Moncas is a prescription medication with the active ingredient montelukast sodium, a leukotriene receptor antagonist. It is the generic version of the brand-name drug Singulair. By blocking leukotrienes, Moncas helps reduce inflammation in airways and nasal passages, easing breathing and alleviating allergy symptoms.
Primary Uses of Montelukast (Moncas)
Montelukast is approved for several key indications for long-term management, not immediate relief. It's available in film-coated tablets, chewable tablets, and oral granules for various age groups.
Asthma Treatment
Moncas is used for long-term asthma control in adults and children 12 months and older. It helps prevent asthma symptoms like wheezing, shortness of breath, and coughing. It's not for acute asthma attacks; use a rescue inhaler for sudden attacks and take Moncas daily, even when symptoms are absent.
Allergic Rhinitis
It also treats seasonal and perennial allergic rhinitis (hay fever). For seasonal allergies, it's for patients aged 2 years and older; for perennial allergies, it's for those 6 months and older. Montelukast is generally for patients whose symptoms aren't controlled by or who can't tolerate other therapies like nasal corticosteroids.
Prevention of Exercise-Induced Bronchoconstriction (EIB)
For adults and children 6 years and older, Moncas can prevent airway tightening during exercise. It's taken at least two hours before activity; don't take an extra dose within 24 hours of a daily dose.
Important Considerations and Side Effects
FDA Boxed Warning
Due to the risk of serious neuropsychiatric events, the FDA has issued a Boxed Warning for montelukast. Patients and caregivers should be aware of potential mood and behavior changes during or after treatment.
Neuropsychiatric side effects may include:
- Agitation or aggressive behavior
- Anxiety and irritability
- Depression, including suicidal thoughts and actions
- Difficulty sleeping or unusual dreams
- Confusion or memory problems
- Restlessness and tremors
If these symptoms occur or worsen, stop the medication and contact a healthcare provider immediately.
Common Side Effects
Common side effects may include:
- Headache
- Stomach pain or discomfort
- Diarrhea
- Upper respiratory infections
- Cough and sore throat
- Ear infections or earache
Churg-Strauss Syndrome
In rare cases, patients taking montelukast, especially those with asthma reducing oral steroids, may develop Churg-Strauss syndrome. Symptoms can include flu-like illness, rash, and pins and needles or numbness in the limbs.
Moncas vs. Inhaled Corticosteroids: A Comparison
Both montelukast and inhaled corticosteroids (ICS) manage asthma, but with different mechanisms. ICS are generally considered more effective first-line treatment for persistent asthma.
| Feature | Montelukast (Moncas) | Inhaled Corticosteroids (ICS) |
|---|---|---|
| Mechanism | Blocks inflammatory leukotrienes. | Reduces inflammation directly in airways. |
| Efficacy | Less effective than ICS for reducing asthma exacerbations and improving lung function in mild-to-moderate asthma. | More effective in reducing exacerbations and improving lung function. |
| Administration | Oral tablet, chewable tablet, or granules, typically once daily. | Inhaled, typically once or twice daily. |
| Indications | Asthma, EIB, and allergic rhinitis. | Primarily asthma; not indicated for allergies. |
| Side Effects | Serious risk of neuropsychiatric side effects with Boxed Warning. | Less risk of neuropsychiatric issues; potential for oral fungal infections. |
| Use in Children | Options for children as young as 6 months (for allergies). | Primary recommendation for asthma maintenance in children. |
Conclusion
Moncas, or montelukast, is a valuable daily medication for chronic asthma, allergic rhinitis, and exercise-induced bronchoconstriction. It reduces airway inflammation by blocking leukotrienes. It is not a rescue medication. The drug carries an FDA Boxed Warning due to the risk of serious neuropsychiatric side effects, including mood changes and suicidal thoughts. Healthcare providers should weigh benefits against risks, especially for allergic rhinitis. Patients should consult their doctor about the benefits, risks, and suitability of Moncas for their condition.
More information on montelukast can be found on the FDA's official website.
