Class Explorer · Respiratory
Leukotriene receptor antagonists
Block the cysteinyl leukotriene receptor, cutting the bronchoconstriction, mucus and eosinophil recruitment that arachidonic acid's other branch produces.
Members
Also in this class: Zafirlukast. Full pages arrive as the library grows.
Compare the members
Montelukast
- Role
- Add-on controller
- Key warning
- Neuropsychiatric effects
Shared across the class
- Indications
- Asthma, as add-on therapy · Allergic rhinitis · Exercise-induced bronchoconstriction · Aspirin-exacerbated respiratory disease
- Adverse effects
- Headache · Neuropsychiatric events including mood change, sleep disturbance, and suicidality
- Contraindications
- Not for acute bronchospasm
- Monitoring
- Symptom control · Mood, sleep and behaviour, especially in children and adolescents
What makes each agent different
- Montelukast is once daily and by far the most used; zafirlukast has food and interaction constraints that make it awkward.
The neuropsychiatric warning is a boxed one in several jurisdictions and is regularly missed at counselling. Parents should be told what to watch for.
Never a substitute for an inhaled corticosteroid in persistent asthma; it is an addition, and a weaker one.
Last reviewed 2026-08-16 · Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed.