Welcome to Beverly Hills Pediatrician, where our commitment is to provide your family with the most accurate and compassionate healthcare information. When a child is diagnosed with conditions like asthma or chronic allergies, a pediatrician often prescribes montelukast, commonly known by its brand name, Singulair, to manage their symptoms. As a parent, understanding your child’s medication is a top priority, and that includes a clear grasp of its purpose, administration, and, most importantly, the correct montelukast dosage. This comprehensive guide is designed to empower you with the knowledge needed to confidently manage your child’s treatment plan.
Understanding Montelukast and Its Role in Your Child’s Health
Montelukast is a type of medication called a leukotriene receptor antagonist. In simple terms, it works by blocking chemicals in the body called leukotrienes. Your body releases these chemicals in response to allergens, and they can cause inflammation, swelling, and mucus production in the airways and nasal passages. By blocking them, montelukast helps to prevent and control the symptoms of asthma and allergic rhinitis, making it easier for your child to breathe. It’s a key component of long-term control for these conditions, which is why consistent, daily montelukast dosage is so important.
Your Child’s Montelukast Dosage: A Guide to Forms and Age Groups
You must base the correct montelukast dosage on your child’s age and the condition they are treating. This medication comes in several forms to make administration easier for young children, including chewable tablets and oral granules. Your pediatrician will determine the most appropriate form and dosage for your child.
Table 1: Standard Montelukast Dosage for Asthma & Allergic Rhinitis
| Age Group | Condition | Recommended Dosage |
| Children 6-14 years old | Asthma, Seasonal & Perennial Allergic Rhinitis | 5 mg chewable tablet once daily in the evening. |
| Children 2-5 years old | Asthma, Seasonal & Perennial Allergic Rhinitis | 4 mg chewable tablet or one 4 mg packet of oral granules once daily in the evening. |
| Children 12-23 months old | Asthma, Perennial Allergic Rhinitis | 4 mg oral granules once daily in the evening. |
| Children younger than 12 months | Asthma, Perennial Allergic Rhinitis | A doctor must determine the use and montelukast dosage. |
Table 2: Montelukast Dosage for Exercise-Induced Bronchoconstriction (EIB)
| Age Group | Recommended Dosage | Important Note |
| Children 6-14 years old | 5 mg chewable tablet | Your child should take this at least 2 hours before exercise. They should not take a second dose within 24 hours of their regular daily dosage. |
| Children younger than 6 years old | A doctor must determine the use and montelukast dosage for this condition. | N/A |
Getting the Dosage Right: How to Administer Montelukast
Correct administration of this medication is vital to ensure your child receives the full therapeutic benefit.
- Chewable Tablets: Your child should chew these tablets completely before swallowing. For best absorption, we recommend taking them at least one hour before or two hours after a meal.
- Oral Granules: This form is ideal for toddlers and very young children. To administer the oral granules, tear open the packet and:
- Directly in the mouth: You can pour the entire contents of the packet directly onto your child’s tongue.
- Mixed with food: Sprinkle the granules onto a spoonful of cold or room-temperature soft foods. Approved options include applesauce, mashed carrots, rice, or ice cream.
- Mixed with liquid: You can also dissolve the granules in 1 teaspoon (5 mL) of cold or room-temperature baby formula or breast milk.
- Important: Your child must take the full dose within 15 minutes of opening the packet. You must not save any mixture for later use. The granules are not designed to be dissolved in water or other beverages.
Understanding Side Effects and What to Watch For
While your child will generally tolerate montelukast well, it’s important for parents to be aware of potential side effects.
Common Side Effects:
- Headache
- Stomach pain or discomfort
- Diarrhea
- Signs of a common cold, such as a stuffy or runny nose, cough, or sore throat
- Fever
Serious Neuropsychiatric Side Effects:
The FDA has issued a Boxed Warning regarding the potential for serious mental health side effects with montelukast. While these side effects are rare, parents should be vigilant and contact their pediatrician immediately if they notice any changes in their child’s mood or behavior. Signs to watch for include:
- Changes in mood or behavior, such as agitation, aggression, or irritability
- Anxiety or depression
- Changes in attention, memory, or focus
- Sleep disturbances, including nightmares or difficulty sleeping
- More serious, though very rare, side effects can include hallucinations, suicidal thoughts or actions.
If you observe any of these symptoms in your child while they are taking montelukast, stop the medication and call your doctor right away.
Frequently Asked Questions
Dosage and Administration
Yes, Singulair is the well-known brand name for the generic drug montelukast.
Montelukast is a long-term control medication. The therapeutic effects build over time. You should continue to give your child the medication for as long as your doctor prescribes it, even if their symptoms improve. Stopping without a doctor’s guidance could lead to a return of symptoms.
If you miss a dosage, give it as soon as you remember. However, if it’s almost time for the next scheduled dose, skip the missed dose and resume your regular schedule. Do not give a double dose to make up for a missed one.
Yes, montelukast is often prescribed alongside other asthma medications, such as inhaled corticosteroids. Always discuss your child’s full medication regimen with your pediatrician to ensure there are no contraindications.
Safety and Effectiveness
Montelukast is not a rescue medication. In the event of an asthma attack, you should use the fast-acting rescue inhaler prescribed by your doctor.
Unlike some other asthma medications, montelukast is not a steroid and is not known to have a negative impact on a child’s growth.
No. Do not stop giving your child montelukast without consulting your doctor. The medication works by providing consistent, long-term control, and stopping it abruptly can lead to a return or worsening of symptoms.
While your child may notice some improvements in symptoms within a day, the full therapeutic effect of montelukast on asthma control occurs over several days or weeks of consistent use.
General Information
Yes, montelukast can be safely taken with many other allergy medications, including antihistamines. Always consult with your doctor about all medications your child is taking.
Both forms of montelukast contain the same active ingredient. The granules are a fine powder you can mix into food, making them easier to administer to very young children. The chewable tablets are a great option for children who can chew and swallow solid food.
No, you should store montelukast at room temperature, away from light and moisture. Always keep all medications out of the reach of children.
Is there a risk of interaction? Montelukast is generally safe to use with corticosteroids. In fact, for some children with severe asthma, a doctor may gradually reduce the dosage of inhaled steroids after starting montelukast. This should only be done under strict medical supervision.
Partnering in Your Child’s Health
Understanding your child’s prescription is a key step in their health journey. While this guide provides a wealth of information on montelukast, administration, and side effects, you must remember that it is not a substitute for professional medical advice. For personalized care and to discuss your child’s specific treatment plan, we invite you to explore our website at https://beverlyhillspediatrician.com/ or to schedule an appointment. We are proud to offer a unique concierge medicine program for kids, ensuring your child receives the highest level of comprehensive and accessible care. For more helpful articles, please visit our blog. If you have any questions, do not hesitate to contact us, your child’s well-being is our highest priority, and we are always here to help.
