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Leukotriene receptor antagonists

Generic name Brand name
___ montelukast Singulair®
___ zafirlukast Accolate®

How does this medicine work?

This medicine prevents swelling and inflammation inside the airways, which cause asthma symptoms. Because it prevents asthma symptoms, it must be given every day as prescribed by the doctor. This medicine should not be used for quick relief of asthma symptoms.

How should I give it?

___ Montelukast is usually taken once a day. It comes as a chewable tablet, a coated tablet to swallow, or a packet of granules. To give the granules, open the packet right before giving it, and give it dry with a spoon, or mix it with a small amount of:

  • unheated formula or breastmilk.
  • applesauce, mashed carrots, rice, or ice cream.

___ Zafirlukast comes as a pill and should be taken twice a day. If your child cannot swallow a pill, crush it between 2 spoons or inside a plastic bag or folded paper. Mix with a very small amount (about 1 teaspoon) of soft food such as applesauce, yogurt, ice cream, jelly, or chocolate syrup.

For either of these medicines, give the mixture right away and make sure your child takes all of it.

Are there any precautions about food or other medicines?

Montelukast can be taken with or without food.

Zafirlukast is best absorbed when taken on an empty stomach (1 hour before or 2 hours after eating).

Certain medicines interfere with zafirlukast. Consult the pharmacist or doctor if your child needs to take any of these:

  • erythromycin (EES®, ERYC®, Ery Ped®)
  • theophylline (SloBid®, Theo-Dur®)
  • warfarin (Coumadin®)

Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

What should I do if a dose is missed?

If a dose is missed, and it is prescribed once daily, take the missed dose as soon as you remember that day. For medicines that are prescribed more often, follow these guidelines:

If it is prescribed: Give it no closer than:
twice daily 6 hours from the next dose
3 times daily 3 hours from the next dose
4 times daily skip the missed dose

If it is too close to the next dose, skip the missed dose and continue with the regular schedule. Never give a double dose.

If your child vomits (throws up) within 30 minutes after receiving a dose, give it again. If your child vomits the second dose, do not repeat it again.

What are the side effects of this medicine?

  • diarrhea (loose bowel movements)
  • dry mouth
  • headache
  • upset stomach
  • unusual dreams

When should I call the doctor?

Call the doctor right away if your child has:

  • tightness in the chest
  • worsening asthma symptoms
  • yellowing of the skin or eyes
  • rash or hives
  • numbness or tingling in hands, arms, legs, or feet
  • signs of allergic reaction:
    - rash or hives
    - wheezing
    - trouble breathing - call 911

What else do I need to know?

If your child is taking zafirlukast, the doctor may order a blood test to see how the liver is working.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child's care. Please bring the medicine container when your child comes to the clinic or emergency department.

Always make sure you have enough medicine on hand. Each time you refill your prescriptions, check to see how many refills are left. If no refills are left, the pharmacist will need 2 or 3 days to contact the clinic to renew the prescription.

Before giving the first dose, read the label. Be sure it is what was prescribed. After a refill, if the medicine looks different to you, ask your pharmacist about it before giving it.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no "take-back" program put them in the trash.

Store all medicines in their original container and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, and locked up if possible.

If too much or the wrong kind of medicine is taken, call the Poison Control Center at 1-800-222-1222. If your child is unconscious or has a seizure, call 911.


This sheet is not specific to your child but provides general information. If you have any questions, please call your clinic or pharmacy.

Last reviewed 8/2015 ©Copyright

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit

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