Montelukast: Mechanism-Dosage forms-Indication-Dosage Guideline-Disease Profile
Montelukast: Mechanism-Dosage forms-Indication-Dosage Guideline-Disease Profile covers how the drug works, its clinical indications, available dosage forms, and standard treatment guidelines. Find detailed insights into leukotriene receptor blocking and its impact on respiratory conditions. Get practical knowledge about Montelukast dosing across different age groups and conditions.
The article outlines therapeutic uses including asthma, allergic rhinitis, and exercise-induced bronchospasm. Learn when and how to use Montelukast safely and effectively with updated clinical guidance.
Table of contents: Montelukast: Mechanism-Dosage forms-Indication-Dosage Guideline-Disease Profile
Montelukast: Mechanism-Dosage forms-Indication-Dosage Guideline-Disease Profile
Montelukast is a popular medication that helps control asthma and various
types of allergies. It works mainly by blocking leukotriene receptors, which
reduces inflammation in the airways.
The dosage of Montelukast is determined based on the patient’s age and
symptoms. Different doses are prescribed for children and adults.
Montelukast Mechanism of action | Montelukast mode of action
Mode of action in short: Montelukast is a Leukotriene receptor
antagonist. It blocks the Leukotriene receptor and gives relief from the
symptoms of Asthma & Allergic Rhinitis.
Step-by-Step Explanation: How Montelukast Works
Step 1: Allergens Enter the Body
- Substances like dust, pollen, smoke, or other allergy triggers enter your body. The immune system sees them as harmful.
Step 2: Activation of Mast Cells & Eosinophils
- These are immune cells. When triggered, they release chemicals to "fight" the allergen — but this overreaction causes symptoms.
Step 3: Arachidonic Acid Metabolism Starts
- This is a chemical process in the body where arachidonic acid is converted into inflammatory substances.
Step 4: Cysteinyl Leukotrienes (LTC₄, LTD₄, LTE₄) are Released
- These are powerful inflammatory chemicals. They play a major role in causing asthma and allergy symptoms.
Step 5: Leukotrienes Bind to CysLT₁ Receptors
- These receptors act like “locks,” and the leukotrienes are the “keys.”
When they bind:
- Airways tighten (Bronchoconstriction)
- More mucus is produced (Mucus Secretion)
- Fluid leaks out causing swelling (Plasma Exudation)
Step 6: Montelukast Blocks These Receptors
- Montelukast blocks the CysLT₁ receptors, so the leukotrienes cannot bind.
This means:
- Airways stay open
- Mucus is reduced
- Swelling is controlled
Step 7: Relief from Asthma & Allergic Rhinitis
- As the inflammation, mucus, and airway tightening reduce, the patient feels relief from asthma and allergy symptoms.
In Summary: Montelukast is a Leukotriene Receptor Blocker.
It prevents leukotrienes from causing:
- Wheezing
- Shortness of breath
- Runny nose
- Cough
- Chest tightness
Various dosage forms and strengths of Montelukast
| Tablet | 10 mg |
| Chewable Tablet | 4 mg |
| Chewable Tablet | 5 mg |
| OFT | 4 mg |
| OFT | 5 mg |
OFT = Oroflash Tablet
Major Indication
- Asthma
- Allergic Rhinitis Exercise induced asthma.
Indication & Dosage Guideline
| Indication | Patient Category | Recommended dose |
|---|---|---|
| Asthma & Allergic Rhinitis | Adults & Adolescents (15 Yrs & older) | Montelukast 10 mg tablet once daily |
| Asthma & Allergic Rhinitis | Pediatric Patients 6 to 15 years | Montelukast 5 mg Chewable tablet/OFT once daily |
| Asthma & Allergic Rhinitis | Pediatric Patients 6 Month to 6 years | Montelukast 4 mg Chewable tablet/OFT once daily |
| Exercise-induced Bronchoconstriction | Adults & Adolescents (15 Yrs & older) | Montelukast 10 mg tablet once daily |
| Exercise-induced Bronchoconstriction | Pediatric Patients 6 to 15 years | Montelukast 5 mg Chewable tablet/OFT once daily |
Disease Profile
Asthma: Asthma is a condition in which our airways become narrow and
swell and produce extra mucus. This can make breathing difficult and trigger
coughing, wheezing and shortness of breath.
Exercise-induced asthma: Exercised-induced asthma is a narrowing of
the airways in the lungs triggered by strenuous exercise. It causes
shortness of breath, wheezing, coughing and other symptoms during or after
exercise. which may be worse when the air is cold and dry.
Occupational asthma: Occupational asthma is caused by breathing in
chemical fumes, gases, dust or other substances on the job.
Allergy-induced asthma: It is triggered by airborne substances, such
as pollen, mold spores, cockroach waste or particles of skin and dried
saliva shed by pets (pet dander).
Allergic Rhinitis: Allergic rhinitis is a type of inflammation in the
nose which occurs when the immune system overreacts to allergens in the air.
Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and
watery eyes, and swelling around the eyes.
Seasonal Allergic Rhinitis (SAR): Seasonal allergic rhinitis occurs
in particular during pollen seasons. It does not usually develop until after
6 years of age.
Perennial Allergic Rhinitis (PAR): Perennial allergic rhinitis occurs
throughout the year. This type of allergic rhinitis is commonly seen in
younger children.
Specialization
- GP
- Chest
- ENT
- Medicine
Monas by ACME (Generic: Montelukast)
What caution should one take who takes Monas and does regular
exercise?
- Take Monas at least 2 hours before exercise. In addition, always have your rescue inhaler medicine with you for asthma attacks.
What are the most common side effects of Monas?
- Fever, headache, sore throat, cough, stomach pain, diarrhea, earache or ear infection, flu, runny nose, sinus infection etc.
I have frequent acute asthma attacks, is Monas the perfect option for
me?
- Monas is not for the treatment of acute asthma attacks. One should have appropriate short-acting inhaled B-agonist medication available to treat asthma exacerbations. Patients who have exacerbations of asthma after exercise should be instructed to have available for rescue a short-acting inhaled B-agonist. Daily administration of Montelukast for the chronic treatment of asthma has not been established to prevent acute episodes of EIB.
What is the US-FDA DMF number of Montelukast used in Monas?
- 24445
What is the flavor of Monas 4 & 5 Chewable Tablet and Monas 4 &
5 OFT?
- Cherry flavor and Banana flavor.
Can Monas be given with bronchodilator, cough syrup or inhaler?
- Montelukast can be prescribed with bronchodilator, cough syrup or inhaler as there is no significant drug interaction.
What is the highest safe dose of Montelukast? (This message is only
to highlight safety profile, not to prescribe)
- In chronic asthma, 200 mg/day for 22 weeks. 900 mg/day for one week.
FAQ
1. What are Leukotrienes?
Leukotrienes are inflammatory mediators produced in leukocytes by the
oxidation of arachidonic acid (AA).
2. What are Cysteinyl leukotrienes?
LTC4, LTD4, LTE4 and LTF4 are often called cysteinyl leukotrienes due to the
presence of the amino acid cysteine in their structure.
3. What is the Role of cysteinyl leukotrienes?
Cysteinyl leukotriene receptors CYSLTRı and CYSLTR2 are present on mast
cells, eosinophil, and endothelial cells. They mediate inflammation, they
induce asthma and other inflammatory disorders, thereby reducing the airflow
to the alveoli.
4. How cysteinyl leukotrienes influence Asthma and Allergic rhinitis?
Cysteinyl leukotrienes bind with CysLT1 receptors and initiate the
pathophysiology of Asthma and Allergic rhinitis. In Asthma,
leukotriene-mediated effects include airway edema, smooth muscle contraction
and altered cellular activity associated with the inflammatory process. In
Allergic rhinitis, CysLTs are released from the nasal mucosa after allergen
exposure and are associated with symptoms of allergic rhinitis.
5. What should I do if I miss a regular dose?
If you or your child misses a dose of Montelukast, just take the next dose
at your regular time. Do not take 2 doses at the same time to balance the
missed dose.
6. Is Montelukast safe in pregnancy & lactation?
Pregnancy Category B. Studies in rats have shown that montelukast is
excreted in milk. It is not known if montelukast is excreted in human milk.
Because many drugs are excreted in human milk, caution should be exercised
when Montelukast is given to a nursing mother.
7. How do I adjust the dose in case of hepatic and renal
insufficiency?
No dosage adjustment is required in patients with hepatic and renal
insufficiency.
Conclusion
Montelukast: Mechanism-Dosage forms-Indication-Dosage Guideline-Disease Profile offers essential information for understanding its therapeutic role. Its correct use supports better outcomes in asthma and allergy management. Knowing the right dosage form and indication helps prevent misuse and side effects. Healthcare professionals rely on standard guidelines for Montelukast administration. This profile helps reinforce safe and evidence-based use in relevant disease conditions.
Sarwar Hossain Himel
I am Sarwar Hossain Himel — a sports-loving person. Education: I have obtained a BBA and MBA degree in Accounting. Profession: Currently, I am working as a Medical Promotion Officer (MPO). In addition, I have over 5 years of experience in teaching. Freelance Work: I work as a Google Blogger and Article Writer in freelancing. Passion: I love doing web design and digital marketing. Especially, web design is one of my passions.