Idaub asked
Can I take Singulair twice in a 24 hour period? I take 10 mg in the evening so I can breathe at night but seems to wear off during the day.
At a glance
- Singular (montelukast) is only FDA-approved to be dosed once-daily.
Answer
Singulair (montelukast), an oral medication indicated for the prophylaxis and chronic treatment of asthma, as well as allergic rhinitis, is only indicated to be dosed once daily (i.e. every 24 hours).
Per the prescribing information for Singulair, the recommended (and FDA approved) dosage information is as follows:
- Singulair should be taken once daily in the evening.
- For adults and adolescents 15 years of age and older: one 10-mg tablet.
- For pediatric patients 6 to 14 years of age: one 5-mg chewable tablet.
- For pediatric patients 2 to 5 years of age: one 4-mg chewable tablet or one packet of 4-mg oral granules.
- For pediatric patients 12 to 23 months of age: one packet of 4-mg oral granules.
- For the prevention of exercise-induced bronchospasm: 10 mg once, at least 2 hours before exercise.
Neither the Guidelines for the Diagnosis and Management of Asthma nor the Pharmacologic Treatment of Seasonal Allergic Rhinitis guidelines recommends that Singulair be dosed more than once daily.
Additionally, there have been studies evaluating higher Singulair doses, but efficacy doesn't appear to increase with doses above 10 mg per day.
If you aren't getting proper symptom control from Singulair once daily, you should discuss options with your doctor, which include adding on an antihistamine (such as Claritin), or a nasal/inhaled corticosteroid.
Below is some additional information regarding Singulair
What Is Singulair?
Singulair, classified as a leukotriene antagonist, is indicated for:
- Allergic rhinitis
- Asthma
- Exercise-induced bronchospasm
Unlike antihistamines, which block the binding of histamine to their respective receptors, Singulair blocks the binding of leukotrienes. Leukotrienes are well known to be involved in the pathophysiology of asthma.
The various effects of leukotrienes in the body include:
- Stimulation of inflammatory mediators
- Increased airway edema
- Smooth muscle contraction
- Increased mucus
- Causing nasal symptoms (e.g. sneezing, nasal itching and congestion)
Singulair, by blocking the binding of leukotrienes to their receptors, helps to reduce the above effects.
References
- Singulair Prescribing Information. Merck
- Montelukast adult (10-mg film-coated tablet) and pediatric (5-mg chewable tablet) dose selections. Journal of Allergy and Clinical Immunology
- Montelukast, a once-daily leukotriene receptor antagonist, in the treatment of chronic asthma: a multicenter, randomized, double-blind trial. Montelukast Clinical Research Study Group. PubMed
- Clinical effectiveness and safety of montelukast in asthma. What are the conclusions from clinical trials and meta-analyses? PubMed
- A placebo-controlled, dose-ranging study of montelukast, a cysteinyl leukotriene-receptor antagonist. Montelukast Asthma Study Group. PubMed
