How Effective Is Montelukast for Asthma?

S. Berger

Montelukast is a drug that is classified as a leukotriene receptor antagonist, which indicates that it inhibits the effect of leukotrienes, immune system compounds involved in the inflammatory response. One of its effects in the respiratory system is to reduce bronchoconstriction, or tightening of the lung tissue, as well as inflammation of the bronchial tubes. For this reason, it is marketed as an asthma medication. Different studies suggest conflicting professional opinions on the efficacy of montelukast for asthma.

A montelukast inhaler.
A montelukast inhaler.

Given that its actions take some time to affect the body, patients are given montelukast for asthma in the interest of preventing attacks and chronic inflammation. It does not, however, seem to be able to stop acute asthma attacks. Studies comparing the use of this drug against a placebo found that responses to montelukast were dose-dependent. Dosages of 2 milligrams (mg) provided chronic asthma relief that was superior to the placebo. Higher dosages of 10 mg and 50 mg provided similar relief of chronic asthma symptoms, and groups of individuals taking these doses experienced greater relief than either the 2 mg or placebo groups.

An illustration of the pathology of asthma.
An illustration of the pathology of asthma.

Other research has found that the greatest efficacy using montelukast for asthma is by combining this drug with inhaled corticosteroids. Steroid medications are useful in suppressing the immune response quickly, and may be used for the relief of acute asthma attacks. Taking montelukast for asthma on a regular basis allowed patients to lower their corticosteroid doses and dosing frequencies for these drugs. Asthma relief for individuals taking both medications improved in this study, as well.

Types of asthma vary, and taking montelukast for asthma with certain triggers may provide better relief than cases of this medical condition with other causes. Exercise-induced asthma seems to be, in particular, effectively treated with this medication. Asthma cases related to smoking, taking aspirin, or having an initial viral infection seem to be alleviated by this drug, as well.

Some research regarding montelukast seems to leave questions about its effectiveness. There are no studies that compare it to stimulant medications, such as theophylline, that are also used to treat chronic asthma. Limited data suggests that this medication may provide a more effective treatment for effort-induced asthma than the medication salmeterol, but few other drug-comparison studies have been performed. Studies show that montelukast provides greater relief of asthma symptoms than a placebo, but it does not necessarily follow that this medication is more effective than less-expensive remedies that are already on the market.

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