Montelukast

Montelukast
Clinical data
Pronunciationmon te loo' kast
Trade namesSingulair, others
AHFS/Drugs.comMonograph
MedlinePlusa600014
License data
Pregnancy
category
Routes of
administration		By mouth
Drug classLeukotriene receptor antagonist
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability63–73%
Protein binding99%
MetabolismLiver (CYP2C8-major, CYP3A4 and CYP2C9-minor)[3]
Elimination half-life2.7–5.5 hours [5]
ExcretionBile duct[5]
Identifiers
  • (E,Z)-2-(1-((1-(3-(2-(7-Chloroquinolin-2-yl)vinyl)phenyl)-3-(2-(2-hydroxypropan-2-yl)phenyl)propylthio)methyl)cyclopropyl)acetic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.115.927 Edit this at Wikidata
Chemical and physical data
FormulaC35H36ClNO3S
Molar mass586.19 g·mol−1
3D model (JSmol)
Melting point145 to 148 °C (293 to 298 °F)
  • O=C(O)CC1(CC1)CS[C@@H](c2cccc(c2)\C=C\c3nc4cc(Cl)ccc4cc3)CCc5ccccc5C(O)(C)C
  • InChI=1S/C35H36ClNO3S/c1-34(2,40)30-9-4-3-7-25(30)13-17-32(41-23-35(18-19-35)22-33(38)39)27-8-5-6-24(20-27)10-15-29-16-12-26-11-14-28(36)21-31(26)37-29/h3-12,14-16,20-21,32,40H,13,17-19,22-23H2,1-2H3,(H,38,39)/b15-10+/t32-/m1/s1 checkY
  • Key:UCHDWCPVSPXUMX-TZIWLTJVSA-N checkY
  (verify)

Montelukast, sold under the brand name Singulair among others, is an antileukotriene medication used in the maintenance treatment of asthma.[6] It is generally less preferred for this use than inhaled corticosteroids.[6] It is not useful for acute asthma attacks.[6] Other uses include allergic rhinitis and hives of long duration.[6] For allergic rhinitis it is a second-line treatment.[7]

Common side effects include abdominal pain, cough, and headache.[6] Severe side effects may include allergic reactions, such as anaphylaxis and eosinophilia,[6] and neuropsychiatric impacts.[8] Use in pregnancy appears to be safe.[6] Montelukast is in the leukotriene receptor antagonist family of medications.[6] It works by blocking the action of leukotriene D4 in the lungs resulting in decreased inflammation and relaxation of smooth muscle.[6]

Montelukast was approved for medical use in the United States in 1998.[6] It is available as a generic medication.[9] In 2022, it was the seventeenth most commonly prescribed medication in the United States, with more than 29 million prescriptions.[10][11]

  1. ^ "Montelukast (Singulair) Use During Pregnancy". Drugs.com. 13 December 2019. Archived from the original on 7 August 2019. Retrieved 4 March 2020.
  2. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
  3. ^ a b Cite error: The named reference med.org.uk was invoked but never defined (see the help page).
  4. ^ "Singulair- montelukast sodium granule Singulair- montelukast sodium tablet, chewable Singulair- montelukast sodium tablet, film coated". DailyMed. 29 April 2020. Archived from the original on 15 October 2020. Retrieved 12 October 2020.
  5. ^ a b "Elsevier – Drug Monograph │Montelukast". Elsevier's Healthcare Hub. 4 March 2020. Archived from the original on 27 January 2023. Retrieved 27 January 2023. Montelukast and its metabolites are excreted almost exclusively via the bile; less than 0.2% of the drug is excreted in urine. Mean elimination half-life (half-life) of montelukast is 2.7 to 5.5 hours in healthy young adults.
  6. ^ a b c d e f g h i j Cite error: The named reference AHFS2018 was invoked but never defined (see the help page).
  7. ^ Grainger J, Drake-Lee A (October 2006). "Montelukast in allergic rhinitis: a systematic review and meta-analysis". Clinical Otolaryngology. 31 (5). Wiley: 360–367. doi:10.1111/j.1749-4486.2006.01276.x. PMID 17014443. S2CID 27200676.
  8. ^ https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-finds-widely-used-asthma-drug-impacts-brain-2024-11-22/
  9. ^ British national formulary: BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 269. ISBN 978-0-85711-338-2.
  10. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  11. ^ "Montelukast Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.