Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 2000 Jan;46:86–99.

Montelukast. No current use for asthma.

PMCID: PMC1987658  PMID: 10660791

Abstract

Montelukast (Singulair), an antiasthma drug belonging to the leukotriene antagonist family, has two indications: as adjunctive treatment for mild-to-moderate chronic asthma when regular inhaled steroid therapy and short-acting inhaled beta2 stimulants "on demand" are inadequate; and in prevention of effort-induced asthma. The clinical file on montelukast contains no methodologically acceptable comparisons with reference treatments. Several placebo-controlled trials have shown the efficacy of montelukast, with improvement in clinical scores and respiratory function tests in those with chronic asthma and prevention of effort-induced asthma. For chronic asthma, montelukast has not been compared with oral or inhaled long-acting beta2 stimulants or with sustained-release theophylline in patients inadequately controlled by steroid therapy. For effort-induced asthma, only two trials have compared montelukast with salmeterol.On the basis of preliminary results, the authors of both studies concluded that montelukast was superior. Clinical trials showed no clear difference in the frequency of side effects in patients taking montelukast and patients taking placebo. Montelukast, however, might be associated with Churg-Strauss syndrome in rare cases. Montelukast is expensive.

Full text

PDF
86

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bronsky E. A., Kemp J. P., Zhang J., Guerreiro D., Reiss T. F. Dose-related protection of exercise bronchoconstriction by montelukast, a cysteinyl leukotriene-receptor antagonist, at the end of a once-daily dosing interval. Clin Pharmacol Ther. 1997 Nov;62(5):556–561. doi: 10.1016/S0009-9236(97)90051-5. [DOI] [PubMed] [Google Scholar]
  2. Bronsky E. A., Kemp J. P., Zhang J., Guerreiro D., Reiss T. F. Dose-related protection of exercise bronchoconstriction by montelukast, a cysteinyl leukotriene-receptor antagonist, at the end of a once-daily dosing interval. Clin Pharmacol Ther. 1997 Nov;62(5):556–561. doi: 10.1016/S0009-9236(97)90051-5. [DOI] [PubMed] [Google Scholar]
  3. D'Cruz D. P., Barnes N. C., Lockwood C. M. Difficult asthma or Churg-Strauss syndrome? BMJ. 1999 Feb 20;318(7182):475–476. doi: 10.1136/bmj.318.7182.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. D'Cruz D. P., Barnes N. C., Lockwood C. M. Difficult asthma or Churg-Strauss syndrome? BMJ. 1999 Feb 20;318(7182):475–476. doi: 10.1136/bmj.318.7182.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. De Lepeleire I., Reiss T. F., Rochette F., Botto A., Zhang J., Kundu S., Decramer M. Montelukast causes prolonged, potent leukotriene D4-receptor antagonism in the airways of patients with asthma. Clin Pharmacol Ther. 1997 Jan;61(1):83–92. doi: 10.1016/S0009-9236(97)90184-3. [DOI] [PubMed] [Google Scholar]
  6. De Lepeleire I., Reiss T. F., Rochette F., Botto A., Zhang J., Kundu S., Decramer M. Montelukast causes prolonged, potent leukotriene D4-receptor antagonism in the airways of patients with asthma. Clin Pharmacol Ther. 1997 Jan;61(1):83–92. doi: 10.1016/S0009-9236(97)90184-3. [DOI] [PubMed] [Google Scholar]
  7. Horwitz R. J., McGill K. A., Busse W. W. The role of leukotriene modifiers in the treatment of asthma. Am J Respir Crit Care Med. 1998 May;157(5 Pt 1):1363–1371. doi: 10.1164/ajrccm.157.5.9706059. [DOI] [PubMed] [Google Scholar]
  8. Horwitz R. J., McGill K. A., Busse W. W. The role of leukotriene modifiers in the treatment of asthma. Am J Respir Crit Care Med. 1998 May;157(5 Pt 1):1363–1371. doi: 10.1164/ajrccm.157.5.9706059. [DOI] [PubMed] [Google Scholar]
  9. Kemp J. P., Dockhorn R. J., Shapiro G. G., Nguyen H. H., Reiss T. F., Seidenberg B. C., Knorr B. Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma. J Pediatr. 1998 Sep;133(3):424–428. doi: 10.1016/s0022-3476(98)70281-1. [DOI] [PubMed] [Google Scholar]
  10. Kemp J. P., Dockhorn R. J., Shapiro G. G., Nguyen H. H., Reiss T. F., Seidenberg B. C., Knorr B. Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma. J Pediatr. 1998 Sep;133(3):424–428. doi: 10.1016/s0022-3476(98)70281-1. [DOI] [PubMed] [Google Scholar]
  11. Knorr B., Matz J., Bernstein J. A., Nguyen H., Seidenberg B. C., Reiss T. F., Becker A. Montelukast for chronic asthma in 6- to 14-year-old children: a randomized, double-blind trial. Pediatric Montelukast Study Group. JAMA. 1998 Apr 15;279(15):1181–1186. doi: 10.1001/jama.279.15.1181. [DOI] [PubMed] [Google Scholar]
  12. Knorr B., Matz J., Bernstein J. A., Nguyen H., Seidenberg B. C., Reiss T. F., Becker A. Montelukast for chronic asthma in 6- to 14-year-old children: a randomized, double-blind trial. Pediatric Montelukast Study Group. JAMA. 1998 Apr 15;279(15):1181–1186. doi: 10.1001/jama.279.15.1181. [DOI] [PubMed] [Google Scholar]
  13. Leff J. A., Busse W. W., Pearlman D., Bronsky E. A., Kemp J., Hendeles L., Dockhorn R., Kundu S., Zhang J., Seidenberg B. C. Montelukast, a leukotriene-receptor antagonist, for the treatment of mild asthma and exercise-induced bronchoconstriction. N Engl J Med. 1998 Jul 16;339(3):147–152. doi: 10.1056/NEJM199807163390302. [DOI] [PubMed] [Google Scholar]
  14. Leff J. A., Busse W. W., Pearlman D., Bronsky E. A., Kemp J., Hendeles L., Dockhorn R., Kundu S., Zhang J., Seidenberg B. C. Montelukast, a leukotriene-receptor antagonist, for the treatment of mild asthma and exercise-induced bronchoconstriction. N Engl J Med. 1998 Jul 16;339(3):147–152. doi: 10.1056/NEJM199807163390302. [DOI] [PubMed] [Google Scholar]
  15. Markham A., Faulds D. Montelukast. Drugs. 1998 Aug;56(2):251–257. doi: 10.2165/00003495-199856020-00010. [DOI] [PubMed] [Google Scholar]
  16. Markham A., Faulds D. Montelukast. Drugs. 1998 Aug;56(2):251–257. doi: 10.2165/00003495-199856020-00010. [DOI] [PubMed] [Google Scholar]
  17. Noonan M. J., Chervinsky P., Brandon M., Zhang J., Kundu S., McBurney J., Reiss T. F. Montelukast, a potent leukotriene receptor antagonist, causes dose-related improvements in chronic asthma. Montelukast Asthma Study Group. Eur Respir J. 1998 Jun;11(6):1232–1239. doi: 10.1183/09031936.98.11061232. [DOI] [PubMed] [Google Scholar]
  18. Noonan M. J., Chervinsky P., Brandon M., Zhang J., Kundu S., McBurney J., Reiss T. F. Montelukast, a potent leukotriene receptor antagonist, causes dose-related improvements in chronic asthma. Montelukast Asthma Study Group. Eur Respir J. 1998 Jun;11(6):1232–1239. doi: 10.1183/09031936.98.11061232. [DOI] [PubMed] [Google Scholar]
  19. Reiss T. F., Altman L. C., Chervinsky P., Bewtra A., Stricker W. E., Noonan G. P., Kundu S., Zhang J. Effects of montelukast (MK-0476), a new potent cysteinyl leukotriene (LTD4) receptor antagonist, in patients with chronic asthma. J Allergy Clin Immunol. 1996 Sep;98(3):528–534. doi: 10.1016/s0091-6749(96)70086-6. [DOI] [PubMed] [Google Scholar]
  20. Reiss T. F., Altman L. C., Chervinsky P., Bewtra A., Stricker W. E., Noonan G. P., Kundu S., Zhang J. Effects of montelukast (MK-0476), a new potent cysteinyl leukotriene (LTD4) receptor antagonist, in patients with chronic asthma. J Allergy Clin Immunol. 1996 Sep;98(3):528–534. doi: 10.1016/s0091-6749(96)70086-6. [DOI] [PubMed] [Google Scholar]
  21. Reiss T. F., Chervinsky P., Dockhorn R. J., Shingo S., Seidenberg B., Edwards T. B. Montelukast, a once-daily leukotriene receptor antagonist, in the treatment of chronic asthma: a multicenter, randomized, double-blind trial. Montelukast Clinical Research Study Group. Arch Intern Med. 1998 Jun 8;158(11):1213–1220. doi: 10.1001/archinte.158.11.1213. [DOI] [PubMed] [Google Scholar]
  22. Reiss T. F., Chervinsky P., Dockhorn R. J., Shingo S., Seidenberg B., Edwards T. B. Montelukast, a once-daily leukotriene receptor antagonist, in the treatment of chronic asthma: a multicenter, randomized, double-blind trial. Montelukast Clinical Research Study Group. Arch Intern Med. 1998 Jun 8;158(11):1213–1220. doi: 10.1001/archinte.158.11.1213. [DOI] [PubMed] [Google Scholar]
  23. Reiss T. F., Hill J. B., Harman E., Zhang J., Tanaka W. K., Bronsky E., Guerreiro D., Hendeles L. Increased urinary excretion of LTE4 after exercise and attenuation of exercise-induced bronchospasm by montelukast, a cysteinyl leukotriene receptor antagonist. Thorax. 1997 Dec;52(12):1030–1035. doi: 10.1136/thx.52.12.1030. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Reiss T. F., Hill J. B., Harman E., Zhang J., Tanaka W. K., Bronsky E., Guerreiro D., Hendeles L. Increased urinary excretion of LTE4 after exercise and attenuation of exercise-induced bronchospasm by montelukast, a cysteinyl leukotriene receptor antagonist. Thorax. 1997 Dec;52(12):1030–1035. doi: 10.1136/thx.52.12.1030. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Reiss T. F., Sorkness C. A., Stricker W., Botto A., Busse W. W., Kundu S., Zhang J. Effects of montelukast (MK-0476); a potent cysteinyl leukotriene receptor antagonist, on bronchodilation in asthmatic subjects treated with and without inhaled corticosteroids. Thorax. 1997 Jan;52(1):45–48. doi: 10.1136/thx.52.1.45. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Reiss T. F., Sorkness C. A., Stricker W., Botto A., Busse W. W., Kundu S., Zhang J. Effects of montelukast (MK-0476); a potent cysteinyl leukotriene receptor antagonist, on bronchodilation in asthmatic subjects treated with and without inhaled corticosteroids. Thorax. 1997 Jan;52(1):45–48. doi: 10.1136/thx.52.1.45. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. SOLTI F., ISKUM M., KRASZNAI I., MARK G., REV J., FOELDESSY K., HERMANN R. EFFECT OF CHLORPROMAZINE ON PERIPHERAL CIRCULATION AND ON THE OXYGEN CONSUMPTION OF THE EXTREMITIES MUSCLES. Cor Vasa. 1964;6:130–137. [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES