singulair
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $3.35 | $100.41 (0%) | 🛒 Add to cart |
| 60 | $2.51 | $200.81 $150.61 (25%) | 🛒 Add to cart |
| 90 | $2.23 | $301.22 $200.81 (33%) | 🛒 Add to cart |
| 120 | $2.10 | $401.63 $252.02 (37%) | 🛒 Add to cart |
| 180 | $1.96 | $602.44 $352.43 (42%) | 🛒 Add to cart |
| 270 | $1.87
Best per pill | $903.66 $504.04 (44%) | 🛒 Add to cart |
| Product dosage: 4mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.41 | $42.17 (0%) | 🛒 Add to cart |
| 60 | $1.15 | $84.34 $69.28 (18%) | 🛒 Add to cart |
| 90 | $1.08 | $126.51 $97.39 (23%) | 🛒 Add to cart |
| 120 | $1.05 | $168.68 $125.51 (26%) | 🛒 Add to cart |
| 180 | $1.00 | $253.02 $180.73 (29%) | 🛒 Add to cart |
| 270 | $0.98 | $379.54 $264.07 (30%) | 🛒 Add to cart |
| 360 | $0.97
Best per pill | $506.05 $347.41 (31%) | 🛒 Add to cart |
| Product dosage: 5mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $2.38 | $71.29 (0%) | 🛒 Add to cart |
| 60 | $1.89 | $142.58 $113.46 (20%) | 🛒 Add to cart |
| 90 | $1.74 | $213.87 $156.63 (27%) | 🛒 Add to cart |
| 120 | $1.66 | $285.15 $198.80 (30%) | 🛒 Add to cart |
| 180 | $1.58 | $427.73 $284.15 (34%) | 🛒 Add to cart |
| 270 | $1.53
Best per pill | $641.60 $412.67 (36%) | 🛒 Add to cart |
Synonyms
| |||
Singulair, known generically as montelukast, is a leukotriene receptor antagonist available as oral tablets, chewables, and granules. It’s a prescription medication, not a dietary supplement or medical device, used primarily for managing asthma and allergic rhinitis by blocking inflammatory pathways. Its role in modern medicine is significant because it offers a non-steroidal option for chronic inflammatory airway diseases, which is crucial for patients who can’t tolerate inhaled corticosteroids or need additional control. Leukotrienes are potent mediators in the inflammatory cascade, and by antagonizing the cysteinyl leukotriene type 1 receptor, Singulair reduces bronchoconstriction, edema, and mucus secretion. This mechanism provides a targeted approach that complements other asthma therapies, and it’s often preferred for its once-daily dosing, which improves adherence. Many patients, especially children and those with exercise-induced symptoms, find it easier to use than inhalers, though it’s not a rescue medication for acute attacks. Over the years, I’ve seen it become a staple in pediatric asthma management due to its safety profile and oral formulation.
Key Components and Bioavailability of Singulair
The active component in Singulair is montelukast sodium, which is formulated to be highly bioavailable. It’s available in several forms: 10 mg film-coated tablets for adults, 4 mg and 5 mg chewable tablets for children, and 4 mg oral granules for younger patients who can’t swallow pills. The bioavailability is approximately 64% for the tablet form when taken orally, and it’s not significantly affected by food, allowing flexible administration. Montelulakst is rapidly absorbed, with peak plasma concentrations reached in 3-4 hours, and it’s extensively metabolized in the liver via cytochrome P450 enzymes, primarily CYP3A4 and CYP2C9. The half-life is around 2.7 to 5.5 hours in adults, supporting once-daily dosing. Unlike some compounds that require enhancers for absorption, montelukast’s structure is optimized for systemic delivery without adjuvants, making it reliable across different age groups. In practice, I’ve noticed that consistency in timing—often recommending evening doses—can help with overnight symptom control, particularly for nocturnal asthma.
Mechanism of Action of Singulair: Scientific Substantiation
Singulair works by selectively inhibiting the cysteinyl leukotriene type 1 (CysLT1) receptor, which is key in the inflammatory response. Leukotrienes, such as LTC4, LTD4, and LTE4, are derived from arachidonic acid through the 5-lipoxygenase pathway and play a major role in bronchoconstriction, increased vascular permeability, and mucus production in asthma and allergies. By blocking CysLT1 receptors in the airway smooth muscle and other tissues, Singulair prevents leukotriene-mediated inflammation, leading to reduced airway hyperresponsiveness and symptom frequency. Studies, including randomized controlled trials, show that this action decreases eosinophil infiltration and cytokine release, which are hallmarks of allergic inflammation. For instance, a 2018 meta-analysis in the Journal of Allergy and Clinical Immunology demonstrated that montelukast significantly improved lung function (FEV1) and reduced exacerbation rates in mild to moderate asthma. It’s not a bronchodilator, so it doesn’t provide immediate relief, but its prophylactic use can lessen the need for rescue inhalers. I often explain to patients that it’s like putting a shield on their airways to prevent triggers from causing inflammation, rather than fighting it after it starts.
Indications for Use: What is Singulair Effective For?
Singulair for Asthma
Singulair is indicated for the prophylaxis and chronic treatment of asthma in adults and children aged 12 months and older. It helps control symptoms, improve lung function, and reduce exacerbations, especially in cases of aspirin-exacerbated respiratory disease (AERD) or exercise-induced bronchoconstriction. Clinical evidence supports its use as add-on therapy when inhaled corticosteroids alone are insufficient.
Singulair for Allergic Rhinitis
For seasonal and perennial allergic rhinitis, Singulair alleviates symptoms like sneezing, nasal congestion, and rhinorrhea. It’s approved for patients as young as 2 years old and can be used alone or with antihistamines. Studies indicate it reduces nasal symptoms scores by up to 40% in allergic individuals, making it a valuable option for those with concurrent asthma and rhinitis.
Singulair for Exercise-Induced Bronchoconstriction
In exercise-induced bronchoconstriction, Singulair taken at least 2 hours before physical activity can prevent airway narrowing. It’s particularly useful for athletes or active individuals, with trials showing a significant reduction in post-exercise FEV1 decline compared to placebo.
Singulair for Other Conditions
Off-label, it’s sometimes used for urticaria or atopic dermatitis, though evidence is weaker. In my experience, it can help in chronic urticaria cases where antihistamines fail, but it’s not a first-line treatment.
Instructions for Use: Dosage and Course of Administration
Dosage varies by age and indication. For asthma and allergic rhinitis in adults and adolescents 15 years and older, the typical dose is 10 mg once daily. Children 6 to 14 years often use 5 mg chewable tablets, and those 2 to 5 years take 4 mg (chewable or granules). For exercise-induced bronchoconstriction, a single dose at least 2 hours before activity is recommended, not to exceed once daily. It’s best taken in the evening for 24-hour coverage, with or without food. Adherence is critical; missing doses can lead to symptom recurrence. Here’s a quick reference table:
| Indication | Age Group | Dosage | Frequency | Timing |
|---|---|---|---|---|
| Asthma | Adults/Adolescents (≥15 years) | 10 mg | Once daily | Evening |
| Asthma | Children (6-14 years) | 5 mg | Once daily | Evening |
| Asthma | Children (2-5 years) | 4 mg | Once daily | Evening |
| Allergic Rhinitis | Adults/Adolescents (≥15 years) | 10 mg | Once daily | Anytime |
| Exercise-Induced | Adults/Children (≥6 years) | 10 mg or age-appropriate | As needed | 2+ hours before activity |
Side effects are generally mild and include headache, abdominal pain, or upper respiratory infection, but serious neuropsychiatric events like agitation or depression have been reported, requiring monitoring.
Contraindications and Drug Interactions of Singulair
Singulair is contraindicated in patients with hypersensitivity to montelukast or any component. Caution is advised in those with phenylketonuria, as chewable tablets contain aspartame. It should not be used for acute asthma attacks. Drug interactions are minimal but notable; montelukast may reduce the efficacy of phenobarbital or rifampin due to enzyme induction, and it can be affected by strong CYP450 inducers or inhibitors. Concomitant use with other leukotriene modifiers is not recommended. In pregnancy, it’s category B—no evidence of risk in humans, but use only if clearly needed. I’ve seen cases where patients on multiple meds had reduced montelukast levels, necessitating dose adjustments. Always review the full medication list to avoid interactions.
Clinical Studies and Evidence Base for Singulair
Numerous studies support Singulair’s efficacy. A landmark trial, the MOCCA study, showed that adding montelukast to inhaled corticosteroids in asthma patients reduced exacerbation rates by 21% compared to placebo. For allergic rhinitis, a 2015 systematic review in Allergy found it significantly improved nasal symptoms and quality of life. In pediatrics, research in the Journal of Pediatrics demonstrated that children aged 2-5 years on montelukast had fewer asthma symptoms and rescue medication use. Long-term data up to 2 years indicate sustained benefits without tolerance development. However, real-world evidence also highlights variability; some patients respond exceptionally well, while others see minimal effect, likely due to genetic factors in leukotriene pathways. This aligns with my practice—I recall a teen, Liam, with severe allergies who improved dramatically on Singulair, while another, Sophia, showed little change, prompting a switch to immunotherapy.
Comparing Singulair with Similar Products and Choosing a Quality Product
Compared to other leukotriene receptor antagonists like zafirlukast, Singulair offers once-daily dosing and a better safety profile, with fewer liver toxicity concerns. Versus inhaled corticosteroids (e.g., fluticasone), it’s less potent for inflammation control but useful for patients averse to inhalers. Antihistamines like loratadine are better for pure allergic rhinitis but don’t address asthma. When choosing, consider patient age, compliance, and comorbidities; generics are bioequivalent and cost-effective. Look for FDA-approved products to ensure quality, as unregulated supplements claiming similar effects lack evidence. In my clinic, I emphasize brand or reputable generic sources to avoid substandard formulations that could compromise efficacy.
Frequently Asked Questions (FAQ) about Singulair
What is the recommended course of Singulair to achieve results?
For chronic conditions like asthma, it’s typically used long-term, with effects seen within 1-2 days for allergic rhinitis and up to a week for asthma; continuous use is necessary for sustained benefit.
Can Singulair be combined with other medications like antihistamines?
Yes, it’s often used with antihistamines or inhaled corticosteroids for synergistic effects, but always under medical supervision to monitor for interactions.
Is Singulair safe for children?
Yes, it’s approved down to 12 months for asthma and 2 years for rhinitis, with a strong safety record, though watch for behavioral changes.
How does Singulair differ from rescue inhalers?
Singulair is for prevention and chronic control, not acute relief; rescue inhalers like albuterol work quickly for sudden symptoms.
Are there any dietary restrictions with Singulair?
No specific restrictions, but taking it consistently with or without food aids absorption.
Conclusion: Validity of Singulair Use in Clinical Practice
Singulair remains a valid, evidence-based option for asthma and allergic rhinitis, offering a non-steroidal alternative with good tolerability. Its risk-benefit profile favors use in appropriate patients, though vigilance for neuropsychiatric side effects is essential. Based on clinical experience and data, it’s a reliable choice for long-term management, particularly in pediatrics and exercise-induced cases.
I remember when we first started using Singulair in our practice years ago—there was skepticism among some colleagues who doubted its efficacy compared to inhaled steroids. We had a team disagreement; Dr. Adams argued it was just a “band-aid,” while I pushed for its role in combo therapy. Over time, we saw mixed results. One patient, Mrs. Gable, a 68-year-old with AERD, had remarkable improvement and could reduce her steroid dose, but another, young Jake, experienced mood swings that we initially missed. It taught us to tailor treatments closely and monitor beyond physical symptoms. Follow-ups with patients like Sarah, now 25, who’s been on it since childhood for asthma, show she’s maintained good control with no major issues, affirming its value in longitudinal care. Testimonials often highlight the ease of use, though some wish for stronger effects—reinforcing that medicine is as much art as science.