Safety, Efficacy, and Patient Acceptability of Montelukast in Exercise-Induced Asthma

Abstract

Exercise-induced bronchoconstriction (EIB) can be a troublesome problem in asthmatic children and in some children withoutasthma.Self-reportedexerciserelatedsymptomsshouldbeverifiedformally.EIBismediatedbychangesintemperatureand humidityintheairwayandissecondarytoreleaseofseveralmediatorsofthebronchoconstrictionincludingleukotrienes.Montelukast asaleukotrienereceptorantagonistoffersprotectionagainstbutdoesnotcompletelyameliorateEIB.Regularusedoesnotappearto leadtotolerance.Nightmares,abdominalpain,fever,nauseaandaggressivenessarecommonlydescribedsideeffects;however,the overallsafetyprofileofmontelukastisgoodanddoesnotchangewithlongtermuse.Thereareindividualdifferencesinresponseto montelukastforprotectionagainstEIB.Bronchoconstrictiontriggeredbyexerciserespondstocessationofexerciseinitsnaturalcourse. Duetoitspharamacokineticprofile,montelukastmaybemoreusefulasaprophylaxisthantorelievesymptoms.