What are the effects and side effects of montelukast sodium?

Montelukast sodium is a leukotriene receptor antagonist, a class of non-hormonal anti-inflammatory drugs that act by competitively binding to cysteinyl leukotriene receptors and thereby blocking their activity. It inhibits leukotriene-induced airway smooth muscle contraction and inflammatory effects on the airway, and also reduces the synthesis and release of inflammatory mediators in the airway caused by allergenic stimuli. So, what are the effects and side effects of montelukast sodium?

Efficacy of montelukast sodium

①Bronchial asthma (asthma for short)

Leukotriene (LT) is an important inflammatory mediator, and montelukast sodium has anti-inflammatory effects as a leukotriene receptor antagonist, which can work in different periods of asthma. In addition, montelukast sodium has a relatively unique effect on exercise-induced asthma, virus-induced asthma, and aspirin-induced asthma.

②Cough variant asthma (CVA)

CVA is a specific type of asthma in which cough is the only or main manifestation without obvious signs and symptoms such as wheezing and shortness of breath, and anti-inflammatory therapy reduces the risk of developing CVA into typical asthma. Because LT plays an important role in this particular type of asthma, montelukast sodium is used for CVA.

(iii) Allergic rhinitis (allergic rhinitis, AR)

AR is an IgE-mediated non-infectious inflammation of the nasal mucosa caused by exposure to allergens in susceptible individuals and is characterized by nasal congestion, nasal itching, runny nose, and sneezing. In the pathogenesis of AR, LT plays an important role in both the rapid-onset and late-onset phases, and is an important inflammatory mediator that triggers symptoms such as nasal congestion and runny nose in AR pathogenesis. Montelukast sodium can improve the symptoms of sneezing, runny nose and nasal congestion as well as eye symptoms in AR patients, and it is suitable for AR patients with combined asthma.

Capillary bronchitis

Capillary bronchitis is mostly caused by infections such as respiratory syncytial virus, and some of them may develop into asthma after the acute phase with repeated wheezing. LT levels are significantly elevated in patients with capillary bronchitis, and their levels are related to the severity of capillary bronchitis. Montelukast sodium is an LT receptor antagonist and is one of the ways to prevent and treat recurrent wheezing after capillary bronchitis.

Side effects of montelukast sodium

Montelukast sodium is safe and well tolerated. Adverse reactions are mild, mainly headache, dry mouth, pharyngitis, transient rash, abdominal pain, and upper respiratory tract infection-like symptoms. Rare neuropsychiatric events such as nightmares, nonspecific anxiety, sleep disturbances (e.g., insomnia, etc.), irritability, hallucinations, aggressive behavior, irritability, depression, hyperexcitability, personality disorders, suicidal thoughts, and suicidal behavior.