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Dosing & administration
Dosing varies by indication and patient profile. Always follow your institution's current prescribing guidelines.
Renal impairment
Consult protocols for adjustment.
Liver impairment
Consult protocols for adjustment.
Use during pregnancy
1st trimester
Caution. Limited pregnancy data but no clear signal of teratogenicity. Prefer ICS + SABA if initiating.
2nd trimester
Caution. May continue if well-controlled.
3rd trimester
Caution. Same guidance.
Clinical note
Used for asthma and allergic rhinitis. Human pregnancy data are limited but reassuring — no consistent increase in malformations in available cohort studies. The FDA added a boxed warning in 2020 regarding neuropsychiatric events (not pregnancy-specific). Inhaled corticosteroids and beta-agonists remain first-line for asthma in pregnancy; montelukast may be continued if the patient was well-controlled on it prior to pregnancy.
Breastfeeding
Caution. Limited breastfeeding data; likely compatible at standard doses.
