SINGULAIR ® is a Montelukast sodium based drug
THERAPEUTIC GROUP: Leukotriene receptor antagonists
Indications SINGULAIR ® - Montelukast
SINGULAIR ® is indicated in the treatment of asthma unresponsive adequately to inhalation therapy with corticosteroids or with beta 2 adrenergic agonists.
SINGULAIR ® is also successfully used in the symptomatic treatment of seasonal allergic rhinitis and in the prophylaxis of asthma characterized by exercise-induced bronchoconstriction.
Mechanism of action SINGULAIR ® - Montelukast
SINGULAIR ® is a medicinal product based on Montelukast, a leukotriene receptor inhibitor, successfully used in the treatment of asthma.
The mechanism of action of this active principle, now well characterized also from the molecular point of view, is basically realized in the ability to inhibit the activation of the leukotriene receptors, and in particular of the type 1 receptor, constitutionally expressed by the smooth muscle cells of the airways and other elements of inflammation.
The increased release of series 4 leukotrienes in the course of asthmatic disease generally induces an increased activation of this receptor with consequent bronchoconstriction, vasodilation and associated edema, hypersecretion of mucus, activation of the elements of inflammation and congestion of the respiratory tract.
Montelukast, taken orally, absorbed systemically and distributed in the circulation bound to plasma proteins, reaches the respiratory tract, antagonizing the effects of leukotrienes and causing a significant reduction in the symptoms complained of.
Once its activity of action is terminated, Montelukast is generally eliminated via the bile after an intense hepatic metabolism.
Studies carried out and clinical efficacy
MONTELUKAST IN THE PREVENTION OF POST-BRONCHIOLITIS DYSPNEA
Pediatr Allergy Immunol. 2013 Oct 7. doi: 10.1111 / pai.12124. [Epub ahead of print]
Systematic review of montelukast "s efficacy for preventing post-bronchiolitis wheezing.
Peng WS, Chen X, Yang XY, Liu EM.
Study demonstrating how treatment with Montelukast can lead to a reduction in the frequency of dyspnoea in patients with post-bronchiolitis, especially following respiratory syncytial virus infection, with the appearance of side effects only in 1.5% of treated patients.
COMPARING BUDESONIDE AND MONTELUKAST
J Allergy Clin Immunol Pract. 2013 Jan; 1: 58-64. doi: 10.1016 / j.jaip.2012.08.005. Epub 2012 Nov 8.
Budesonide inhalation suspension versus montelukast in children aged 2 to 4 years with mild persistent asthma.
Szefler SJ, Carlsson LG, Uryniak T, Baker JW.
Study conducted on over 200 children aged between 2 and 4 years that demonstrates how the treatment with Montelukast can be as effective as that with Budesonide in the initial control of the disease, although in the long-term management Budesonide seems to guarantee better control.
INHIBITORS OF LEUCOTRIENE RECEPTORS IN ALLERGIC CONJUNCTIVITIS
J Allergy Clin Immunol Pract. 2013 Jan; 1: 65-74. doi: 10.1016 / j.jaip.2012.07.001. Epub 2012 Nov 2.
Leukotriene Receptor Antagonists in Allergic Eye Disease: A Systematic Review and Meta-analysis.
Gane J, Buckley R.
Study that demonstrates how Montelukast can also be used successfully in the treatment of allergic conjunctivitis, however, it is less effective than the oral antihistamine.
Such evidence suggests the possibility of considering an integrated approach.
Method of use and dosage
SINGULAIR ®
Montelukast 10 mg coated tablets.
Therapy with SINGULAIR ® must necessarily be defined by a doctor specialized in the treatment of respiratory tract diseases, considering the possibility of associating everything with supportive therapy.
In general and nonspecific way, generally the most used dosage in the treatment of asthmatic pathology or allergic rhinitis in adult patients is that of one 10 mg tablet per day, to be taken preferably in the evening.
SINGULAIR ® - Montelukast warnings
Treatment with SINGULAIR ® must necessarily be periodically supervised by the doctor, especially due to the increased risk, documented by some clinical evidence, of hypereosinophilia with symptoms similar to Churg-Strauss vasculitis.
It is also important to reiterate that the treatment with Montelukast is not a suitable treatment for the acute asthmatic attack, for which the doctor should instead define a supportive therapy suitable for a basic therapy to be maintained, always according to medical prescription, even in stages of remission of the disease.
SINGULAIR ® has lactose among its excipients, making it unsuitable for patients with galactose intolerance, lactase enzyme deficiency or glucose-galactose malabsorption syndrome.
PREGNANCY AND BREASTFEEDING
Although there is currently no scientific evidence such as to associate an increased risk of fetal malformations with the administration of Montelukast, the use of SINGULAIR ® during pregnancy and in the subsequent period of breastfeeding should be limited to cases of real and inevitable necessity. and be carried out exclusively under medical supervision.
Interactions
Given the hepatic metabolism of Montelukast, such as to involve cytochromial enzymes, it would be advisable to avoid the simultaneous intake of active ingredients potentially endowed with inducing or inhibiting activity on these systems, capable of altering the normal pharmacokinetic properties of the active ingredient.
Contraindications SINGULAIR ® - Montelukast
The use of SINGULAIR ® is contraindicated in patients with hypersensitivity to the active substance or to one of its excipients or to structurally and chemically related molecules.
Undesirable Effects - Side Effects
SINGULAIR ® therapy may expose the patient to an increased risk of side effects such as headache, upper respiratory tract infections, diarrhea, nausea, vomiting, hypertransaminasemia and skin rashes.
The incidence of clinically more serious adverse reactions was rarer.
Note
SINGULAIR ® is a prescription drug.
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