Montelukast: Pharmacology, Safety, Tolerability and Efficacy

Abstract

Allergic rhinitis and asthma are common disorders effecting large percentages of the population of Western countries. There are multiple treatment options available for allergic rhinitis and asthma and stepwise approaches to therapy have been recommended. Montelukast is a cysteinyl leukotriene receptor antagonist that has been found to be effective both in the treatment of allergic rhinitis and asthma. This paper will describe the pharmacology, safety, efficacy and tolerability of montelukast. It will examine the comparative efficacy of montelukast to other medications for the treatment of allergic rhinitis and asthma, as well as discuss the recent studies of combination therapy.

Discovery of Inhibitors of Soluble Epoxide Hydrolase: A Target with Multiple Potential Therapeutic Indications

“…6 In addition, montelukast is a leukotriene (LT) receptor antagonist blocking the action of LTD 4 and secondary ligands LTC 4 and LTE 4 . 7 Zileuton inhibits 5-lipoxygenase, an enzyme of the eicosanoid synthesis pathway for the production of LTs. 8 Both montelukast and zileuton are effective therapies for treatment of asthma.…”

Montelukast for the treatment of asthma in the adult population

“…It is apparent that, despite high-dose ICS, a proportion of asthmatics have uncontrolled symptoms. This is evidenced by frequent hospitalizations and emergencyroom visits by 23% of adults and 32% of children with asthma [5]. Factors cited for the low efficacy of ICS in adults and children over the age of 12 include poor inhaler technique, exposure to environmental irritants and cigarettes, and inappropriate interruption of therapy.…”

“…Montelukast is the first mediator-specific therapeutic option for asthma that is able to reach the lower airways and improve peripheral airway function [5]. Initially licensed in 1998 for adults, and extended for use in children 2 --5 years of age in 2001, montelukast is indicated for treatment of asthma as addon therapy in those patients with mild to moderate persistent asthma who are inadequately controlled on ICS and in whom as-needed SABA provides suboptimal control of asthma [5].…”

“…Initially licensed in 1998 for adults, and extended for use in children 2 --5 years of age in 2001, montelukast is indicated for treatment of asthma as addon therapy in those patients with mild to moderate persistent asthma who are inadequately controlled on ICS and in whom as-needed SABA provides suboptimal control of asthma [5]. It is also indicated in the asthma phenotype with a predominant exercise-induced bronchoconstriction (EIB) component [12].…”

“…Approximately 4 --11% of these patients experience asthmatic episodes annually [5]. It is particularly common in industrialized countries and is associated with significant morbidity, mortality and economic burden [2].…”