Montelukast

Montelukast

Drug monograph · NCLEX study reference
Trade names	Singulair
Therapeutic class	Antiasthmatic, antiallergy
Pharmacologic class	Leukotriene receptor antagonist
Onset / peak / duration	Effect within a day; once-daily dosing.
Half-life / level	Half-life 2.7 to 5.5 hours; no routine level.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Not applicable.
Pregnancy / lactation	Use if needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Montelukast (brand name Singulair) — Antiasthmatic, antiallergy; Leukotriene receptor antagonist.

Identification

• Therapeutic class: Antiasthmatic, antiallergy.
• Pharmacologic class: Leukotriene receptor antagonist.

Pharmacology

• Mechanism of action: Blocks leukotriene receptors to reduce inflammation and bronchoconstriction.
• Onset / peak / duration: Effect within a day; once-daily dosing.
• Half-life / therapeutic level: Half-life 2.7 to 5.5 hours; no routine level.

Clinical use

• Indications: Asthma maintenance, allergic rhinitis, exercise-induced bronchospasm prevention.
• Usual dose, route, frequency: 10 mg PO daily in the evening (chewable and granule forms for children).
• Maximum dose / adjustments: Once daily.

Safety

• Contraindications: Hypersensitivity.
• Black box warning: Serious neuropsychiatric events, including mood changes and suicidal thoughts; reserve in allergic rhinitis for patients without other options.
• Interactions: CYP inducers (phenobarbital, rifampin) lower levels.
• Pregnancy / lactation: Use if needed.
• High-alert: No.

Adverse effects

• Common side effects: Headache, abdominal pain.
• Serious effects to report: Mood or behavior changes, agitation, depression, suicidal thoughts.
• Antidote / reversal: Not applicable.

Nursing process

• Assessment before administration: Asthma control, mental health history.
• Interventions during therapy: Screen for mood changes; not for acute attacks.
• Monitor: Symptom control, mood and behavior.
• Evaluation / expected outcome: Fewer symptoms.

Patient teaching

• Patient teaching: Take in the evening; report any mood or behavior change.
• Notify provider if: Mood changes, agitation, depression, thoughts of self-harm.
• Administration tips: Evening dosing; controller, not a rescue.