Singulair: an oral asthma medication

The Facts Every Parent Should Know

Singulair is a prescribed medication used to treat and prevent chronic asthma for children as young as twelve months old. It comes as a regular tablet; a chewable tablet; or an oral granule which can be sprinkled onto ice cream, applesauce, mashed carrots, baby formula or mixed into breast milk.

Do not use any other liquids. It is also best recommended for children who have allergies.

However, parents must be wary of the side effects it may cause:

The most common side effects include: fevers, pharyngitis or raw throat, coughing, stomach pain, upper respiratory infection, diarrhea, ear infection, influenza, running nose, and sinus infection.

There are also reports about changes in behaviour and mood while taking Sinclair: aggressive behaviour, bad dreams, dejection, awkwardness, anxiety, sleepwalking, hallucination, restlessness, irritability, suicidal thoughts, tremor and sleeplessness. Consult a health practitioner at once should your child suffer from any of these symptoms while taking Singulair.

Sometimes, people who stopped or lowered their steroid medicine intake by mouth, and take Singulair may increase the count of certain white blood cells, and blood vessels all over the body.

Other side effects with Singulair are: increased bleeding tendency; inflammation of the face, tongue, lips and/or throat that might cause trouble in breathing or swallowing; hives and itching; giddiness, lethargy, numbness or lack of sensation, seizures; palpitations; nosebleed, stuffy nose; diarrhea; heartburn, indigestion; nausea; stomach upset; vomiting; hepatitis; bruising; rash; muscle aches, pain in joints, muscle cramps; tiredness and swelling.

People with phenylketonuria, or any other medical conditions that requires you to limit or avoid aspartame must avoid its cherry chewable tablets as it contains aspartame.

Always discuss with your doctor if you are taking other medical or herbal drugs. It may increase your risk of side-effects or hamper the effectiveness of your medication. It is of utmost importance to always consult your doctor before discontinuing the medication, as it may make your child’s asthma worse if not done properly.

Some side effects of Singulair may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Get emergency medical help if you have any of these signs of an allergic reaction while taking montelukast (the active ingredient contained in Singulair) hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

·         skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

·         mood or behavior changes, anxiety, depression, or thoughts about suicide or hurting yourself;

·         tremors or shaking;

·         easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

·         severe sinus pain, swelling, or irritation;

·         worsening asthma symptoms; or

·         severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects of montelukast may include:

·         headache;

·         stomach pain, heartburn, upset stomach, nausea, diarrhea;

·         tooth pain;

·         tired feeling;

·         fever, stuffy nose, sore throat, cough, hoarseness; or

·         mild rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Nervous system

Nervous system side effects have included headache (18% to 20%) and dizziness (2%). Isolated and rare reports of somnolence have been associated with the use of higher than recommended doses. Seizures have been reported very rarely. Paresthesias, hypoesthesia, and drowsiness and have been reported in postmarketing experiences.

Respiratory

Respiratory system side effects have included influenza (4%), cough (3%), and nasal congestion (2%). In some studies, upper respiratory tract infection (28%) and worsened asthma (4% to 11%) were associated with the use of this drug. However, many patients with asthma have some or all of these symptoms, and a causal relationship has not been proven. Rhinorrhea, sinusitis, otitis, influenza, epistaxis, and pneumonia have also been reported.

Gastrointestinal

Gastrointestinal side effects have included abdominal pain, dyspepsia, or infectious gastroenteritis in up to 3% of patients. Diarrhea has been associated with the use of higher than recommended doses.

General

In general, montelukast (the active ingredient contained in Singulair) is well tolerated. Asthenia, fatigue, or fever has been associated with the use of this drug in approximately 2% of patients. Varicella has also been reported.

Dermatologic

Dermatologic side effects have included rash, eczema, urticaria, and dermatitis. Postmarketing experience has included erythema multiform.

Churg-Strauss syndrome has been reported in association with montelukast therapy.

Hepatic

Postmarketing experience has reported rare cases of cholestatic hepatitis, hepatocellular liver injury and mixed pattern liver injury.

Hepatic side effects have included elevated hepatic serum transaminases in approximately 2% of patients. Pancreatitis has been reported very rarely. Jaundice with elevated liver enzymes are described in a 42 year old man several months after starting montelukast therapy. Serum enzymes completely normalized 4 months after drug withdrawal.

Other

Churg-Strauss syndrome is a rare granulomatous eosinophilic condition that involves the upper and lower airways and manifests as rhinitis, sinusitis and asthma. If untreated the syndrome may progress to systemic vasculitis, peripheral neuropathy and potentially fatal cardiac complications. In most cases, the condition emerged during withdrawal of oral corticosteroid therapy. A causative role for leukotriene receptor antagonists has not been ruled out.

Other side effects have included isolated cases of Churg-Strauss syndrome, a rare systemic vasculitis associated with asthma.

Musculoskeletal

Musculoskeletal side effects have included myalgia, muscle cramps, and muscle aches. Postmarketing experience has reported arthralgia.

Hematologic

Hematologic side effects have included increased bleeding tendencies and bruising. Thrombocytopenia has also been reported.

Ocular

Ocular side effects have included conjunctivitis.

Psychiatric

Psychiatric side effects have included agitation including aggressive behavior, anxiousness, dream abnormalities and hallucinations, depression, insomnia, irritability, restlessness, suicidal thinking and behavior (including suicide), and tremor. Postmarketing reports include agitation, hostility, insomnia, and somnambulism.

Hypersensitivity

Hypersensitivity side effects have included anaphylaxis, erythema nodosum, pruritus, urticaria, and very rarely hepatic eosinophilic infiltration. Postmarketing reports have included angioedema.

If you are currently taking prescription medication for your symptoms and are interested in building more health and perhaps getting off your medication by addressing the cause of your health concern, please call the office and let us discuss your options.  I will work with your medical doctor to restore your health and reduce or eliminate the need for medication.

Dr. Huntoon has a single mission:

To support as many people as possible in their quest for health and enable them to improve and maintain their health to the highest level possible, while educating them about the benefits of Chiropractic, Natural Healthcare and Holistic Living, so they in turn can teach others to support us having a healthy community.

Your Choice

• Continue doing the same thing and nothing changes or it may get worse

OR

• Try something different and get a different result that makes you happier and healthier.