Standard Dosing for Children
Montelukast, sold as Singulair, treats asthma and allergies in children by blocking leukotrienes that cause inflammation. For kids aged 6 months to 5 years with asthma or allergies, give 4 mg orally once daily in the evening, using chewable tablets, oral granules, or granules mixed with food like applesauce (do not use hot food or liquids). Children 6-14 years take 5 mg chewable tablets once daily in the evening. Those 15 years and older use 10 mg tablets or film-coated tablets once daily in the evening.[1][2]
Forms Available for Kids
- Oral granules (4 mg): For ages 6 months to 5 years; sprinkle on soft food if needed, but take immediately. No crushing or chewing.
- Chewable tablets (4 mg or 5 mg): For ages 2-14 years; must be chewed, not swallowed whole.
- Avoid film-coated tablets in young children due to swallowing risk.[1][3]
How to Give It Safely
Administer in the evening for asthma to align with peak symptoms, though timing is flexible for allergies. No dose adjustment for mild liver/kidney issues, but skip missed doses—do not double up. Store at room temperature, away from moisture.[1][2]
With Food or Other Meds?
Can take with or without food. It does not interact much with other asthma drugs like inhaled steroids or albuterol, but tell doctors about all medications to check for rare issues like with phenobarbital or rifampin.[1][3]
What If a Child Misses a Dose or Overdoses?
Missed dose: Give next evening dose as usual. Overdose (e.g., stomach pain, thirst, vomiting): Seek emergency care immediately, as it can cause agitation or rare seizures in kids.[2]
Common Parent Questions on Side Effects
Watch for neuropsychiatric effects like mood changes, anxiety, or sleep issues—report to a doctor right away, as the FDA added a boxed warning in 2020. Other risks include rash or flu-like symptoms. Not for acute asthma attacks; use rescue inhalers instead.[1][4]
When to Talk to a Doctor
Consult for kids under 6 months, during pregnancy/breastfeeding, or if asthma worsens. Long-term use needs monitoring; taper only under guidance.[2][3]
[1]: FDA Singulair Label
[2]: Merck Singulair Prescribing Info
[3]: Medscape Montelukast Dosing
[4]: FDA Montelukast Warning