Cough variant asthma and Montelukast

[Santan]

My daughter has cough variant asthma and was prescribed montelukast for the winter. We took a break but restarted just a while ago in the summer when the cough came back, with a daily antihistamine. The doctor asked us to do ventolin and pulmicort nebilizations whenever she catches a cold. She was doing well on montelukast but now she has caught a cold and back to nebulizations. Is it normal to still catch colds of the same intensity while being on montelukast? It seems like montelukast is no longer working ever since the cold started.

As in she has started the persistent coughing with this cold while we continue montelukast.

Yes. A common trigger for asthma is catching a cold. So with cough variant, there will be greater chances of coughing/attacks. If you’re on Montelukast, the coughing will be milder than it would have been if you hadn’t been taking it.

Montelukast is a preventative that works best if taken continuously every day as it needs to build up to a therapeutic level in your system and then maintained- so not sure what you meant by “we took a break but restarted just awhile ago in the summer when the cough came back”…if this means you stopped the Montelukast, then that’s the reason the coughing has come back and also why it doesn’t seem to be helping much during a cold. You need to not stop the Montelukast when her coughing subsides as that means her asthma is now better controlled because of the Montelukast.

(My youngest has cough variant asthma and was on Montelukast from 6mos to 9yrs old. Her asthma got a lot milder as she grew older)

@Discovereads Thank you for your message! Would the cough increase for a while after albuterol inhalation?...hers does for a good 20 mins before calming down...gets me all worried

It shouldn’t get worse with albuterol, but it can take several doses and 20min (or longer) to calm a coughing attack. But should still not be seeing a worsening.

Are you using a spacer? Only thing I can think of is if the inhaler medication hits the back of the throat, it can irritate and set off a bit of coughing. So she really needs to do a big inhale when taking it to get the medication direct to her lungs.