Montelukast (Singulair): Risks and Benefits

By: Nicole Rae, PA-C

Nicole Rae, PA-C

The Benefits

Montelukast (Singulair) is a drug that has been used to treat allergies and asthma for years.  It helps to treat sneezing, nasal congestion and eye symptoms in patients with allergies.  It also helps to treat inflammation in some patients with asthma. Montelukast is a pill taken once daily and it is not a steroid.  This drug requires a prescription.

The Risk?

Recently, Montelukast has been linked to mood related adverse events and so the FDA has placed a black box warning on this medication.  A ‘box warning’ appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks. Many large observational studies have found no link between Montelukast and mood changes; however one large study did show that the patients taking Montelukast had twice the amount of mood changes as those patients not taking Montelukast. 


In allergic patients it is recommended to try nasal steroids and/or antihistamines first for allergies before adding Motelukast (Singulair) for treatment.  In asthmatic patients it is recommended to discuss the risks and benefits of taking Montelukast with your doctor prior to starting this medication.

If you are currently on this medication and tolerating it without side effects it is worth continuing treatment.  If you are having any adverse side effects contact your physician’s office to discuss alternative treatments.

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