Montelukast


ATC CODE

  • R03DC03

INDICATION

  • Chronic management of severe uncontrolled asthma.

NEMLC RECOMMENDATION

  • Approved - for use in:
    • In adults (>12 years) with difficult to control asthma despite receiving high dose inhaled steroids and long-acting β2 agonist, a trial of low dose sustained release theophylline should be tried before use of montelukast. If there is no response to low dose theophylline, a 2-week trial of montelukast may be used.
    • In children between 6 and 12 years of age with severe uncontrolled asthma despite being on high dose corticosteroids and long acting β2 agonist, a 2-week trial of montelukast could be considered.

In children less than 6 years with severe uncontrolled asthma on high dose inhaled corticosteroids, a 2-week trial of montelukast could be considered. If no benefit can be demonstrated after this period, montelukast should be discontinued.

REVIEW INDICATORS

  • Properly randomized efficacy and safety comparative studies of LTRA, low dose sustained release theophyllines and long acting beta2 agonist at all ages

DATE RATIFIED

  • 13 March 2008