Montelukast - reviews about the drug can be easily found on thematic forums and sites dedicated to the problem of bronchial asthma - it is a classic antagonist of leukotriene D4 receptors. The medication is widely used both in basic therapy, and in order to prevent the characteristic attacks of the disease. A balanced composition allows you to use the medicine to treat patients of almost any age category.
Release form
There are a lot of reasons why Montelukast reviews are mostly positive. However, the first thing that catches your eye is, of course, the range of tablets produced under this trade name.
Currently, three technological matrices dominate. We are talking about standard film-coated pills (1 unit contains 10 mg of active substance) and their chewing analogues (4 mg and 5 mg of reagent, respectively). Montelukast sodium acts as the basic basis in both cases, but the composition of auxiliary components varies somewhat - mannitol and aspartame are not present in samples intended for immediate swallowing when consumed.
In the comments, quite often the question arises about fakes, which now and then appear in pharmacy chains. You can protect yourself from counterfeiting if you pay attention to the appearance of the pharmacological product in a timely manner.
So, in particular, a chewable pill with 4 milligrams of the active ingredient has an oval shape and a pink hue (the description corresponds to tablets with a cherry flavor; when using other flavors, differences are acceptable), as well as markings in the form of the number “4” on one side. Analogs in which the main active ingredient is 1 mg more are round and are labeled with a "five". Pills with a shell geometrically resemble a rectangle; they are beige in color and numbered with the number "10".
Pharmacological affiliation
"Montelukast" (reviews describing situations when the reagent provoked complex allergies, are extremely rare) - this is a typical representative of the group of anti-bronchoconstrictor drugs. The algorithm of its action allows us to talk about "close relationship" with intermediates / prostaglandins and thromboxanes.
The main function of the drug is to block cysteinyl leukotriene “sensors” of the respiratory system. It is these receptors that support the high activity of the bronchi during the development of asthma, and they also stimulate the synthesis of secretions, which then accumulate and complicate the work of the mucous membrane.
Regular intake leads to a significant decrease in the severity of symptoms against the background of a general decrease in the number of asthmatic attacks (as many patients note, positive changes are observed already on the first day of therapy).
Metabolic features
Montelukast (pharmaceutical reviews indicate that the real choice of understudies is limited by the manufacturers' pricing policy, that is, individual synonyms, having identical structured molecules of the main component in their composition, are several times more expensive than the described drug), getting into plasma blood, perfectly binds to its proteins. During clinical trials, the result was fixed at the level of 99, 37%. However, its bioavailability is directly dependent on the technological form of release. For example, the ingredients of 5-milligram tablets can be absorbed by 73%, while analogs with a film coating, in which there is 2 times more active substance, are only 64%.
A similar situation with the half-life of the reagent: the components of chewing pills, metabolized, leave the body 2 hours after ingestion, and the constituent elements of conventional tablets after 180-200 minutes. In this case, the plasma clearance varies between 43-45 ml / minute. And, interestingly, only 0.2% of the dose is transported by the urinary tract. The intestines, for comparison, are more than 85%.
From the comments of reputable experts it follows that the pharmacokinetic process proceeds equally smoothly in patients of both sexes, and that some serious adjustments for age and renal pathology are not required when calculating the daily dose of the medication. But malfunctions in the liver, especially when it comes to serious illnesses, deserve increased attention when drawing up a therapeutic schedule.
Indications for appointment
When the use of the Montelukast drug is justified, the reviews (recommended for children in chewing form; film-coated pills should be prescribed exclusively for adults and adolescents) left on the forums, of course, help to understand. However, to be guided only by the opinions of others is a big mistake, because without consulting a doctor, "identifying" the type of asthma, and most importantly, finding out the causes of its occurrence, is almost impossible.
As for the official instructions, there the circle of symptoms, ailments and other conditions is outlined as follows:
- bronchial spasms provoked by excessive physical exertion;
- seasonal / chronic rhinitis of an allergic nature of origin;
- bronchial asthma;
- the need for preventive measures.
Optimal dosage
Montelukast (negative reviews is extremely difficult to find, since the active component has long been successfully used as an integral part of many specialized drugs) is taken orally, once a day, without reference to the “breakfast - lunch - dinner” schedule.
For chewable tablets of 4 mg and 5 mg, the following dosage rules apply:
- children aged 2 to 5 years: 1 unit of the drug (4 mg) per day, at bedtime, until the control of symptoms is achieved, and with a mandatory extension of the course for 2-4 weeks to consolidate the effect;
- patients from 6 to 14 years: a similar regimen, but a one-time rate of 5 mg.
For film-coated pills, the following recommendations are relevant:
- adults and children over 15 years old suffering from asthma or chronic rhinitis: 1 unit (10 mg of substance) / day, in the evening;
- for the prevention of spasms: the same dose in a temporary period of 14-28 days.
Side effect
“Montelukast” instruction (reviews confirm that even with full compliance with the official guidelines, atypical reactions to the presence of ingredients cannot be completely ruled out) it is positioned as a potentially safe medication, but with the proviso that an uncharacteristic “response” from the body in individual cases still possible.
Valid Scenarios:
- Gastrointestinal tract: diarrhea, dry mouth, pain in the abdomen, nausea;
- heart and blood lines: very noticeable increased heart rate;
- skin: rash, urticaria, local hematomas;
- respiratory system: rhinorrhea and severe cough;
- Central nervous system: dizziness, a feeling of fatigue, depression, alternating with excessive psychomotor agitation;
- musculoskeletal system: arthralgia and myalgia (including cramps)
- other: symptoms characteristic of acute respiratory infections and flu.
Limitations and contraindications
"Montelukast" (the instructions for use, the reviews are the most positive, and to the information contained in it, from the point of view of objectivity, the members of the forum practically do not have any questions) are not appointed if:
- hypersensitivity to the composition of the drug was found (the rule is relevant for all types of tablets);
- rare hereditary diseases were diagnosed, including those in which the body does not absorb galactose, or experiences a critical deficiency of lactase (this restriction does not apply to chewing pills);
- the patient's condition is weighed down by phenylketonuria;
- the patient has not yet reached the age of two (for tablets in the “age qualification” shell - 15 years).
Overdose: symptoms and treatment
Studies have shown: "Montelukast" 4 mg (the reviews for this trading form of the reagent are essentially identical to the comments that are addressed to chewing analogues containing 5 mg of active substance) when the daily intake is exceeded, it has the same effect on the body as 10 mg tablets . The most pronounced symptoms of overdose are seen in patients of the younger group. Adults, even when taking 200 mg / day for 5 months, did not notice any atypical reactions.
In single episodes, a sign of an increased concentration of the drug was:
- insatiable thirst;
- drowsiness;
- pain in the abdomen;
- vomiting
Treatment is based on the observed clinical picture. There is no information on the effectiveness of hemodialysis.
Drug Interactions and the Most Popular Analogs
"Montelukast" 5 mg (reviews of chewing samples left by pediatricians come down to the idea that the medication is undoubtedly worthy of the attention of young parents), like other forms of the antagonist of leukotriene receptors, when used concurrently with profile reagents, it accelerates positive dynamics : The symptoms of bronchial asthma become less pronounced, the number of seizures decreases. However, a sharp abolition of therapy carried out on the basis of inhaled corticosteroids is not recommended.
Significant fluctuations in the pharmacokinetic processes involving theophylline and prednisolone were not detected. But the absorption at the “union” with phenobarbital drops by as much as 40%.
Reagents that inhibit the synthesis of the CYP3A4 isoenzyme should be used only under medical supervision.
Structural analogues that are most often found on sale:
- Moncasta.
- Singleton
- "Singular".
- Ektalust.
- "Singulex".
"Singular" or "Montelukast": reviews of doctors and pharmacologists
According to experienced pharmacologists, the debate about which of the given drugs is safer and more effective is meaningless, since both Singular and Montelukast have the same drug base. Just the first trade name has passed patent registration, and the second is international. Individual doctors and patients, however, hold a different point of view, and consider the medication distributed under INN to be the only right decision.