Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Montelukast
Drug ID BADD_D01496
Description Montelukast was first approved for clinical use by the US FDA in 1998 as Merck's brand name Singulair.[L6301] The medication is a member of the leukotriene receptor antagonist (LTRA) category of drugs.[L6301,L6304,L6307,L6310,L6325,L6328,L6331] Although capable of demonstrating effectiveness, the use of such LTRAs like montelukast is typically in addition to or complementary with the use of inhaled corticosteroids or other agents in asthma step therapy.[A178645] Regardless, in 2008-2009, there were FDA-led investigations into the possibility of montelukast to elicit neuropsychiatric effects like agitation, hallucinations, suicidal behaviour, and others in individuals who used the medication.[A178651] And although these kinds of effects are currently included in the official prescribing information for montelukast,[L6301,L6304,L6307,L6310,L6325,L6328,L6331] the drug still sees extensive use worldwide via millions of prescriptions annually and has since become available as a generic and as a brand name product.
Indications and Usage Montelukast is indicated for: (a) the prophylaxis and chronic treatment of asthma in adults and pediatric patients who are 12 months of age and older[L6301], although other regional health authorities specifically note this indication for adults and adolescents who are 15 years and older[L6304,L6307] and also include indications for preventing day and night-time symptoms, and the treatment of acetylsalicylic acid-sensitive asthma[L6304]; (b) the prevention of exercise-induced bronchoconstriction (EIB) in patients who are 6 years of age and older[L6301], although other regional health authorities specifically note this indication for adults and adolescents who are 15 years and older[L6304,L6307]; and (c) the relief of symptoms of seasonal allergic rhinitis in patients 2 years of age and older and perennial allergic rhinitis in patients 6 months of age and older[L6301], although other regional health authorities specifically note the relief of seasonal allergic rhinitis symptoms for adults and adolescents who are 15 years and older[L6304,L6307]. Furthermore, some formulations like chewable montelukast tablets may also be specifically indicated by particular regulatory bodies for the prophylaxis and chronic treatment of asthma, including the prevention of day and night-time symptoms, the treatment of acetylsalicylic acid based asthma, and the prevention of exercise-induced bronchoconstriction in adult and pediatric patients aged 2 and older[L6328], between the ages 2 and 5[L6325], or between the ages of 6 and 14 years.[L6331] Moreover, when employed for such indications montelukast is considered effective as monotherapy or when combined with other medications indicated for the maintenance treatment of chronic asthma.[L6304,L6328] For instance, montelukast and inhaled corticosteroids can be used concomitantly to demonstrate additive effects to control asthma or to decrease the necessary inhaled corticosteroid dose while still maintaining clinical stability.[L6304,L6328] Additionally, in patients who continue to experience asthma symptoms, montelukast can also be combined with an 'as required' short-acting beta-agonist, an inhaled corticosteroid, or inhaled corticosteroid paired with a long-acting beta-agonist.[L6304,L6328]
Marketing Status approved
ATC Code R03DC03
DrugBank ID DB00471
KEGG ID D08229
MeSH ID C093875
PubChem ID 5281040
TTD Drug ID D00QET
NDC Product Code 51128-501; 51128-502; 65162-732; 71335-1979; 0781-5560; 82982-040; 65977-0040; 27241-017; 31722-726; 55154-8075; 72865-175; 0781-5554; 0781-5555; 70518-2603; 68645-560; 70518-3133; 71205-128; 0904-6808; 50090-6108; 65162-771; 68071-1561; 51128-503; 63629-4886; 65162-772; 68788-8099; 63629-8235; 68001-361; 71610-563; 82009-009; 50268-556; 63187-626; 33342-102
UNII MHM278SD3E
Synonyms montelukast | 1-((((1R)-1-(3-((E)-2-(7-chloro-2-quinolinyl)ethenyl)phenyl)-3-(2-(1-hydroxy-1-methylethyl)phenyl)propyl)thio)methyl)-cyclopropaneacetic acid | MK 0476 | MK-0476 | Singulair | montelukast sodium | sodium 1-(((1-(3-(2-(7-chloro-2-quinolinyl)ethenyl)phenyl)-3-(2-(1-hydroxy-1-methylethyl)phenyl)propyl)thio)methyl)cyclopropylacetate
Chemical Information
Molecular Formula C35H36ClNO3S
CAS Registry Number 158966-92-8
SMILES CC(C)(C1=CC=CC=C1CCC(C2=CC=CC(=C2)C=CC3=NC4=C(C=CC(=C4)Cl)C=C3)SCC5(CC5)CC(=O)O) O
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Mixed liver injury09.01.07.015--Not Available
Liver injury12.01.17.012; 09.01.07.022--Not Available
Adverse reaction08.06.01.0180.000075%Not Available
Type 1 diabetes mellitus14.06.01.010; 10.04.08.007; 05.06.01.0100.000015%Not Available
Traumatic liver injury09.01.08.010; 12.01.17.027--Not Available
Oropharyngeal pain22.12.03.016; 07.05.05.0040.000168%
Kounis syndrome24.04.04.020; 10.01.03.037; 02.02.02.0200.000029%Not Available
Langerhans' cell histiocytosis15.09.03.008; 16.21.04.003; 01.13.04.003; 09.01.08.018; 22.01.01.0160.000022%Not Available
Upper-airway cough syndrome22.12.03.0360.000032%
Neuropsychiatric syndrome19.07.03.009; 17.02.10.0140.000037%Not Available
Drug-induced liver injury09.01.07.023; 12.03.01.0440.000112%Not Available
White matter lesion24.04.06.027; 17.11.01.0090.000015%Not Available
Platelet dysfunction01.08.03.0030.000022%Not Available
Complication associated with device08.07.01.011--Not Available
Intrusive thoughts19.10.03.0080.000022%Not Available
Frustration tolerance decreased19.04.02.0160.000051%Not Available
Alice in wonderland syndrome19.03.03.0030.000029%Not Available
Bipolar II disorder19.16.01.0050.000029%Not Available
Borderline personality disorder19.05.03.0030.000044%Not Available
Coeliac disease14.02.01.007; 10.04.04.012; 07.17.01.0080.000064%Not Available
Concomitant disease aggravated08.01.03.0630.000015%Not Available
Head banging19.11.03.0070.000015%Not Available
Nikolsky's sign23.03.07.0090.000022%Not Available
Post-traumatic stress disorder19.06.06.0020.000037%Not Available
Social anxiety disorder19.06.03.0100.000037%Not Available
Systemic mastocytosis16.21.01.008; 01.13.01.008; 10.02.01.0140.000015%Not Available
Violence-related symptom19.05.01.022--Not Available
Weight loss poor14.03.02.0270.000015%Not Available
Self esteem decreased19.05.02.0040.000044%Not Available
Eosinophilic pneumonia chronic01.02.04.017; 22.01.01.0200.000080%Not Available
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