What can montelukast treat? A Guide to its Uses and Benefits

October 7, 2025 •

3 min read

Montelukast, a medication known by the brand name Singulair, was FDA-approved in 1998 and is widely used for its anti-inflammatory properties in respiratory conditions. As a leukotriene receptor antagonist, understanding what can montelukast treat is crucial for patients with specific types of asthma and allergic rhinitis.

Quick Summary

Montelukast is prescribed for the long-term management of chronic asthma, prevention of exercise-induced bronchoconstriction, and relief of seasonal and perennial allergic rhinitis symptoms. It works by blocking leukotrienes, which are inflammatory chemicals in the body.

Key Points

Treats Asthma: Montelukast is a long-term control medication used to prevent and manage chronic asthma symptoms in adults and children over 12 months old.
Prevents Exercise-Induced Bronchoconstriction: It can be used to prevent breathing difficulties triggered by exercise in individuals aged six years and older.
Relieves Allergic Rhinitis: Montelukast helps control the symptoms of seasonal and perennial allergies, such as sneezing, runny nose, and itching.
Not a Rescue Medication: It is not effective for treating sudden asthma attacks and should not be used as a substitute for a rescue inhaler.
Has Neuropsychiatric Side Effects: The FDA has issued a warning regarding potential mood changes, sleep disturbances, and suicidal thoughts, and patients should be monitored for these symptoms.
Works Differently than Other Meds: It is a leukotriene receptor antagonist, which sets it apart from inhaled steroids and antihistamines by targeting a different chemical pathway.
Sometimes Used for Urticaria: In specific cases, it can be used off-label to help manage chronic hives, especially when other treatments have been ineffective.

Introduction to Montelukast

Montelukast is a prescription medication that belongs to a class of drugs known as leukotriene receptor antagonists (LTRAs). It works by blocking the action of inflammatory substances called leukotrienes, helping to reduce inflammation, swelling, and tightening of airways. This improves breathing and prevents symptoms. It's available as tablets, chewable tablets, and oral granules and is a long-term management tool, not for acute attacks.

Primary Conditions Montelukast Can Treat

Montelukast is FDA-approved for several conditions. Its use for allergic rhinitis may be considered when other treatments are not effective.

Chronic Asthma

Approved for adults and children as young as 12 months, montelukast is used for the long-term management of asthma by reducing airway inflammation and preventing attacks. It's typically taken once daily in the evening.

Exercise-Induced Bronchoconstriction (EIB)

Montelukast helps prevent the narrowing of airways during or after exercise in individuals six years and older. It's taken as a single dose at least two hours before activity; an extra dose is not needed if already taking it daily for asthma.

Allergic Rhinitis

It treats symptoms of seasonal and perennial allergic rhinitis, such as sneezing, runny nose, and nasal itching. Its use is often considered when other allergy medications are not effective or tolerated.

Off-Label Uses

Montelukast has been used off-label for chronic idiopathic urticaria (hives) that haven't responded to other treatments. It may also benefit some patients with aspirin-exacerbated respiratory disease (AERD).

Side Effects and Important Warnings

Montelukast can cause side effects. Common ones include headache, stomach issues, and flu-like symptoms. The FDA has issued a black-box warning about serious neuropsychiatric side effects, such as agitation, anxiety, depression, mood changes, sleep problems, and suicidal thoughts or actions. Any behavioral changes should be reported to a healthcare provider immediately.

Montelukast vs. Other Respiratory Medications

Choosing the right medication depends on the individual. The table below compares montelukast with other common respiratory and allergy medications.


Feature	Montelukast	Inhaled Corticosteroids (e.g., fluticasone)	Antihistamines (e.g., cetirizine)	Beta-Agonist Inhalers (e.g., albuterol)
Drug Class	Leukotriene Receptor Antagonist	Anti-inflammatory Steroid	Histamine-1 Blocker	Bronchodilator
Action	Blocks leukotriene chemicals to reduce inflammation and relax airways	Reduces inflammation in the airways to prevent symptoms	Blocks histamine to relieve allergy symptoms like sneezing and itching	Relaxes muscles around airways for immediate symptom relief
Primary Uses	Maintenance treatment for asthma, EIB prevention, allergic rhinitis	Primary long-term control for persistent asthma	Allergic rhinitis, hives	Rescue for acute asthma attacks, EIB
Speed of Action	Long-term, not for acute relief	Long-term, not for acute relief	Fast-acting for immediate relief of allergy symptoms	Immediate relief for acute bronchospasm
Form	Oral tablet, chewable, granules	Inhaler	Oral tablet, liquid	Inhaler

Conclusion

Montelukast is a valuable medication for managing chronic asthma, preventing exercise-induced bronchoconstriction, and relieving allergic rhinitis symptoms. Its mechanism of blocking inflammatory leukotrienes makes it a useful option, especially when other treatments are not suitable. It is a maintenance medication and should not be used for acute attacks. It is crucial to be aware of potential neuropsychiatric side effects. Patients should discuss the benefits and risks with a healthcare provider.

A Note on Asthma Management

Montelukast is usually part of a comprehensive asthma plan. It is not a substitute for a rescue inhaler for sudden attacks. Always have your rescue inhaler available and follow your doctor's instructions regarding all your medications. For more information on asthma management guidelines, refer to resources like the National Institutes of Health.

Frequently Asked Questions

No, montelukast is not a steroid. It is a leukotriene receptor antagonist, which works differently than inhaled corticosteroids to reduce inflammation in the airways.

No, montelukast is a maintenance medication for long-term control and prevention of symptoms. It is not designed to provide fast-acting relief during an acute asthma attack.

For chronic asthma, it is typically taken once daily in the evening. For allergic rhinitis, it can be taken at any time of day, once daily. If used for exercise-induced bronchoconstriction, it should be taken at least two hours before exercise.

Common side effects can include headache, stomach pain, fever, flu-like symptoms, diarrhea, cough, or sore throat.

Yes, montelukast has been associated with neuropsychiatric side effects, including mood and behavior changes, anxiety, depression, and in rare cases, suicidal thoughts and actions. Patients should be monitored for these symptoms.

Singulair is the brand name for the generic drug montelukast. They are the same medication.

Yes, montelukast is approved for use in children for certain conditions, starting from as young as 6 months for perennial allergic rhinitis and 12 months for asthma.