Singulair (montelukast). Composition, mechanism of action, release forms. Analogues. Indications, contraindications, instructions for use. Side effects, prices and reviews

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What is the drug Singulair ( montelukast)?

The drug can also be used for some allergic diseases, such as allergic rhinitis. It reduces allergic swelling of the upper respiratory tract, reduces mucus secretion, sneezing. In addition, recent research data indicate good experience with the use of the drug in neurodegenerative diseases, Alzheimer's, Parkinson's diseases.

The drug is known under various trade names. Singulair, montelukast, montelar, almont, singlon - all these are the names of the same drug. Depending on the manufacturer, the cost of the drug may differ. However, the active substance, form of release, indications and method of application for the listed drugs are the same.

Pharmacological group of the drug. Leukotriene antagonists

One of the mechanisms of spasm of the bronchial tree is the release of inflammatory mediators in response to contact with an allergen. Histamine and leukotrienes are usually mediators of inflammation in the bronchi. If histamines cause short-term and instantaneous bronchospasm ( narrowing of the bronchial tree), then leukotrienes can cause bronchospasm, the duration of which is several days.

Leukotriene antagonists are drugs that compete with leukotriene for binding to receptors. As a result, this mediator loses its ability to exert all influence on the bronchial tree. Thus, the respiratory system is protected from attacks of bronchial asthma mediated by leukotriene. Unfortunately, this group of drugs is not able to protect against other options for the development of bronchospasm ( for example, from the action of histamine), so patients suffering from bronchial asthma have to take other drugs.

The main active ingredient of the drug. The mechanism of action of the drug

Taking montelukast in bronchial asthma has the following effects:

• relieves spasm of smooth muscles of the bronchi and blood vessels;
• expands the bronchial tree ( this effect lasts about 2 hours);
• reduces mucus secretion;
• improves bronchial cleansing;
• reduces the migration of cellular elements of the blood ( neutrophils, leukocytes) in the region of the bronchial wall.

Forms of release of the drug Singular ( tablets 10 mg, chewable tablets 4 mg, 5 mg)

The drug is also available in the form of chewable tablets. The dosage of 5 mg is intended for ages 6 to 15 years, and tablets containing 4 mg of montelukast are used for 2 to 6 years. Chewable tablets have a round or oval shape, white color, have a pleasant smell ( cherry or other). The appearance of the tablets may vary slightly depending on the manufacturer. Chewable tablets should be taken once a day in the evening, chewing in the mouth until completely dissolved.

Are there other forms of release of the drug ( drops, solution, spray, ointment)?

The composition of various dosage forms of the drug

The composition of the Singular tablets for oral administration includes the following excipients:

• hyprolosis;
• lactose monohydrate;
• magnesium stearate;
• titanium dioxide;
• iron oxide;
• wax.

• mannitol;
• hyprolosis;
• microcrystalline cellulose;
• magnesium stearate;
• iron oxide;
• aspartame;
• cherry flavor.

Is Singulair a hormonal drug or an antibiotic?

Singulair is also not an antibiotic. Antibiotics are not used in the treatment of allergic diseases and bronchial asthma in particular. They help to cope with the bacterial flora that lives in the respiratory tract, but are not able to influence the mechanism of allergy development. That is why they should not be used in the treatment of bronchial asthma. Sometimes coughing, difficulty breathing caused by bacterial bronchitis, pneumonia, whooping cough, can mimic the symptoms of bronchial asthma. In these cases, a thorough medical examination is required. Antibiotics are sometimes prescribed for the treatment of such diseases.

Analogues of the drug Singular

There are the following groups of analogues of the drug singular:

• Direct analogues of the singular in composition. They contain the same active ingredient, but are produced by different manufacturers. The rules for using these analogues are almost completely the same.
• Glucocorticoids. They are used for bronchial asthma in the form of inhalations, they have anti-inflammatory, anti-allergic and immunosuppressive effects.
• Antihistamines. They are mainly used systemically, they can reduce the allergic manifestations of various diseases ( e.g. allergic rhinitis). Their disadvantage is the lack of effectiveness in bronchial asthma.

Singular and montelar, singleon, almont. Which is better, montelukast, singular or another generic?

Montelukast as an active ingredient is found in the following trade names of drugs:

• montelukast;
• singular;
• Montelar;
• singleon;
• almont;
• Monler;
• ectalust;
• singulex and others.

In Russian pharmacies, it is not always possible to find all existing drugs containing montelukast. Usually the patient can choose from 2 - 3 generics. It is very difficult to say for sure which of the drugs is the best in terms of price-quality ratio. It is worth noting that a generic called montelukast is several times cheaper than the original singular, and in terms of effectiveness it is quite comparable to it. The patient, knowing all the advantages and disadvantages of the original drug and generics, can make an independent decision on the purchase of a drug containing montelukast.

Singular and glucocorticoids. Singulair and Pulmicort ( budesonide). Singular and Nasonex ( mometasone)

Pulmicort is a white suspension that is supplied in single doses for inhalation through a nebulizer. A nebulizer is a drug that mixes medicine with a liquid and sprays it into the air you breathe. The active ingredient in Pulmicort is budesonide. Treatment with glucocorticoids lasts a month or more. Singulair in bronchial asthma is used for the same purpose ( prevention of acute attacks), but it is not a hormonal drug, which makes it easier to tolerate and has fewer side effects. However, the combined use of Pulmicort and Singulair is not excluded.

Severe coughing fits are the main concern of parents with whooping cough and sometimes lead to misdiagnosis ( e.g. bronchial asthma). In addition to antibiotics for whooping cough, it is necessary to use sedatives, a diet rich in vitamins, and breathing exercises. Some doctors prescribe montelukast to reduce the frequency and duration of coughing. Unfortunately, its effectiveness in whooping cough is being questioned. Sometimes breathing moist air gives better results in stopping whooping cough than using montelukast. This drug is used only for bronchial asthma, with whooping cough and other bacterial infections, it brings very little benefit.

Is cough, fever an indication for the use of Singulair?

Contraindications to the use of Singulair

Singulair is contraindicated for use in the following cases:

• Phenylketonuria. This hereditary disease is associated with a congenital lack of enzymes that process the amino acid phenylalanine. Montelukast contains this amino acid ( in the form of aspartame), therefore its use for this category of patients is prohibited.

• Serious liver disease. In severe liver diseases, the drug is excreted from the body for a very long time, which can lead to toxic damage to various systems and undesirable side effects. For moderate and mild liver damage, the drug is allowed in a reduced dose under the supervision of medical specialists.
• Childhood ( up to 2 or 6 years). The drug is available for children in the form of chewable tablets. They contain less active ingredient than conventional tablets. Chewable tablets containing 4 mg of montelukast can be taken from 2 to 6 years, and with a content of 5 mg - from 6 to 15 years. Up to 2 years, the use of the drug is prohibited.
• Pregnancy and lactation. When using the drug during pregnancy or breastfeeding, various pathologies in the fetus and infant may be observed.
• Hypersensitivity to the components of the drug. Allergy to the components of the drug is very rare. Despite this, in case of hypersensitivity, the use of the drug should be discontinued.

Can I use the drug during pregnancy and lactation?

There are no data on the use of the drug during breastfeeding in humans. It is not known if montelukast is excreted in breast milk. However, studies in rats have shown that in rodents it can actually pass into milk. Therefore, during lactation, doctors usually do not prescribe montelukast.

Can this drug be used in the treatment of children?

It should be borne in mind that the original drug is available in three dosage forms, and generics do not always fully correspond to it. Therefore, in the absence of 4 mg chewable tablets in pharmacies, the drug can only be used from 6 years of age. When treating children with Singulair, it is recommended to consult with pediatrician ( enroll) .

Can I use the drug during vaccinations in children?

It is worth noting that the drug may reduce the reliability of allergic tests, including the Mantoux test. This test is used to diagnose tuberculosis and involves the detection of a specific immune response ( redness and swelling of the skin) to the subcutaneous injection of tuberculin. When using montelukast, the immune response may be weaker, which theoretically can lead to false negative results. In order to avoid mistakes, it is necessary to warn the doctor about all the medicines that the patient is taking at the time of the allergy tests.

Instructions for use of the drug

How to take Singulair in the form of tablets?

The use of this drug usually does not require dose adjustments. As a rule, patients with liver and kidney disease take standard doses of the drug. Individual selection of dosage is necessary only in case of severe liver failure. In general, Singulair is usually well tolerated and rarely causes side effects.

Can I split a montelukast tablet?

How to use Singulair chewable tablets?

What is the duration of taking Singulair?

How quickly does the drug start to work?

How long does the singular last? Does the drug have a cumulative effect?

How to combine Singular with other drugs for the treatment of bronchial asthma?

What should I do if I missed one of the Singularity tricks?

Shelf life and storage conditions of the singular

Singulair is recommended to be stored in its original packaging in a dark, dry place out of direct sunlight. Storage temperature - room temperature, from 15 to 25 degrees. The drug should be kept out of the reach of children, as they are attracted by the pleasant taste of the tablets, which can lead to an overdose.

Side effects of the drug

• Nervous system. If any side effects occur, you should consult a doctor and, if necessary, stop using the drug.

  The effect of the drug on the central nervous system and psyche

  Singulair can really have a negative impact on the nervous system and psyche. This phenomenon is the most common side effect of the drug. Doctors recommend taking the drug at night, just before bed, in order to reduce the likelihood of developing these side effects. Negative effects on the nervous system can have different manifestations, from anxiety and agitation to hallucinations and suicidal tendencies. Unfortunately, it is impossible to predict the effect of the drug in this regard. In case of serious mental disorders, mood deterioration, depression, the drug should be discontinued and other drugs should be used to treat bronchial asthma.

  Does the drug affect the ability to drive vehicles and other mechanisms?

  It is believed that the drug does not affect the ability to drive vehicles and other mechanisms. However, it is not fully researched and does not have much clinical experience. That is why individual reactions to the drug can be unpredictable. In addition, there are cases of a negative effect of the drug on the nervous system and mental state. Therefore, when treating with montelukast, it is recommended to take precautions when driving mechanical means and transport.

  Does the drug cause addiction, addiction, withdrawal syndrome?

  Cases of dependence on montelukast have not been observed. The drug, although it has an effect on the nervous system, does not cause physical or mental dependence. This feature is important, since the drug is intended for long-term use. Compared with montelukast, hormonal drugs for the treatment of bronchial asthma ( budesonide) have a significant drawback, since their use cannot be abruptly terminated. This can lead to a deterioration in the production of one's own hormones.

  Is it possible to combine Singulair treatment with alcohol intake?

  The combination of Singulair and alcohol is not recommended, despite the fact that no particular interaction between the active ingredient of the drug and alcohol has been found. The disadvantage of taking Singular and alcohol at the same time is the increased risk of toxic effects of the drug on the liver. As you know, Singulair is almost completely excreted through the liver, which is why its use creates an increased load on this organ. Additional alcohol consumption further wears out the liver and can lead to hepatitis.

  Singular overdose

  Clinical trials have not revealed cases of drug overdose. During a five-month treatment with the drug ( when using 200 mg per day, which is 20 times the recommended dose) patients showed no symptoms of overdose. It has been proven that an overdose of montelukast can occur only at a hundredfold excess of the usual dose ( taking 1000 mg per day). Overdose is characterized by thirst, drowsiness, nausea, vomiting, and abdominal pain.

  Singularity price ( montelukast) in Russian cities

  The active substance montelukast is sold in pharmacies under various trade names. The original American drug Singular is quite expensive. Fortunately, there are various generics that have a more affordable price. So, for example, Russian-made montelukast costs 2 times cheaper and contains 2 times more tablets per package. Given that a patient with bronchial asthma must take the drug for a sufficiently long time, buying a cheaper generic brings good savings.
  The cost of regular and chewable tablets is about the same. When buying, it should be borne in mind that chewable tablets are intended for children, and regular tablets are for adults. The price of the drug may differ depending on the general price level in the region of Russia, on the cost of transporting and storing the drug. In addition, in some pharmacies drugs are sold at a significantly lower price than in others within the same city.

  The cost of various dosage forms of the drug Singular ( montelukast)
  

  City	Manufacturer, dosage forms
  	Singular ( USA), tablets 10 mg, 14 pieces	Singular ( USA), chewable tablets 5 mg, 14 pieces	Montelukast ( Russia), tablets 10 mg, 30 pieces	Montelukast ( Russia), chewable tablets 5 mg, 28 pieces
  Moscow		940 rubles	499 rubles	599 rubles
  Saint Petersburg	900 rubles	928 rubles	567 rubles	612 rubles
  Novosibirsk	1098 rubles	1017 rubles	510 rubles	627 rubles
  Ekaterinburg	1040 rubles	980 rubles	498 rubles	537 rubles
  Voronezh	1113 rubles		569 rubles	576 rubles
  Chelyabinsk	905 rubles	807 rubles		537 rubles
  Krasnoyarsk	1140 rubles	1050 rubles	625 rubles	675 rubles
  Kazan	1010 rubles		458 rubles	512 rubles
  Samara	1038 rubles	998 rubles	510 rubles	580 rubles
  Rostov-on-Don			539 rubles

  Can I buy the drug without a doctor's prescription?

  To buy a drug be it singular or its generic) requires a doctor's prescription. However, this is not due to the peculiarities of its interaction with the human body. The drug has no particularly serious contraindications or side effects. The requirement of a prescription when buying this drug is explained by the fact that the treatment of bronchial asthma requires supervision by a doctor. If necessary, only a doctor can correctly adjust the treatment regimen.

  Can I get the drug for free?

  The drug is not included in the list of essential medicines, so it cannot be obtained free of charge in the usual way. However, there is the possibility of preferential treatment at the place of permanent treatment. To do this, you must write a statement to the pulmonologist, in which the patient is undergoing therapy for bronchial asthma. Further, the issue of its free provision is decided by a special commission.

  In people who suffer from attacks of rhinitis of allergic origin, or they experience periodic exacerbations of allergic asthma, these diseases are often catalysts for the appearance of such a dangerous condition as bronchospasm. During it, there is an increased production of mucus, the lumen in the bronchi decreases. Therefore, in such a state, proper therapy is indispensable.

  One of the drugs that are designed to stop bronchospasm and prevent its development during asthma is a drug called Singular (Singlon, Ketotifen, Pulmicort - its analogues). The active substance of the drug - montelukast or montelar - blocks receptors in the respiratory center, which are responsible for the appearance of spasm in the bronchi.

  The drug Singular and its analogues (Ketotifen, Pulmicort, Singlon, Montelar) in medical sources is more common under the name Montelukast. Instructions for use says that the active substance of the drug - montelukast sodium - blocks leukotriene receptors in the respiratory center.

  The constituent elements of the drug Singular (Singlon, Ketotifen, Montelar, Pulmicor) are:

  • microcrystalline cellulose;
  • mannitol;
  • hyprolosis;
  • iron oxide;
  • flavor "cherry";
  • magnesium stearate;
  • aspartame.

  The main form of release of the drug Singular (Singlon, Ketotifen, Pulmicort, Montelukast, Montelar - its analogues that contain the same elements in their composition) - tablets. They differ in a light brown tint, there is a shell on top. Also, Singulair and its analogues can be found as pink-colored tablets.

  It is important to remember that high-quality analogues of Singulair are currently unknown. The listed analogs of Singular have in their composition a common active active substance.

  What is this drug or its analogues for?

  Under the influence of reactions in the body during bronchial asthma, such a dangerous condition as bronchospasm is formed. At the same time, mucus and sputum secretion are intensively produced, the lumen in the bronchi narrows, and the level of eosinophils rises sharply. The active substance of Singulair called montelukast or montelar stops an attack of bronchospasm by blocking effects on certain receptors in the respiratory center and organs of the respiratory system. This effect of the singular is explained by its ability to inhibit bronchostriction in people who suffer from any form of bronchial asthma.

  According to reviews, the use of the drug Singular or its analogues (ketotifen, singlelon, pulmicort, montelar, montelukast), even after the first ingestion in small volumes, blocks bronchoconstriction, eliminates bronchospasm in both adults and children. The same effect of the drug Singular describes the instructions for use.

  Also, the instructions for the use of Singulair say that a few minutes after taking the drug Singulair (Singlon, Ketotifen, Pulmicort, Montelar, Montelukast), bronchodilation occurs, lasting up to several hours.
  The main indications for the use of the drug

  Instructions for use states that Singular tablets or its analogues (Ketotifen, Pulmicort, Singlon, Montelukast, Montelar) are prescribed by doctors in such situations:

  1. As a prophylactic to prevent the development of bronchospasm in bronchial asthma in adults and children over six years of age.
  2. To prevent the occurrence of bronchospasm during physical activity in adults and children.
  3. As a drug for long-term therapy of bronchial asthma.
  4. To prevent the appearance of dangerous signs of the disease.
  5. When conducting therapy in those patients who do not tolerate the use of acetylsalicylic acid.
  6. For blocking at any time seasonal allergic rhinitis in children over six years of age and in adults.

  Solid tablets Singulair or its analogues (Ketotifen, Singlon, Pulmicort), coated on top of the shell, are necessary as a medicine for patients whose age is over 15 years.

  The instructions for use indicate that the tablets are used as an additional medicine for the treatment of asthma at all stages of the development of the disease, which is difficult to control by various inhalants.

  Singulara chewable tablets can be used for the treatment of children from the age of two, as an additional medicine. Any analogue of Singular has in its composition an identical active substance, which analogue of Singular is better, it is difficult to decide.

  The prices for other medicines also differ, some of them are much cheaper than Singulair, since the prices for this drug in different pharmacy chains vary within 1000 rubles. A cheaper drug, Montelukast, does not differ much from Singulair in its action, but at the same time its prices allow most people to buy it. The price difference for such generics is significant for many patients, and their opinions about what is better - an expensive or cheap drug, also differ.

  Application features

  In the predominant number of situations, Singulair is taken once a day, regardless of when the food was taken. Singulara tablets are taken only inside. For those people who suffer from bronchial asthma, the use of the drug is recommended at bedtime. Replacing Singular with its counterpart does not diminish the health benefits. Instructions for use indicate that for each age group the dosage of the drug is different:

  • for children from 6 to 14 years of age, the recommended dosage of the drug is 5 mg once a day;
  • for adults and children over 15 years of age, the required dose of the drug is 10 mg per day (one solid tablet).

  A day after the start of taking the pill, a pronounced therapeutic effect is observed, this is also confirmed by multiple reviews.

  It must be remembered that in the presence of bronchial asthma, tablets or their analogues (Ketotifen, Singlon, Pulmicort) must be used not only to stop asthma attacks, but also at a time when the disease is in remission. This will make it possible to control the symptoms of the disease.

  Drug analogues

  To date, there are no high-quality analogues of the drug, which have an absolutely identical composition. But there are analogues that are similar in their therapeutic effect. The most common analogues of Singular are Ketotifen, Pulmicort, Singlon, Lukast.

  All these drugs - Singlon, Ketotifen, Pulmicort and others are used by patients as adjuvants for the treatment of bronchial asthma, preventing the development of bronchospasm, and preventing serious complications of the disease. The mechanism of action of these drugs practically does not differ from the mechanism of action of Singular.

  The main contraindications to the use of Singular

  Among the main contraindications of the drug are the following:

  • hypersensitivity or individual intolerance to any of the active substances of the agent;
  • tablets are not prescribed until the age of two;
  • solid tablets are not prescribed until 15 years of age.

  According to the reviews, this medication is well tolerated by patients without causing any side effects.

  But sometimes (very rarely) when using this medication, or when its analogue is used, conditions such as:

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  Often such manifestations go away on their own after discontinuation of the drug. For women during the period of bearing a child and during breastfeeding, the medication is prescribed only when comparing the pros and cons. He is appointed only by a doctor after a preliminary examination and examination. When therapy is carried out, you should not feed the baby with breast milk.

  During laboratory studies of the drug, no signs of overdose were found. There have been isolated cases of acute overdose with oral administration of more than 1000 milligrams per day.

  When used with some antidepressants, the effectiveness of the drug may decrease. If the use of the drug occurs in parallel with inhalers, Singulair has an additional therapeutic effect. But the replacement of inhalers with this medicine is not carried out. With an attack of acute asthma, the effectiveness of this medication has not been proven.

  The drug related to leukotriene receptor antagonists is Singulair. The instructions for use indicate that these 5 mg and 10 mg, 4 mg chewable tablets are called Montelukast in international medicine. Pulmonologists show in their reviews that the medicine helps in the treatment of bronchial asthma and allergic rhinitis.

  Release form and composition

  The drug Singulair is available in the form of chewable tablets, convex on both sides, pink. On one side of the tablet, the name of the drug is engraved in Latin letters. Tablets are packed in blisters of 7 pieces, 1-4 blisters in a cardboard box with instructions attached.

  Each tablet contains 4 or 5 mg of the active ingredient montelukast sodium, as well as a number of auxiliary components, including aspartame and cherry flavor.

  10 mg film-coated tablets are also produced.

  pharmachologic effect

  Under the action of leukotriene-mediated effects in bronchial asthma, the mechanism of bronchospasm is triggered, sputum is formed, bronchial patency decreases and the concentration of eosinophils increases. Montelukast has a blocking effect on cysteinyl leukotriene receptors in the respiratory system.

  This action occurs due to the ability of Singular to inhibit bronchoconstriction in patients suffering from bronchial asthma. Even small doses of the drug can block bronchoconstrictions that are caused by LTD4.

  A few minutes after taking, bronchodilation occurs, the duration of which reaches two hours. The drug is able to stop bronchospasm in the early and late stages, reducing the response to antigens.

  Indications for use

  What helps Singulair? Tablets are used for:

  • prevention of bronchospasm due to heavy physical exertion;
  • relief of allergic rhinitis;
  • therapy of bronchial asthma in case of hypersensitivity to acetylsalicylic acid;
  • prevention and long-term treatment of bronchial asthma;
  • prevention of asthma in children aged 2-5 years, caused by physical activity.

  Instructions for use

  Singulair film-coated tablets

  The drug is taken orally 1 time per day, regardless of the meal. For the treatment of bronchial asthma, Singulair should be taken in the evening. In the treatment of allergic rhinitis, the drug can be taken at any time of the day. With combined pathology (bronchial asthma and allergic rhinitis), the drug should be taken in the evening.

  Adults and adolescents aged 15 years and older are prescribed the drug at a dose of 10 mg (1 coated tablet) per day.

  Chewable tablets

  Inside 1 time per day, regardless of the meal. For the treatment of bronchial asthma, Singulair should be taken in the evening. In the treatment of allergic rhinitis, the drug can be taken at any time of the day at the request of the patient. Patients with bronchial asthma and allergic rhinitis should take 1 tablet of Singulair 1 time per day in the evening.

  Children aged 6 to 14 years are prescribed at a dose of 5 mg (1 chewable tablet) per day. No dose adjustment is required for this age group. Children aged 2 to 5 years are prescribed at a dose of 4 mg (1 chewable tablet) per day.

  The therapeutic effect of the drug Singulair on indicators reflecting the course of bronchial asthma develops during the first day. The patient should continue to take Singular both during the period of achieving control of the symptoms of bronchial asthma, and during periods of exacerbation of bronchial asthma.

  For elderly patients, patients with renal insufficiency, as well as patients with mild or moderate hepatic impairment, and also depending on gender, a special dose selection is not required. Appointment of the drug Singulair simultaneously with other types of treatment of bronchial asthma The drug can be added to the patient's treatment with bronchodilators and inhaled glucocorticosteroids (GCS).

  Contraindications

  • hypersensitivity to the components of Singulair;
  • age up to 2 years.
  • Additionally for chewable tablets:
  • phenylketonuria;
  • age up to 6 years (for chewable tablets 5 mg).

  Additionally for coated tablets:

  • age up to 15 years;
  • syndrome of glucose-galactose malabsorption, lactase deficiency, lactose intolerance.

  The use of Singular during pregnancy and breastfeeding is possible only if the expected effect of therapy for the mother outweighs the potential threat to the fetus or child.

  Side effects

  In general, the drug is normally tolerated by patients, however, against the background of long-term use of tablets in children with increased individual sensitivity to the components of the drug, side effects may develop from:

  • organs of the respiratory system - the development of inflammatory diseases of the respiratory organs caused by a viral, infectious and fungal nature;
  • cardiovascular system - shortness of breath, palpitations, a feeling of lack of air, pain behind the sternum;
  • nervous system - dizziness, lethargy, apathy, drowsiness, a feeling of crawling on the skin, in rare cases, the development of a convulsive syndrome;
  • psyche - aggression, isolation, depression, walking in a dream, somnambulism, memory impairment, anxiety, unreasonable feeling of fear;
  • liver - increased activity of hepatic transaminases, pain in the right hypochondrium, hepatitis, cholecystitis;
  • circulatory system - weakening of the strength of the vascular wall, a tendency to bleeding;
  • skin - rash, small petechial hemorrhages under the skin, hematomas, skin itching, scratching;
  • allergic reactions - the development of angioedema and anaphylactic shock;
  • digestive organs - stomach pain, inflammation of the pancreas (reactive pancreatitis), nausea, vomiting, upset stool, flatulence.

  As a side effect while taking the drug Singulair in children, enuresis (urinary incontinence) may occur, which disappears after discontinuation of therapy on its own.

  Children, during pregnancy and lactation

  Singulair should be used during pregnancy and lactation only in cases where the expected benefit to the mother outweighs the potential risk to the fetus or child.

  Use in children

  Contraindicated in the form of chewable tablets for children under the age of 2 years, for coated tablets - under the age of 6 years. For children aged 2 to 5 years with bronchial asthma and / or allergic rhinitis, the dose is 4 mg (1 chewable tablet) per day. Children aged 6 to 14 years are prescribed at a dose of 5 mg (1 chewable tablet) per day. No dose adjustment is required for this age group.

  special instructions

  The drug should be continued during the period of reducing the symptoms of bronchial asthma, and during an exacerbation of the disease. Singular tablets should not be prescribed for the treatment of acute attacks of bronchial asthma. If you are allergic to acetylsalicylic acid and other NSAIDs, these drugs should not be taken during treatment with Singulair.

  drug interaction

  It is acceptable to prescribe with other drugs that are used for the prevention or long-term treatment of asthma.

  With caution, this agent must be administered in conjunction with CYP 3A4, 2C9 and 2C8 blockers.

  The systemic exposure of montelukast increases 4.4 times when combined with gemfibrozil. Dosage adjustment is not required, but the doctor must take into account the possibility of adverse reactions.

  If treatment with bronchodilators is not effective, Singulair can be added to therapy. When the desired effect is achieved, the dose of bronchodilators can be gradually reduced.

  The drug also allows you to achieve an additional therapeutic effect in patients who use inhaled corticosteroids. When the condition stabilizes, the dose of corticosteroids can be reduced. But this should be done gradually and under the supervision of a specialist. In some cases, the reception can be canceled completely. Abrupt changes in therapy are not recommended.

  Analogues of the drug Singulair

  According to the structure, analogues are determined:

  1. Montelukast sodium amorphous.
  2. Singlon.
  3. Syngulex.
  4. Moncasta.

  Holiday conditions and price

  The average cost of Singulair (tablets 10 mg No. 28) in Moscow is 1686 rubles. Released by prescription.

  Store in a place protected from light and moisture at temperatures up to 30 C. Keep away from children. Shelf life: chewable tablets - 2 years, coated tablets - 3 years.

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  MCC, iron oxide red, cherry flavor, magnesium stearate.

  Pink 5 mg tablets contain the following excipients: mannitol, iron oxide red, hyprolose, aspartame, croscarmellose sodium, cherry flavor, MCC, magnesium stearate.

  Coated tablets 10 mg include such additional components as croscarmellose sodium, MCC, magnesium stearate, lactose, hyprolose. Shell composition: red iron oxide, yellow iron oxide, hyprolose, titanium dioxide, hypromellose, carnauba wax.

  Release form

  Chewable tablets in dosages of 10, 5 and 4 mg.

  pharmachologic effect

  Blocker leukotriene receptors. The tool is used for obstructive respiratory diseases.

  Pharmacodynamics and pharmacokinetics

  The active substance of the drug blocks cysteinyl leukotriene receptor respiratory tract. It inhibits bronchospasm caused by leukotriene LTD4 , when .

  calls bronchodilation within a couple of hours after taking.

  The drug is rapidly absorbed after oral administration. When taking the usual dosages of 10 mg, the maximum plasma concentration is reached after 3 hours. Bioavailability 64%. The product is safe and effective regardless of meals.

  In the case of taking 5 mg tablets after ingestion on an empty stomach, the maximum concentration is reached after 2 hours. Bioavailability in this case is 73%, it decreases by 10% when taken with meals.

  Tablets of 4 mg are indicated for children 2-5 years old. The maximum concentration is reached after 2 hours.

  About 99% of the active substance binds to proteins. Actively metabolized. Main in - cytochrome P450 2C8 . Participation in the therapeutic effect is minimal.

  Clearance active substance from plasma approximately 45 ml / min. Excreted in the bile almost completely along with metabolites .

  Indications for use

  Tablets are used for:

  • therapy in case of hypersensitivity to acetylsalicylic acid ;
  • prevention and long-term treatment bronchial asthma ;
  • warnings bronchospasm due to heavy physical exertion;
  • prevention asthma in children aged 2-5 years, caused by physical activity;
  • for relax .

  Contraindications

  This drug should not be taken with hypersensitivity to its components. Not intended for children under 2 years of age.

  Side effects

  When taking the drug, the following negative side effects may appear:

  • : , anaphylaxis , rash, ;
  • digestive system: nausea, pain in the abdomen, vomiting,;
  • nervous system: nightmares, excessive agitation or fatigue, hypoesthesia , increased irritability, aggressive behavior, lethargy;
  • musculoskeletal system: myalgia , arthralgia ;
  • hepatobiliary system: level up transaminases , hepatitis ;
  • others: increased likelihood of subcutaneous hemorrhages and increased bleeding, increased heart rate, thirst, discomfort,.

  In rare cases it is possible eosinophilic infiltrates liver, suicidal tendencies and seizures.

  In general, the drug is well tolerated. Side effects, as a rule, do not require discontinuation of therapy.

  Instructions for use Singular (Method and dosage)

  The use of the drug for children is indicated under the supervision of adults.

  When allergic rhinitis And asthma The instructions for Singulair say that you need to take 1 tablet of 4 mg once a day. To alleviate symptoms allergic rhinitis the scheme of reception is selected individually.

  At asthma for children 2-5 years old, the drug is given one 4 mg chewable tablet every day in the evening.

  The therapeutic effect when taking the medicine is achieved within a day. It is recommended to continue taking the tablets even if control is achieved. asthma .

  The use of the drug as an alternative means of low-dose inhaled corticosteroids for children with persistent asthma a mild degree is possible only if there have been no serious attacks recently asthma who required admission corticosteroids and if patients cannot use . The patient's condition must be periodically assessed. If the desired effect is not achieved, you need to consider another or additional anti-inflammatory therapy.

  For those who are going to take Singulair tablets, the instructions for use say that they can be added to bronchodilators .

  For the purpose of prevention bronchospasm , which is provoked by physical activity, the patient's condition should be assessed after 2-4 weeks of using the drug. If there is not sufficient effect, additional or other treatment should be considered.

  Instructions for use of Singular for adult patients and children from 15 years of age inform that they need to take the medicine every day at a dosage of 10 mg 1 time. Children 6-14 years old are prescribed 5 mg per day.

  Overdose

  In most reports of overdose, no adverse events were observed. Possible adverse reactions that correspond to the safety profile of the drug: , abdominal pain, thirst, vomiting, psychomotor hyperactivity . Therapy is symptomatic.

  Interaction

  It is acceptable to prescribe with other means that are used for the purpose of prevention or long-term treatment asthma .

  With caution, this drug must be administered in conjunction with CYP 3A4 blockers , 2C9 And 2C8 .

  Systemic exposure montelukast increases 4.4 times when combined with Gemfibrozil . Dosage adjustment is not required, but the doctor must take into account the possibility of adverse reactions.

  If treatment bronchodilators not effective, Singulair can be added to therapy. When the desired effect is achieved, the dose bronchodilators can be gradually reduced.

  The drug also allows you to achieve an additional therapeutic effect in patients who use inhaled corticosteroids . When the condition stabilizes, the dose corticosteroids can be reduced. But this should be done gradually and under the supervision of a specialist. In some cases, the reception can be canceled completely. Abrupt changes in therapy are not recommended.

  Terms of sale

  The medicine is sold in the pharmacy network by prescription.

  Storage conditions

  The medicine should be kept in a dark and dry place. The temperature is not higher than 30°C. You need to make sure that the drug is not available for children.

  Best before date

  Coated tablets should be stored for no longer than three years; for chewable tablets, the shelf life is 2 years. Do not apply after this time.

  Analogues of Singulair

  Coincidence in the ATX code of the 4th level:

  Pharmacies sell the following analogues of Singular:

  • Vansair ;
  • Glemont ;
  • Lucast ;
  • Milukant ;
  • Moncasta ;
  • Montel ;
  • Tevalukast .

  All drugs have their own nuances of use. It is impossible to use analogues of Singular without the appointment of a specialist. All of these funds have a fairly high cost. But the price of analogues of Singular is noticeably lower than the described drug. Of these, the most affordable are considered Vansair And Tevalukast .

  Singlon or Singular - which is better?

  Singlon is one of the most popular analogues of Singulair. The last drug is too expensive for many, so they try to look for substitutes for it. Questions " Singlon or Singular - which is better? often seen on the forums. Those who have tried both means write that they did not notice the difference. Wherein Singlon two times cheaper.

  Doctors report that there is still a difference in effectiveness and in most cases it is better to take Singulair, but if it is necessary to replace it, then it is advisable to start taking it Singlon .

  Or asthma, leukotriene-mediated effects trigger the bronchospasm mechanism. At the same time, active sputum production begins, bronchial patency decreases. The number of eosinophils increases.

  Necessary Therapy

  This state of affairs cannot be left unattended. It is necessary to block the cysteinyl leukotriene receptors located in the respiratory organs. Preparations with the active substance montelukast are able to bind to special substances and inhibit the bronchoconstriction process that occurs in people suffering from asthma.

  The most famous drug with the specified active ingredient is Singulair. The instruction (reviews about the remedy only confirm this) says that it is able to suppress bronchospasm at any stage. In this case, the effect appears even when taking low doses of the drug. After taking the remedy, the process of expanding the lumen of the bronchi begins.

  The specified Italian drug is produced in the form of chewable or coated tablets, on one side of which must be the inscription MSD 275 or MSD 117, and on the other - SINGULAIR. In the first tablets, the dosage of montelukast sodium is 5.2 mg, in the second - 10.4 mg.

  Indications for prescribing

  

  Tablets "Singulair" refers to They prevent bronchospasm, which can develop when inhaled cysteinyl leukotriene LTD 4.

  Assign as a prophylactic or therapeutic agent "Singulair". The drug is used to prevent the development or long-term treatment of bronchial asthma, including for:

  Prevention of the occurrence of nocturnal or daytime symptoms of the disease;

  Prevention of the development of bronchospasm during exercise;

  Treatment of patients with identified sensitivity to acetylsalicylic acid.

  The therapeutic effect is achieved already on the first day of taking the "Singulair". The drug can be drunk both during the period of exacerbation of asthma, and during the period of reduction of its manifestations. It can be used simultaneously with other bronchodilators and inhaled glucosteroids.

  The cost of the drug and possible substitutes

  Despite the high effectiveness of the drug and its indispensability for certain people, many doubt and think whether it is worth buying it. The reason for such fluctuations is the cost of the Singulair. The price of a package containing 14 tablets is about 1000 rubles. In this case, the prescribed dosage does not affect the cost. The price of tablets containing 4, 5 or 10 mg of montelukast is practically the same. In some pharmacies they can be found for 864, but there are those in which they cost 1045 rubles.

  

  Having learned about the cost of this drug, many begin to look for analogues of Singulair. On sale now there are several types of products, the active ingredient in which is montelukast. At the same time, some of them are noticeably cheaper than the main drug, although their composition does not differ significantly.

  Possible substitutes include such funds as Singlon, Montelast, Ektalust, Montelar.

  Features of the active substance

  All analogues of "Singular" are identical means. Indeed, in all tablets, the main component is montelukast. Regardless of the trade name of the drug, the active substance in it is rapidly absorbed from the gastrointestinal tract.

  At the same time, the instructions for the drug "Singulair" indicate that the intake of ordinary food does not affect the effectiveness of the medication. When using 5 mg chewable tablets on an empty stomach in adults, the maximum concentration of the drug in the blood plasma occurs after 2 hours. And for coated tablets at a dosage of 10 mg, this period is 3 hours.

  Montelukast is metabolized in the liver. It is completely excreted from the body with feces for 5 days. This confirms that this drug is excreted in the bile.

  The drug "Singlon"

  This remedy is available in the form of chewable tablets. The concentration of the active substance can be 4.16 or 5.2 mg. Tablets are lenticular in shape, they are pale yellow in color, with a pronounced smell of cherries. These tablets are produced by Gideon Richter Poland.

  

  Many people want to figure out what to buy - "Singlon" or "Singular"? What's better? It's hard to choose. After all, in these drugs the same active substance. They differ only in the concentration of the dye and the substance mannitol. The dosage of the main active and other auxiliary components in these preparations is absolutely the same.

  As with the use of the "Singular" remedy, when using the "Singlon" preparation, a day is enough for the onset of a therapeutic effect. But it is recommended to take the drug both during remission and during exacerbation of asthma.

  Features of taking drugs

  According to the instructions for the "Singulair" tool, the tablets must be taken 1 time per day, not focusing on food intake. The only thing that matters is the timing of the drug. For example, if you need to treat asthma, doctors recommend taking it at night. And to get rid of allergic rhinitis, you can drink it at any convenient time. If the patient suffers from both asthma and a runny nose, then it is better to transfer the time of admission to the evening hours.

  

  Children aged 2 to 5 years are prescribed the indicated drug or analogues of Singulair at a dosage of 4 mg / day. No special dose selection is required. From the age of 6 to 14 years, you need to take a 5 mg tablet every day. But adolescents over 15 years of age and adult patients should drink a different form of the drug. They need coated tablets. The concentration of the active substance in them is 10 mg.

  By the way, the instructions for the drug "Singlon" indicate that it is necessary to drink it on an empty stomach. This should be done 1 hour before a meal or 2 hours after a meal. The same is indicated in the instructions for the Montelast tablets.

  Cost of funds

  All drugs in which the main active ingredient is montelukast prevent the development of bronchospasm. Often doctors do not prescribe a specific drug. They say that it is necessary to use medicines that contain montelukast. Patients themselves can choose whether to buy them "Singlon" or "Singular". Which is better, you have to find out yourself. Also, the patient can buy other analogues - Montelast, Ektalust, Montelar.

  

  These medicines are produced by different manufacturers. This is one of the reasons for such a significant difference in cost. One of the most expensive is the Singulair tool. The price for a package of 14 tablets is about 1000 rubles. More affordable is the tool "Singlon". A pack of 28 tablets costs about 760 rubles. Approximately the same price for the drug "Montelast". But on sale you can also find packages of 98 pcs. The price of such a box is about 2150 rubles. for tablets with a dosage of 4 mg, and about 2500 rubles. - for a dosage of 10 mg.

  The drug "Ektalust" is produced in the form of chewable tablets of 14 pcs. packaged. It costs from 350 rubles. But the price of the Montelar tool exceeds 900 rubles. for 14 tablets, it is almost the same as for the drug "Singulair".

  Asthma does not allow the patient to be particularly picky. To prevent seizures, many patients are forced to choose the most appropriate drug and drink it both at times of deterioration and during periods of remission.