• CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:
    Prednisone

April 2024, UK MHRA -- Montelukast: reminder of the risk of neuropsychiatric reactions.
Healthcare professionals prescribing montelukast should be alert to the risk of neuropsychiatric reactions in all patients including children and adolescents. Reported neuropsychiatric reactions include sleep disorders, hallucinations, anxiety and depression, as well as changes in behaviour and mood. Healthcare professionals should advise patients and their caregivers to be alert to these risks and seek medical advice as soon as possible if neuropsychiatric reactions occur.
New boxed warnings are being added to the patient information leaflet supplied for montelukast in the UK.

FDA BLACK BOX WARNING (added April 2020)

WARNING: SERIOUS NEUROPSYCHIATRIC EVENTS

SERIOUS NEUROPSYCHIATRIC EVENTS HAVE BEEN REPORTED IN PATIENTS TAKING MONTELUKAST

DISCUSS BENEFITS AND RISKS OF MONTELUKAST WITH PATIENTS AND CAREGIVERS

MONITOR FOR NEUROPSYCHIATRIC SYMPTOMS IN PATIENTS TAKING MONTELUKAST

DISCONTINUE MONTELUKAST IMMEDIATELY IF NEUROPSYCHIATRIC SYMPTOMS OCCUR

BECAUSE THE BENEFITS OF MONTELUKAST MAY NOT OUTWEIGH THE POTENTIAL RISK OF NEUROPSYCHIATRIC SYMPTOMS IN PATIENTS WITH ALLERGIC RHINITIS, RESERVE USE FOR PATIENTS WHO HAVE AN INADEQUATE RESPONSE OR INTOLERANCE TO ALTERNATIVE THERAPIES

See full prescribing information for complete boxed warning

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Page last updated 02/18/2025

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Incidence

<1% 1‑5% 5‑10% 10‑15% 15‑20% 20‑30% >30%

Seriousness

Hospitalization possible
Life threatening
Fatal

Warnings in other populations

BreastfeedingBreast feeding

GeriatricGeriatric

PediatricPediatric