Montelukast

Montelukast
Clinical data
Pronunciation	mon te loo' kast
Trade names	Singulair, others
AHFS/Drugs.com	Monograph
MedlinePlus	a600014
License data	US DailyMed: Montelukast;
Pregnancy; category	AU: B1; ;
Routes of; administration	By mouth
Drug class	Leukotriene receptor antagonist
ATC code	R03DC03 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only); CA: ℞-only; UK: POM (Prescription only); US: WARNINGRx-only;
Pharmacokinetic data
Bioavailability	63–73%
Protein binding	99%
Metabolism	Liver (CYP2C8-major, CYP3A4 and CYP2C9-minor)
Elimination half-life	2.7–5.5 hours
Excretion	Biliary
Identifiers
	IUPAC name (E,Z)-2-(1-((1-(3-(2-(7-Chloroquinolin-2-yl)vinyl)phenyl)-3-(2-(2-hydroxypropan-2-yl)phenyl)propylthio)methyl)cyclopropyl)acetic acid;
CAS Number	158966-92-8 ;
PubChem CID	5281040;
IUPHAR/BPS	3340;
DrugBank	DB00471 ;
ChemSpider	4444507 ;
UNII	MHM278SD3E;
KEGG	D08229 ; as salt: D00529 ;
ChEBI	CHEBI:50730 ;
ChEMBL	ChEMBL787 ;
CompTox Dashboard (EPA)	DTXSID9023334 ;
ECHA InfoCard	100.115.927
Chemical and physical data
Formula	C35H36ClNO3S
Molar mass	586.19 g·mol−1
3D model (JSmol)	Interactive image;
Melting point	145 to 148 °C (293 to 298 °F)
	SMILES O=C(O)CC1(CC1)CS[C@@H](c2cccc(c2)\C=C\c3nc4cc(Cl)ccc4cc3)CCc5ccccc5C(O)(C)C;
	InChI InChI=1S/C35H36ClNO3S/c1-34(2,40)30-9-4-3-7-25(30)13-17-32(41-23-35(18-19-35)22-33(38)39)27-8-5-6-24(20-27)10-15-29-16-12-26-11-14-28(36)21-31(26)37-29/h3-12,14-16,20-21,32,40H,13,17-19,22-23H2,1-2H3,(H,38,39)/b15-10+/t32-/m1/s1 ; Key:UCHDWCPVSPXUMX-TZIWLTJVSA-N ;
	(verify)

Montelukast, sold under the brand name Singulair among others, is a medication used in the maintenance treatment of asthma.^[6] It is generally less preferred for this use than inhaled corticosteroids.^[6] It is not useful for acute asthma attacks.^[6] Other uses include allergic rhinitis and hives of long duration.^[6] For allergic rhinitis it is a second-line treatment.^[7]

Common side effects include abdominal pain, cough, and headache.^[6] Severe side effects may include allergic reactions, such as anaphylaxis and eosinophilia.^[6] Use in pregnancy appears to be safe.^[6] Montelukast is in the leukotriene receptor antagonist family of medications.^[6] It works by blocking the action of leukotriene D4 in the lungs resulting in decreased inflammation and relaxation of smooth muscle.^[6]

Montelukast was approved for medical use in the United States in 1998.^[6] It is available as a generic medication.^[8] In 2021, it was the fourteenth most commonly prescribed medication in the United States, with more than 30 million prescriptions.^[9]^[10]

^ "Montelukast (Singulair) Use During Pregnancy". Drugs.com. 13 December 2019. Archived from the original on 7 August 2019. Retrieved 4 March 2020.
^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
^ ^a ^b Cite error: The named reference med.org.uk was invoked but never defined (see the help page).
^ "Singulair- montelukast sodium granule Singulair- montelukast sodium tablet, chewable Singulair- montelukast sodium tablet, film coated". DailyMed. 29 April 2020. Archived from the original on 15 October 2020. Retrieved 12 October 2020.
^ ^a ^b "Elsevier – Drug Monograph │Montelukast". Elsevier's Healthcare Hub. 4 March 2020. Archived from the original on 27 January 2023. Retrieved 27 January 2023. Montelukast and its metabolites are excreted almost exclusively via the bile; less than 0.2% of the drug is excreted in urine. Mean elimination half-life (half-life) of montelukast is 2.7 to 5.5 hours in healthy young adults.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Cite error: The named reference AHFS2018 was invoked but never defined (see the help page).
^ Grainger J, Drake-Lee A (October 2006). "Montelukast in allergic rhinitis: a systematic review and meta-analysis". Clinical Otolaryngology. 31 (5). Wiley: 360–367. doi:10.1111/j.1749-4486.2006.01276.x. PMID 17014443. S2CID 27200676.
^ British national formulary: BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 269. ISBN 978-0-85711-338-2.
^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
^ "Montelukast - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.

[Drugs.com_pregnancy-1] "Montelukast (Singulair) Use During Pregnancy". Drugs.com. 13 December 2019. Archived from the original on 7 August 2019. Retrieved 4 March 2020.

[FDA-AllBoxedWarnings-2] "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.

[med.org.uk-3] Cite error: The named reference med.org.uk was invoked but never defined (see the help page).

[Singulair_FDA_label-4] "Singulair- montelukast sodium granule Singulair- montelukast sodium tablet, chewable Singulair- montelukast sodium tablet, film coated". DailyMed. 29 April 2020. Archived from the original on 15 October 2020. Retrieved 12 October 2020.

[Elseviers_Healthcare_Hub_2020-5] "Elsevier – Drug Monograph │Montelukast". Elsevier's Healthcare Hub. 4 March 2020. Archived from the original on 27 January 2023. Retrieved 27 January 2023. Montelukast and its metabolites are excreted almost exclusively via the bile; less than 0.2% of the drug is excreted in urine. Mean elimination half-life (half-life) of montelukast is 2.7 to 5.5 hours in healthy young adults.

[AHFS2018-6] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Cite error: The named reference AHFS2018 was invoked but never defined (see the help page).

[Grainger_Drake-Lee_2006_pp._360–367-7] Grainger J, Drake-Lee A (October 2006). "Montelukast in allergic rhinitis: a systematic review and meta-analysis". Clinical Otolaryngology. 31 (5). Wiley: 360–367. doi:10.1111/j.1749-4486.2006.01276.x. PMID 17014443. S2CID 27200676.

[BNF76-8] British national formulary: BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 269. ISBN 978-0-85711-338-2.

[9] "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.

[10] "Montelukast - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.

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