Montelukast should not be used as monotherapy for the treatment and management of exercise-induced bronchospasm (EIB). Patients who have exacerbations of asthma after exercise should continue to use their usual regimen of inhaled-agonist as prophylaxis and have available for rescue a short-acting inhaled-agonist.
Patients with known aspirin hypersensitivity should continue avoidance of aspirin or non steoridal anti-inflammatory agents while taking montelukast.
Patients and/or caregivers should notify their physician if these psychiatric disorders occur. (See Adverse reactions).
Montelukast 10 mg tablets should not be prescribed to patients <15 years of age.
Patient should be advised never to use oral montelukast to treat acute asthma attacks and to keep their usual appropriate rescue medication.
Montelukast should not be abruptly substituted for inhaled or oral corticosteroids.
Patients on therapy with antiasthma agents including montelukast may present with systemic eosinophilia, sometimes with clinical features of vasculitis consistent with Churg-Strauss syndrome. Patients who develop eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy, should contact their physician to be reassessed and evaluated their treatment regimen.
Patients with hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Montelukast may be used during pregnancy and in breast-feeding mothers only if it is considered to be clearly essential.