"Montelukast" - reviews of the drug can be easily found on thematic forums and websites dedicated to the problem of bronchial asthma - this is a classic leukotriene D4 receptor antagonist. The drug is widely used both in basic therapy and in order to prevent characteristic attacks of the disease. The balanced composition allows the drug to be used to treat patients of almost any age category.
Issue form
There are a lot of reasons why Montelukast receives mostly positive reviews. 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 the active substance) and their chewable counterparts (4 mg and 5 mg of the reagent, respectively). The basic basis in both cases is sodium montelukast, but the composition of the auxiliary components is somewhat different - mannitol and aspartame do notpresent in samples intended to be swallowed immediately upon consumption.
In the comments, the question of fakes that now and then appear in pharmacy chains often pops up in the comments. You can protect yourself from counterfeit if you pay attention to the appearance of the pharmacological product in a timely manner.
Thus, in particular, a chewable pill with 4 milligrams of the active ingredient has an oval shape and a pink tint (the description corresponds to tablets with a cherry flavor; differences are acceptable when using other flavors), as well as marking in the form of the number "4" on one from the sides. Analogues, in which the main active ingredient is 1 mg more, are round and marked with a “five”. Pills with a shell geometrically resemble a rectangle; they are beige and numbered "10".
Pharmacological affiliation
"Montelukast" (reviews describing situations where the reagent provoked complex allergies are extremely rare) is a typical representative of the group of anti-bronchoconstrictor drugs. The algorithm of its action allows us to speak of a “close relationship” with intermediates/prostaglandins and thromboxanes.
The main function of the drug is to block the cysteinyl leukotriene "sensors" of the respiratory system. It is these receptors that maintain the high activity of the bronchi during the development of asthma, and they also stimulate the synthesis of secretion, which then accumulates and complicates the work of the mucous membrane.
Regular intake leads to a significant decrease inthe 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" (reviews of pharmacists indicate that the real choice of duplicates is limited by the pricing policy of manufacturers, that is, individual synonymous drugs, having identically structured molecules of the main component, are several times more expensive than the described drug), getting into the blood plasma, perfectly binds to its proteins. In the course of clinical studies, the result was recorded at the level of 99.37%. At the same time, its bioavailability is directly dependent on the technological form of release. For example, the ingredients of 5-milligram tablets are 73% absorbable, while the film-coated analogues, which contain 2 times more active substance, are only 64%.
A similar situation with the half-life of the reagent: the components of chewable pills, subjected to metabolism, leave the body 2 hours after ingestion, and the constituent elements of conventional tablets after 180-200 minutes. At the same time, plasma clearance varies between 43-45 ml / minute. And, interestingly, only 0.2% of the dose is transported by the urinary tract. Intestines, for comparison, - more than 85%.
From the comments of authoritative experts it follows that the pharmacokinetic process proceeds equally smoothly in patients of both sexes, and thatmaking any serious adjustments for age and renal pathologies when calculating the daily portion of the drug is not required. But malfunctions in the liver, especially when it comes to serious illnesses, deserve increased attention when drawing up a therapeutic schedule.
Indications for prescription
When the use of the drug "Montelukast" is justified, the reviews (the drug is recommended for children in chewable form; it is advisable to prescribe film-coated pills exclusively to adults and adolescents) left on the forums, of course, help to understand. However, to be guided only by someone else's opinion is a big mistake, because without consulting a doctor, it is almost impossible to “identify” the type of asthma, and most importantly, find out the causes of its occurrence.
As for the official instructions, the circle of symptoms, ailments and other conditions is outlined as follows:
- bronchial spasms provoked by excessive exercise;
- seasonal/chronic rhinitis of allergic origin;
- bronchial asthma;
- need for preventive measures.
Optimal dosage
"Montelukast" (negative reviews are extremely difficult to find, since the active ingredient 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 4mg and 5mg chewable tablets, the following dosage rules apply:
- children aged 2 to 5 years: 1 unit of the drug (4 mg) per day, at bedtime, until control of symptoms is achieved, and with a mandatory prolongation of the course for 2-4 weeks to consolidate the effect obtained;
- patients from 6 to 14 years old: similar regimen, but a single dose of 5 mg.
For film-coated pills, the following recommendations apply:
- Adults and children over 15 with asthma or chronic rhinitis: 1 unit (10 mg of substance)/day, in the evening;
- to prevent spasms: same dose for 14-28 days.
Side effect
"Montelukast" instruction (reviews confirm that even with full compliance with the provisions of the official guidelines, atypical reactions to the presence of ingredients cannot be completely ruled out) positions it as a potentially safe medication, but with the proviso that an uncharacteristic "answer" from organism in individual cases is still possible.
Acceptable Scenarios:
- GIT: diarrhea, dry mouth, abdominal pain, nausea;
- heart and circulatory lines: very noticeable increase in heart rate;
- skin: rash, hives, local hematomas;
- respiratory system: rhinorrhea and severe cough;
- CNS: dizziness, feeling tired, depressed moods alternating with excessivepsychomotor agitation;
- musculoskeletal system: arthralgia and myalgia (including convulsions)
- other: symptoms of acute respiratory infections and influenza.
Restrictions and contraindications
"Montelukast" (instructions for use the reviews find the most positive, and the information contained in it, from the point of view of objectivity, there are practically no questions from members of the forum) are not prescribed if:
- found hypersensitivity to the composition of the drug (the rule is relevant for all types of tablets);
- diagnosed with rare hereditary diseases, including those in which the body does not absorb galactose, or experiences a critical lactase deficiency (this restriction does not apply to chewable pills);
- the patient's condition is aggravated by phenylketonuria;
- patient is under two years of age (age limit for tablets is 15).
Overdose: symptoms and treatment
Studies have shown: "Montelukast" 4 mg (reviews about this trade form of the reagent, in fact, are identical to the comments that are addressed to chewable analogues containing 5 mg of the active substance), when the daily intake is exceeded, it has the same effect on the body, as well 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 note any atypical reactions.
In isolated episodes, a sign of increaseddrug concentration was:
- unquenchable thirst;
- drowsy;
- pain in the abdomen;
- vomit;
Treatment is based on the observed clinical picture. There is no data on the effectiveness of hemodialysis.
Drug interactions and most popular analogues
"Montelukast" 5 mg (reviews of chewable samples left by pediatricians boil down to the idea that the drug is undoubtedly worthy of the attention of young parents), like other forms of leukotriene receptor antagonist, when used in parallel with profile reagents contributes to the acceleration of positive dynamics: the symptoms of bronchial asthma become less pronounced, the number of attacks decreases. However, abrupt withdrawal of therapy based on inhaled corticosteroids is not recommended.
No significant fluctuations in pharmacokinetic processes involving theophylline and prednisol were found. But absorption with the "union" with phenobarbital drops by as much as 40%.
Reagents that inhibit the synthesis of the CYP3A4 isoenzyme should only be used under medical supervision.
Structural analogues that are most often found on sale:
- Moncasta.
- "Singlon".
- "Singular".
- Ektalust.
- Singulex.
"Singular" or "Montelukast": reviews of doctors and pharmacologists
According to experienced pharmacologists, disputes about which of the above drugs is safer and more effective are meaningless, since"Singular" and "Montelukast" have the same drug base. It's just that the first trade name has passed a patent registration, and the second one is international. Individual doctors and patients, however, take a different point of view, and consider the medicine distributed under the INN to be the only right solution.
