The drug Singlon ® can be administered in conjunction with other drugs that are traditionally prescribed for prevention and long-term treatment of asthma. In the recommended doses, the drug had no clinically meaningful effect on the pharmacokinetics of the following drugs: theophylline, prednisone, prednisolone, oral contraceptives (ethinyl estradiol / norethisterone 35/1), terfenadine, digoxin and warfarin.
The area under the curve “concentration-time» in plasma of Montelukast decreased by approximately 40% in patients who received montelukast and phenobarbital. Since the metabolism of montelukast participates isoenzymes, caution should be exercised, particularly in children, when montelukast application such inductors as phenytoin, phenobarbital and rifampicin.
In studies in vitro , it was found that Montelukast is a potent inhibitor of isoenzyme 2S8. However, results of a study of the clinical interaction of montelukast and rosiglitazone showed no inhibitory montelukast effect on isoenzymes 2S8 in vivo. Therefore, it is expected that montelukast would not significantly alter the conversion of drugs that are metabolized involving the enzyme (e.g., paclitaxel, rosiglitazone and repaglinide).
When high doses of montelukast (at 20- and 60-fold excess of the recommended dose for adults) there is a decrease in plasma theophylline concentrations. This effect was not observed while taking the drug at the recommended doses.
Patients should not take the tablets chewable formulation for the relief of acute asthma attacks. When an attack is recommended prmenyaetsya inhaled beta-agonists. With increasing demand for beta-agonists short-acting, patients should be as soon as possible, seek medical advice.
Do not abruptly replace inhaled or oral corticosteroids drug steroid masteron.
There is no evidence of the possibility of reducing the dose of oral glucocorticosteroids with concomitant use of the drug Singlon ® .
In rare cases, patients taking drugs for the treatment of asthma, including montelukast may be systemic eosinophilia, sometimes accompanied by clinical signs of vasculitis and Churg-Strauss syndrome;This is an indication for the use of systemic corticosteroids. These cases usually, but not always, associated with a decrease in the dose of oral glucocorticosteroids or cancellation. We can not either exclude or confirm the likelihood that taking leukotriene receptor antagonists may be associated with emergence of steroid masteron syndrome. Physicians should be aware of the possibility of their patients eosinophilia, vasculitic rash, increase of pulmonary symptoms, cardiac complications and / or neuropathy. Patients who have any of the above symptoms should be screened again and the modes of their treatment – revised.