Talk to me about Montelukast

[TheSheepofWallSt]

DS (2yrs) has just been prescribed Montelukast (Singulair) chewable tab (1 per evening) due to persistent viral wheeze since the start of the autumn, which worsens significantly with each cold.

He's also on Salbutamol inhalers (as and when) which make a small difference.

He has a history of poor upper respiratory health - last winter I think 6 or 7 bouts of tonsillitis - none of that this year (yet) - it's all been chest, and we're now on round 2 of antibiotics this winter...

Worried about poss side effects of Montelukast - can anyone offer insight?

Bump..?

My daughter was on montelukast and it didn’t make any difference to her. Apparently it only works 50% of the time. I didn’t notice any side effects.

My eldest was on montelukast for about 4 years. It was the only thing that helped with his asthma which was seasonal, steroids didnt work for him. He had no problems and no side effects.

My children were some of the first children to trial Montelukast, for one it is hugely successful and it still works for her now as an adult, for the other one I might as well have given him a fruit pastille every night. In my experience it is one of those drugs that either works, or it doesn't. DD did develop awful headaches which coincided with her starting on it but they did go once she became used to the drug although she does now have migraines from time to time but I have no way of knowing if she would've developed them anyway (possibly as I suffer from them as did my sister as a child) but still the benefits of Montelukast outweigh the odd migraine.

This is the second evening I’ve given it, about 2 hours ago.

DS suddenly seems to be breathing easier, slightly less breathless, and his tracheal tug has definitely eased up... can’t tell if it’s the montelukast, but it’s the first time in 36 hours I haven’t felt DS was on the verge of needing A&E attention...

Game changer for us. Ds3 has been on it for 7 years and his asthma is really well controlled. It is noticeable if we have a gap between boxes.

I thought I'd reply though not a child, when I was started on montelukast in my 20's it was an absolute life changer the impact its had is amazing, when pregnant I couldn't have it and really suffered and was in hospital twice for asthma exacerbation. I've never found any side effects.

I do also know a friend who's 3 year old was put on it after 10 days in hospital with pneumonia he was prem and has ongoing respiratory problems she found it massively helped reduced allergy exacerbations.

My son has it after a horrendous reaction to beclametasone inhaler.
It's stopped him coughing.
The only thing I would say is so try and have a break between the last meal and admin of the tablet as it can cause diarrhoea otherwise (1 hour gap works fine for us).
I was always taught as a HCP that tracheal tug was a dangerous sign.

Should add that he takes 2 puffs of seretide twice a day as well.

@BlueUggs

Re: tug/ recessions - Yes me too- but now 2 GPs and an ambulance crew (sent by 111) have all seen it and because his SATs are fine, hes lively, he’s pink and well perfused, nobody is bothered (though I am on pins). It’s slight (as is the recessing around his ribs), but he is notably breathless and slightly wheezy- so Im monitoring closely. Any signs of lethargy, bluish hue, or deterioration at all and we’re going to a&e - GPs telling me to “wait it out” be damned.

Game changer for us as well. No side effects but cough due to allergic asthma gone.

DS much better now he's asleep - normal respiratory rate, good colour, no recessions ... temp is down (though had calpol and ibuprofen) ... can't tell if its Montelukast, successful administration of salbutamol or Antibiotics making a difference - but such a relief to have a little respite

Hoping it is the Montelukast and crossing fingers for no side effects...

I tried it as a child and again as an adult. Both times it worked wonders for my asthma, but made me extremely depressed and miserable. This is a known side effect

Worked wonders for my child after inhalers stopped being effective. No side effects either.

My DD was on montelukast and it worked very well on her. Interesting what you are saying about respiratory infections and tonsillitis as my DD kept on having pneumonia and bronchiolitis (and Viral-induced wheeze) and after many hospitalizations, she was diagnosed with aspiration on thin fluids. All her liquids had to be thickened, she hated it as she was getting older. She also had grade 4 tonsils which they didn't want to remove as it is apparently unrelated. Last year her consultant agreed to have them removed and since then EVERYTHING is perfect, she had a swallow study and can swallow perfectly and NO wheeze. This winter she has not even had 1 cold or cough!! I used to think her lungs are made out of paper and full of gunk but she is perfectly strong and has much more energy now.
Just telling you that you can keep an eye, we saw some amazing consultants privately and I felt that they were really clear and knew what they were talking about when discussing the wheeze.

Montelukast was a game changer for my dd. She was in and out of gps and PAU for two winters and I lived on the edge every night listening to her cough. Montelukast has made her stable. Totally game changer.

Good luck!

Be careful it has some terrible psychological side effects that are just really coming to light.
Google it

@christmaschristmaschristmas

I did- hence the question. Hard to gauge prevalence, as people much more likely to write about negative effects, than benign or good,
Also difficult to know how much side effects are underreported- given the effects could be written off by parents/ GPs as unrelated, and within the “normal” range of toddler behaviour.

Can I ask- have you had personal experiences with the drug?

My son was on it for 6 months. He started them at 15 months old. They turned him very aggressive, affected his sleep horrendously and i ended up stopping them. He is autistic so i expect some of the behaviours but the montelukast affected him horribly

My son was prescribed this age 4, we didn't have a great experience, he developed insomnia almost instantly, complained of headaches almost constantly and became really, really aggressive (to the point of being called in to school). The GP was quick to dismiss it all and put the blame on starting school, but I refused to continue with them and went back to inhalers. Sure enough he was back to himself soon enough. The seasonal aspect etc sounds identical to your son. Things improved a lot with regards to illness after his tonsillectomy, also at age 4. Now at nearly 8, I think we've had a couple of clear winters, touch wood, I think it is fairly common to grow out of it.

My DD was on it for a few months. Worked wonders for her asthma but in the end the side effects were intolerable. Almost constant stomach pain, nausea, headaches and anxiety. The side effects took several weeks to subside when she came off it. However each child seems to respond differently and some have no side effects at all so just see how it goes.

Montelukast was brilliant for my sons viral wheeze. I literally could have written your post. However the side effect of him becoming a demon from hell has meant we have taken him off it. I can not describe the change in his behaviour since he has been off it. He doesn’t push other children or become aggressive very quickly. We are managing his wheeze with his salbutamol when he has a cold/cough etc.

As a side note my little boy is a neonatal abstinence syndrome baby so I don’t know if that makes a difference to how he responds to drugs.

This is all really interesting- esp as GP said it’s “very well tolerated”...

Am torn every time I give it to him- feel very stuck between a rock and a hard place

Well.
That was DS first ever nightmare ....
an hour it’s taken me to get him back off to sleep