand in hand, and that could have to do with the drugs you take or more subtle underlying problems.
In August 2010, researchers from Yale University published a study in the journal Obesity finding that people who took antihistamines regularly were heavier than people who didn’t take them at all. The study’s authors used data from the Centers for Disease Control and Prevention’s (CDC’s) National Health and Nutrition Examination Survey 2005–2006 to compare the body weight of 867 adults and their prescription antihistamine use. The two drugs most common in the study were cetirizine, now sold over-the-counter as Zyrtec, and fexofenadine, also now sold over-the-counter as Allegra, and the effect was more pronounced in men.
The researchers warned that this was an observational study, and couldn’t demonstrate whether antihistamines actually caused the weight gain or if obesity predisposes people to allergies.
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The latter was suggested in a separate study, published in 2009 in the Journal of Clinical Allergy and Immunology. Using data from the same CDC survey, researchers found that obese children were more likely to suffer from allergies, specifically food allergies, than normal-weight children. “It wasn’t clear to us if that really meant that the obesity was the cause of that allergic propensity or not,” says Cynthia Visness, PhD, the study’s lead author and a research scientist at Rho Inc., the research firm that conducted the study.
Story: Allergies make you miserable — and unattractive, too
Inflammation may play role
There isn’t much literature available on the link between obesity and allergies, so possible explanations for the associations seen in these two studies are simply theories at this point, Visness says. In her study, she suggested that inflammation could play a role. Fat cells release cytokines, chemicals that promote inflammation, and an allergic reaction triggers inflammation as well. So people with high levels of inflammation in their bodies are likely to suffer from both conditions.
Another theory suggested in the Yale study was that histamine, which is the neurotransmitter that overreacts when you come into contact with an allergen, has a secondary role in regulating your appetite. Animal studies have shown that dosing mice with histamine reduces their food intake, while dosing them with antihistamines increases their appetites. Therefore, it stands to reason, the authors noted, that if you take a lot of antihistamines, that might cause you to eat more. (Some older antihistamines are even used as appetite stimulants in young children.)
Then there are even more basic explanations. “Some older medications are so sedating that they cause you to be a couch potato,” says Jackie Eghrari-Sabet, MD, a fellow of the American College of Allergy, Asthma and Immunology and an allergist with a private practice in Gaithersburg, MD. Drugs that make you that tired are more than likely to interfere with your getting regular exercise. Secondly, she says, antihistamines can dry you out and make you thirsty. “In some people, the signal for thirst can be confused with the signal for hunger,” she adds, making you more likely to eat when you really should be reaching for a glass of water.
Don’t let allergies ruin your summer beach body
- Opt for newer antihistamines. “In the old days, there were sedating antihistamines that some would claim would make you hungry,” adds Dr. Eghrari-Sabet. Those antihistamines, most common in older over-the-counter medicines like Benadryl and Chlor-Trimeton, are being replaced by newer drugs like Zyrtec, Allegra, and Claritin. Though Zyrtec and Allergra were the most common drugs in the Yale study linking antihistamine use to weight gain, Dr. Eghrari-Sabet says that increased appetite is not a common side effect she’s seen in her patients.
However, Zyrtec may make you more tired than the others. It’s considered a minimally sedating antihistamine, unlike Allegra and Claritin, which are non-sedating. So if you want a medication that won’t make you prone to skipping workouts, choose one of the non-sedating medications.
Story: Your allergies really are getting worse, new study shows
- Get diagnosed. If over-the-counter medications are making you hungry, tired, or just generally miserable, see an allergist. Knowing what you’re allergic to makes it easy to find prescription medications without all the side effects, says Dr. Eghrari-Sabet. And, she adds, “the most important thing an allergist has access to is an allergy shot. Allergy shots don’t have side effects like antihistamines do.”
- Grab the water. Make sure you keep yourself well hydrated whenever you’re taking allergy medications, to prevent your mind from confusing thirst with hunger. Add fruit, cucumbers, or herbs to your water to make it a more interesting drink.
- Fight allergies with food. If you do find that allergies or allergy medications are causing you to overeat, try to indulge in healthy food. In fact, there are a number of healthy foods that provide allergy relief and fight back hunger pangs at the same time. For ideas, see Soothe Spring Allergies: 10 Food and Herb Fixes for Allergy Relief.