In addition to histamine, studies in recent years have shown that leukotrienes also play a very important role in the occurrence of allergic reactions. It has been shown that many symptoms of allergic reactions are related to leukotrienes, such as allergic rhinitis, especially nasal congestion, which is mainly caused by leukotrienes, and bronchospasm in non-steroidal anti-inflammatory drugs-induced aspirin asthma, allergic asthma, and exercise-induced asthma.
Montelukast sodium is a selective leukotriene receptor antagonist, which can specifically antagonize cysteine leukotriene receptors, inhibit the binding of leukotrienes to leukotriene receptors, thereby preventing increased vascular permeability, airway edema and bronchial smooth muscle contraction caused by leukotrienes, inhibiting the increase of eosinophils, lymphocytes and histiocytes, reducing peroxides produced by alveolar macrophage stimulation, reducing organ contraction and inflammation, reducing asthma symptoms, reducing asthma attacks and night awakenings, Reduce the use of 2-receptor agonists such as albuterol, improve lung function, and can reduce nasal airway resistance, relieve nasal congestion symptoms in patients with allergic rhinitis, suitable for the prevention and long-term treatment of children and **chronic asthma**, aspirin asthma and allergic asthma prevention and maintenance**, can also be used for the prevention of exercise-induced asthma, as well as allergic rhinitis, especially for patients with severe nasal congestion.
Abdominal pain and headache may be seen with montelukast sodium, and hypersensitivity reactions, sleep abnormalities, nausea, vomiting, dyspepsia, diarrhea, muscle cramps, and myalgia have been reported.
Under the adverse reactions of montelukast sodium label, it is clearly stated that the drug can cause mental disorders, including anxiety, depression, decreased concentration, insomnia, hallucinations, memory impairment, irritability, irritability, sleepwalking, tremor and even hostile emotions, aggressive behavior, and suicidal thoughts and behaviors. In addition, in September 2018, China's drug regulatory department issued a warning that the Australian drug regulatory department conducted a safety evaluation of montelukast sodium, and the results showed that montelukast sodium was associated with adverse reactions of the psychiatric system, and mental disorders such as excitement, insomnia, irritability, irritability, depression, and anxiety could occur after medication, and rare suicidal ideation and behavior may occur, especially in patients who take drugs for a long time.
Mental abnormalities caused by montelukast sodium usually occur in the initial stage of ** or when the dosage is increased, especially in children, the incidence of mental disorders is high, so in the process of medication, we must pay attention to observe the patient's mental and behavioral changes, once the above symptoms appear, the drug should be stopped in time to seek medical attention, special attention should be paid to children, it is recommended to avoid long-term use of montelukast sodium, the course of medication should be controlled in 1-3 months, and in strict accordance with the instructions for the regular dose (1 time a day, 1 tablet at a time), Do not overdose.
15 years of age and older**, 10 mg once daily at bedtime, children 1-5 years of age, 4 mg once daily, children 6-14 years of age, 5 mg once daily. For patients with allergic rhinitis, the recommended course of treatment is more than 4 weeks, and for patients with allergic asthma, the recommended course of treatment is not less than 3 months.
The drug should be subjected to human clinical trials before marketing to observe its efficacy and safety, and montelukast sodium has only been used in human clinical trials for allergic rhinitis and bronchial asthma before marketing, so its indications are only allergic rhinitis and bronchial asthma, and the efficacy and safety of the common cold are not clear, and routine use is not recommended. The common cold is caused by viral infection, is a self-limiting disease, common fever, cough, sneezing, runny nose and other symptoms, **symptomatic**, alleviate cold symptoms, at the same time should strengthen rest, appropriate hydration, maintain indoor air circulation, avoid secondary bacterial infection, generally 5-7 days can be cured.
The efficacy of oral montelukast sodium** for acute asthma exacerbations has not been established, so it is not suitable for acute asthma exacerbations alone.
When used in combination with glucocorticoids, montelukast sodium should not be abruptly substituted for inhaled or oral corticosteroids.
Aspirin can antagonize the efficacy of montelukast sodium, and aspirin or other nonsteroidal anti-inflammatory drugs should be avoided when taking montelukast sodium in aspirin-sensitive patients.
Use with caution in lactating women.