Montelukast (Singulair) is a leukotriene receptor antagonist that is used in the maintenance treatment of asthma. It is also used to treat exercise-induced asthma and allergic rhinitis.

Indications of Montelukast (Singulair):

• Allergic rhinitis (perennial or seasonal):

  • It is prescribed to treat the signs and symptoms of both seasonal and chronic allergic rhinitis.

• Asthma:

  • It is administered to treat persistent asthma and as a preventative measure.

• Bronchoconstriction, exercise-induced (prevention):

  •  It effectively stops bronchoconstriction brought on by exercise.

Note:

• The American College of Allergy, Asthma, and Immunology (ACAAI), American Academy of Allergy, Asthma, and Surgery, and American Academy of Otolaryngology, Head & Neck Surgery (AAO-HNS) guidelines advise against using montelukast as the first-line treatment for allergic rhinitis (except in patients with concurrent asthma).

• Off Label Use of Montelukast in Adults:

  • Chronic urticaria
  • Urticaria (nonsteroidal anti-inflammatory drug-induced)

Read: Asthma Treatment Guidelines - GINA Updates Simplified

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Montelukast dose in adults:

Note: Patients who suffer from allergic rhinitis as well as asthma should only take one tablet at night.

Montelukast (Singulair) Treatment dose of Allergic rhinitis (perennial or seasonal):

• 10 mg per oral once daily.

Montelukast (Singulair) dose in the treatment of Asthma:

• 10 mg per oral once daily (in the evening).

Montelukast (Singulair) Dose in the prevention of exercise-induced bronchoconstriction:

• At least two hours before exercise, take 10 mg orally.

Note:

• Within 24 hours, no additional dosages should be given.
• It has not been tested whether daily treatment can stop exercise-induced bronchoconstriction.
• Exercise-induced bronchoconstriction should not be avoided by patients taking montelukast for another purpose.

Montelukast (Singulair) Dose in the treatment of Chronic urticaria:

• 10 mg per oral once daily.

Montelukast (Singulair) dose in the treatment of NSAID-induced Urticaria:

• 10 mg per oral once daily.

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Montelukast Dose in Children:

Note:Only one dose should be taken in the evening by those who have both asthma and allergic rhinitis.

Montelukast (Singulair) Dose in the Treatment of Allergic rhinitis:

• Perennial: Oral:

  • Infants ≥6 months and Children <6 years:
    • 4 mg once daily.
  • Children ≥6 years and Adolescents <15 years:
    • 5 mg once daily.
  • Adolescents ≥15 years:
    • 10 mg once daily.

• Seasonal: Oral:

  • Children 2 to 5 years:
    • 4 mg once daily.
  • Children ≥6 years and Adolescents <15 years:
    • 5 mg once daily.
  • Adolescents ≥15 years:
    • 10 mg once daily.

Montelukast (Singulair) Dose in the Maintenance Treatment of Asthma:

• 12 months to 5 years:

  • 4 mg per oral once daily in the evening.

• 6 to 14 years:

  • 5 mg per oral once daily in the evening.

• ≥15 years:

  • 10 mg per oral once daily in the evening.

Montelukast (Singulair) dose in the treatment of acute exacerbation of Asthma (adjunct therapy):

• Children 2 to 5 years:

  • Oral:As a single dose, 4 milligrammes
  • A single dosage of montelukast (4 mg) with concurrent short-acting beta-agonist (salbutamol) decreased respiratory rate and improved pulmonary indices in a double-blind, placebo-controlled trial including 52 children with acute asthma exacerbation.

Montelukast (Singulair) Dose in the prevention of Exercise-induced bronchospasm:

Note:

• Within 24 hours, no additional dosages should be given.
• It has not been tested whether daily dosing can prevent exercise-induced bronchospasm.
• Exercise-induced bronchoconstriction should not be avoided by patients taking montelukast for another purpose.

• Children ≥ 6 years and Adolescents <15 years:

  • 5 mg per oral at least 2 hours prior to exercise.

• Adolescents ≥ 15 years:

  • Tablet: 10 mg per oral at least 2 hours prior to exercise.

Montelukast (Singulair) Dose in the treatment of NSAID-induced Urticaria: 

• Adolescents 15 years of age and older:

  • 10 mg per oral once daily.

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Montelukast (Singulair) Pregnancy Risk Category: B

• It has not been shown that Montelukast is more likely to cause teratogenic effects in pregnant women.
• Adverse pregnancy outcomes, such as an increased risk of preterm birth, preterm mortality, and low birth weight infants, can result from uncontrolled asthma.
• Exacerbations of asthma or poorly controlled asthma may be more dangerous to the foetus and maternal health than correctly administered treatments.
• Montelukast treatment can be continued during pregnancy.

Montelukast use during breastfeeding:

• Breast milk contains Montelukast.
• Based on a comparison of a maternal dose of 10mg/day and an average breastmilk concentration, the relative infant dose for montelukast was 0.68%.
• Breathing is allowed in cases of relative infant doses less than 10%
• Montelukast's RID was calculated using an average milk content of 5.3ng/mL (average range 2.87 to 9.12ng/mL), which gives an estimated daily infant dose via breastmilk of 0.798 mg/kg/day.
• After chronic maternal administration of oral montelukast 10mg daily for 7 patients, the average milk concentration was 1.1 to 8.2 months postpartum.
• For the calculation of the weight-adjusted maternal dose, the mean weight (85.7kg) of all patients was used.
• There were no adverse reactions in breastfeeding mothers or infants.
• Determining whether to breastfeed will depend on a number of factors, including the danger of newborn exposure and the advantages of breastfeeding for the child during therapy.
• Asthmatic patients should be encouraged to breastfeed.

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Singulair Dose adjustment in renal disease:

No dosage adjustment necessary.

Montelukast (Singulair) Dose adjustment in liver disease:

• Mild-to-moderate impairment:

  • No dosage adjustment necessary.

• Severe impairment:

  • There are no dosage adjustments provided in manufacturer’s labeling.

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Side Effects of Montelukast (Singulair):

• Central Nervous System:

  • Headache
  • Dizziness
  • Fatigue

• Dermatologic:

  • Atopic Dermatitis
  • Dermatitis
  • Eczema
  • Skin Infection
  • Urticaria
  • Skin Rash

• Gastrointestinal:

  • Abdominal Pain
  • Diarrhea
  • Nausea
  • Tooth Infection
  • Dyspepsia
  • Gastroenteritis
  • Toothache

• Genitourinary:

  • Pyuria

• Hepatic:

  • Increased Serum Aspartate Aminotransferase
  • Increased Serum Alanine Aminotransferase

• Infection:

  • Influenza
  • Varicella Zoster Infection
  • Viral Infection

• Neuromuscular & Skeletal:

  • Asthenia

• Ophthalmic:

  • Conjunctivitis
  • Myopia

• Otic:

  • Otalgia
  • Otitis
  • Otitis Media

• Respiratory:

  • Cough
  • Acute Bronchitis
  • Laryngitis
  • Pharyngitis
  • Pneumonia
  • Rhinitis
  • Rhinorrhea
  • Nasal Congestion
  • Epistaxis
  • Sinus Headache
  • Sinusitis
  • Upper Respiratory Tract Infection

• Miscellaneous:

  • Fever
  • Trauma

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Contraindications to Montelukast (Singulair):

Intolerance to montelukast and any other ingredient in the formulation

Warnings and precautions

• Eosinophilia, vasculitis:

  • Montelukast is rarely associated with systemic eosinophilia.
  • However, it can sometimes present with clinical features consistent with vasculitis and eosinophilic-granulomatosis.
  • For symptoms like eosinophilia and vasculitic skin rash, deteriorating respiratory symptoms, cardiac problems, neuropathy, and/or vasculitic syndrome, early identification is crucial.
  • It has not been proven that montelukast is causally related to these underlying conditions.

• Events in neuropsychiatrics:

  • Children and adults can both experience behavioral changes, including agitation, aggression and depression, disorientation and hostility, hallucinations and hostility, anxiety, attention deficit and depression, disorientation and hallucinations.
  • Merck performed a retrospective analysis and found that serious behavior-related incidents were very rare. Patients should be evaluated for behaviour changes.
  • Any behavioural changes should be reported by patients to their prescriber immediately.

• Acute asthma and Bronchospasm

  • Although Montelukast has not been approved for the treatment of acute asthma attacks and status asthmaticus, some studies suggest that it could be used as an adjunct therapy.
  • During acute asthma exacerbations, Montelukast may be continued.

• Aspirin-sensitive asthmatics

  • Aspirin and other NSAIDs will still cause bronchoconstriction when used with montelukast.
  • These medications should not be used on patients with known aspirin sensitivity.

Montelukast: Drug Interaction

Risk Factor C (Monitor therapy)
Gemfibrozil	Montelukast serum concentration can rise.
Lumacaftor	Montelukast serum concentration can rise.
Risk Factor X (Avoid combination)
Loxapine	The negative or hazardous effects of loxapine may be increased by medications for airway disease. More precisely, the usage of Agents to Treat Airway Disease is probably a symptom of someone who is more likely to be susceptible to substantial bronchospasm from inhaling loxapine. Management: This only applies to the inhaled version of loxapine sold under the brand name Adasuve. The non-inhaled loxapine formulations are exempt from this rule.

 

Monitoring parameters:

Changes in mood or behaviour, such as suicidal thoughts or actions.

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How to administer Montelukast (Singulair)?

• It should be given orally without regard to food.
• The dose should be given in the evening for treating asthma.
• Individualized administration times may be used for patients with allergic rhinitis (morning or evening).
• A single dose in the evening should be given to patients with both asthma and allergic rhinitis.

Granules:

• Possibly given immediately into the mouth, or combined with a tablespoon of ice cream, rice, applesauce, or carrots that are cold or room temperature.
• It must be consumed within 15 minutes of opening the packet and should not be mixed with any other liquids or foods.

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Mechanism of action of Montelukast (Singulair):

• Montelukast, a selective leukotriene antagonist, works by inhibiting cysteinyl receptor.
• This is responsible for asthma's pathophysiology, which includes edema, contraction of smooth muscles, and altered cell activity due to the inflammation process that contributes to asthma symptoms.
• After allergen, cytosteinyl leukotrienes also get released from the nasal mucosa.
• This can lead to symptoms of allergic rhinitis.

Duration:

• >24 hours

Absorption:

• Rapid

Plasma Protein binding:

• >99%

Metabolism:

• Extensively occurs in liver via CYP3A4, 2C8, and 2C9

Bioavailability:

• Tablet: 10 mg, Mean: 64%.
• Chewable tablet: 5 mg: 73% (63% when administered with a standard meal).

Half-life elimination:

• 2.7 to 5.5 hours.
• Mild-to-moderate hepatic impairment: 7.4 hours.

Time to peak serum concentration:

• Tablet: 10 mg: 3 to 4 hours (fasting).
• Chewable tablet: 4 mg (children 2 to 5 years): 2 hours (fasting)
• Chewable tablet 5 mg: 2 to 2.5 hours (fasting)
• Granules: 2.3 ± 1 hours (fasting) and 6.4 ± 2.9 hours (with high-fat meal)

Excretion:

• Feces (86%);
• Urine (<0.2%)

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International Brand Names of Montelukast:

• Singulair
• ACH-Montelukast
• AG-Montelukast
• APO-Montelukast
• Auro-Montelukast
• BIO-Montelukast
• DOM-Montelukast
• DOM-Montelukast FC
• JAMP-Montelukast
• Mar-Montelukast
• MINT-Montelukast
• MYLAN-Montelukast
• PMS-Montelukast
• PRIVA-Montelukast FC
• RAN-Montelukast
• RIVAMontelukast FC
• SANDOZ Montelukast
• Singulair
• TEVA-Montelukast
• Actamone
• Actamone FC
• Aeron
• Airfast
• Airlukast
• Altra
• Amikast
• Anxokast
• Asmaact
• Asmakast
• Asmax
• Astair
• Asthator
• Asthator 5
• Asthmatin
• Blow
• Breathezy
• Brecare
• Broncolast
• Clear Air
• Cubraxis
• Edron
• Everest
• Glemont
• Glemont-CT
• Glemont-IR
• Inmunobron
• Kast
• Kastair
• Kastair EZ
• Kipel
• Kipres
• Leukast
• Lukair
• Lukakline
• Lukast
• Lumona
• Lungair
• Mediruka
• Milukant
• Miralust
• Mokast
• Monarin
• Monas
• Monast
• Monast 10
• Monest
• Monkalus
• Monolair
• Montair
• Montecad
• Montegol
• Montek-10
• Monteka
• Montekast
• Montelair
• Montelu V
• Monteluk
• Montelukan
• Montelukan QDT
• Montemax
• Montepect
• Montexin
• Montiget
• Montulair
• Oxair
• Regulair
• Respikast
• Reversair
• Romilast
• Sansibast
• Shu Ning An
• Singkalus Chewable
• Singulair
• Singular Chew
• Sinkast
• Sintrine
• Smart-Air
• Synglon
• Tekast
• Telkast
• Unicast
• Valtrover
• Valttrover
• Vizendo

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Montelukast Brand Names in Pakistan:

Montelukast Drops 4 mg
Monekast	Neo Medix
Myteka	Hilton Pharma (Pvt) Limited

 

Montelukast Oral Solution 4 mg
Regulair	Welwrd Pharmaceuticals

 

Montelukast Sachet 4 mg
Aerokast	Barrett Hodgson Pakistan (Pvt) Ltd.
Airvent	Shrooq Pharmaceuticals
Beasy	Bosch Pharmaceuticals (Pvt) Ltd.
Dune	Scotmann Pharmaceuticals
Freehale	High - Q International
Indokast	Indus Pharma (Pvt) Ltd.
Lukomon	Platinum Pharmaceuticals (Pvt.) Ltd.
Lungair	Nabiqasim Industries (Pvt) Ltd.
Monaka	Noa Hemis Pharmaceuticals
Montef	Efroze Chemical Industries (Pvt) Ltd.
Monteser Sachet	Panacea Pharmaceuticals

 

Montelukast Sachet 5 mg
Lukomon	Platinum Pharmaceuticals (Pvt.) Ltd.
Montika	Sami Pharmaceuticals (Pvt) Ltd.

 

Montelukast Sachet 10 mg
Lukomon	Platinum Pharmaceuticals (Pvt.) Ltd.

 

Montelukast Granules 4 Mg/Sachet
Montiget	Getz Pharma Pakistan (Pvt) Ltd.
Myteka	Hilton Pharma (Pvt) Limited
Singulair	Obs

 

Montelukast 4 mg Tablets
Aerokast	Barrett Hodgson Pakistan (Pvt) Ltd.
Aireez	Pharmevo (Pvt) Ltd.
Airflo	Amson Vaccines & Pharma (Pvt) Ltd.
Alveo	Prime Labs. (Pvt) Ltd.
Beasy	Bosch Pharmaceuticals (Pvt) Ltd.
Bronkeez	Standpharm Pakistan (Pvt) Ltd.
Dune Chewable	Scotmann Pharmaceuticals
Inspra	Martin Dow Pharmaceuticals (Pak) Ltd.
Irmax	Navegal Laboratories
Lucast	Agp (Private) Ltd.
Mntk	Macter International (Pvt) Ltd.
Monekast	Neo Medix
Montair	Consolidated Chemical Laboratories (Pvt) Ltd.
Montef	Efroze Chemical Industries (Pvt) Ltd.
Montekarl	Raazee Theraputics (Pvt) Ltd.
Montekast	Legacy Pharmaceuticals
Montelo	Novartis Pharma (Pak) Ltd
Montelo Chewable	Global Pharmaceuticals
Monticare	Aims Pharmaceuticals
Monticare Chew	Adcare Pharma
Montiget	Getz Pharma Pakistan (Pvt) Ltd.
Montilu	Standard Drug Co.
Moutemak	Makson Pharmaceuticals
Mukast	Ambrosia Pharmaceuticals
Myteka	Hilton Pharma (Pvt) Limited
Ontel	Macquins International
Polergen	Rogen Pharmaceuticals
Prevasma Chewable	Mkb Pharmaceuticals( Pvt) Ltd
Purgo	Nexus Pharma (Pvt) Ltd
Remikair	Remington Pharmaceutical Industries (Pvt) Ltd.
Repsil	Libra Pharmaceuticals (Pvt) Ltd
Respicare	Genix Pharma (Pvt) Ltd
Respicare Chew	Genix Pharma (Pvt) Ltd
Singulair	Obs
Sokast	Saffron Pharmaceutical Company
Sontel	Schazoo Zaka
Tair	Wilshire Laboratories (Pvt) Ltd.
Ventek	Searle Pakistan (Pvt.) Ltd.
Verkast	Florence Farmaceuticals (Pvt) Ltd
Whizix	Merck Private Ltd.

 

Montelukast Tablets 5 mg
Aerokast	Barrett Hodgson Pakistan (Pvt) Ltd.
Aeromax	Shrooq Pharmaceuticals
Aerotel	Highnoon Laboratories Ltd.
Aerotel Chewable	Highnoon Laboratories Ltd.
Aireez	Pharmevo (Pvt) Ltd.
Airex	Biorex Pharmaceuticals
Airflo	Amson Vaccines & Pharma (Pvt) Ltd.
Albokast	Albro Pharma
Alerkast	Medifine Laboratories
Almont	Alson Pharmaceuticals
Alukast	Alliance Pharmaceuticals (Pvt) Ltd.
Amacure	Jawa Pharmaceuticals(Pvt) Ltd.
Asfree	Medisure Laboratories Pakistan (Pvt.) Ltd.
Asmakast-5 Chewable	Epla Laboratories (Pvt) Ltd.
Asmax	Epharm Laboratories
Astharid	Beste Pharma (Pvt) Ltd.
Awakast	Usawa Pharmaceuticals
Beasy	Bosch Pharmaceuticals (Pvt) Ltd.
Brancol	Lotus Pharmaceuticals (Pvt) Ltd
Brecare	Efroze Chemical Industries (Pvt) Ltd.
Bronast	Geofman Pharmaceuticals
Bronkeez	Standpharm Pakistan (Pvt) Ltd.
Bronokast	Mass Pharma (Private) Limited
Bronsecur	Pfizer Laboratories Ltd.
Caramont	Caraway Pharmaceuticals
Cingol	Askari Pharmaceuticals.
Conkast	S.J. & G. Fazul Ellahie (Pvt) Ltd.
Dilair	Helix Pharma (Private) Limited
Dune Chewable	Scotmann Pharmaceuticals
Evertop	Everest Pharmaceuticals
Evertop	Everest Pharmaceuticals
Freehale	High - Q International
Indokast	Indus Pharma (Pvt) Ltd.
Inspra	Martin Dow Pharmaceuticals (Pak) Ltd.
Irmax	Navegal Laboratories
Kast	Semos Pharmaceuticals (Pvt) Ltd.
Lakas	Focus & Rulz Pharmaceuticals
Lekotin	Pharmacare Laboratories (Pvt) Ltd.
Linakast	Linear Pharma
Lok	Biogen Pharma
Lowcost	Jinnah Pharmaceuticals
Lucast	Agp (Private) Ltd.
Lukrx	Siza International (Pvt) Ltd.
Lulast	Hygeia Pharmaceuticals
Lungair	Nabiqasim Industries (Pvt) Ltd.
Medikast	Medisave Pharmaceuticals
Mekast	Genome Pharmaceuticals (Pvt) Ltd
Mingair	Popular Chemical Works (Pvt) Ltd.
Mntk	Macter International (Pvt) Ltd.
Monaka	Noa Hemis Pharmaceuticals
Monaz	Shawan Pharmaceuticals
Monchr	Cherwel Pharmaceuticals (Pvt) Ltd
Monekast	Neo Medix
Monest	Bio Labs (Pvt) Ltd.
Monkast	Danas Pharmaceuticals (Pvt) Ltd
Monokast	Vision Pharmacueticals
Mont-Heim	Pakheim Internanational Pharma
Montair	Consolidated Chemical Laboratories (Pvt) Ltd.
Montana	P.D.H. Pharmaceuticals (Pvt) Ltd.
Montaza	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Montbreez	Breeze Pharma (Pvt) Ltd
Montec	Pharmatec Pakistan (Pvt) Ltd.
Montef	Efroze Chemical Industries (Pvt) Ltd.
Montekast	Legacy Pharmaceuticals
Montel	Star Laboratories (Pvt) Ltd.
Montelair	Himont Chemical (Pvt) Ltd.
Montelo	Novartis Pharma (Pak) Ltd
Montero	Rotex Medica Pakistan (Pvt) Ltd
Monteser Tablet	Wisdom Therapeutics
Montewns	Wns Field Pharmaceuticals
Monticare	Adcare Pharma
Monticare	Aims Pharmaceuticals
Montiget	Getz Pharma Pakistan (Pvt) Ltd.
Montilak	Hamaz Pharmaceutical (Pvt) Ltd.
Montilu	Standard Drug Co.
Montrial	Wise Pharmaceuticals (Pvt) Ltd
Monty	Leads Pharma (Pvt) Ltd
Monxe	Xenon Pharmaceuticals (Pvt) Ltd.
Moor	Zephyr Pharmatec (Pvt) Ltd.
Moutemak	Makson Pharmaceuticals
Mulka	Max Pharmaceuticals
Mykast	Mega Pharmaceuticals (Pvt) Ltd
Myteka	Hilton Pharma (Pvt) Limited
Ob-Kast	Obsons Pharmaceuticals
Olicast	Olive Laboratories
Ontel	Macquins International
Openair	Chas. A. Mendoza
Parlokast	Paramount Pharmaceuticals
Pelbim	Meezab International
Prevasma	Mkb Pharmaceuticals( Pvt) Ltd
Pulmease	Kaizen Pharmaceuticals Pvt Ltd.
Pulmikast	Hansel Pharmacueutical Pvt (Ltd)
Purgo	Nexus Pharma (Pvt) Ltd
R-Ease	Saaaf Pharmaceuticals
Rayair	Ray Pharma (Pvt) Ltd
Regulair	Werrick Pharmaceuticals
Remikair	Remington Pharmaceutical Industries (Pvt) Ltd.
Remont	Regent Laboratories Ltd.
Repsil	Libra Pharmaceuticals (Pvt) Ltd
Respicare	Genix Pharma (Pvt) Ltd
Respicare Chew	Genix Pharma (Pvt) Ltd
Respirel	Candid Pharmaceuticals
Seasol	Elko Organization (Pvt) Ltd.
Season	Wilsons Pharmaceuticals
Singulair	Obs
Sokast	Saffron Pharmaceutical Company
Solo	Atco Laboratories Limited
Sontel	Schazoo Zaka
Spree	Tabros Pharma
T-Kast	Lowitt Pharmaceuticals (Pvt) Ltd
Tair	Wilshire Laboratories (Pvt) Ltd.
Telukast	Friends Pharma (Pvt) Ltd
Vent-Ease	Medipak Limited
Ventek	Searle Pakistan (Pvt.) Ltd.
Vividone	Pulse Pharmaceuticals
Wel-Dilate	Valor Pharmaceuticals
Whizix	Merck Private Ltd.
Zemont	Z-Jans Pharmaceutical (Pvt) Ltd.

 

Montelukast Tablets 10 mg
Aerokast	Barrett Hodgson Pakistan (Pvt) Ltd.
Aeromax	Shrooq Pharmaceuticals
Aerotel	Highnoon Laboratories Ltd.
Aireez	Pharmevo (Pvt) Ltd.
Airex	Biorex Pharmaceuticals
Airflo	Amson Vaccines & Pharma (Pvt) Ltd.
Albokast	Albro Pharma
Alerkast	Medifine Laboratories
Almont	Alson Pharmaceuticals
Alukast	Alliance Pharmaceuticals (Pvt) Ltd.
Amacure	Jawa Pharmaceuticals(Pvt) Ltd.
Amisped	Sanofi Aventis (Pakistan) Ltd.
Asfree	Medisure Laboratories Pakistan (Pvt.) Ltd.
Asmakast-10	Epla Laboratories (Pvt) Ltd.
Asmax	Epharm Laboratories
Astel	Fynk Pharmaceuticals
Astharid	Beste Pharma (Pvt) Ltd.
Awakast	Usawa Pharmaceuticals
Beasy	Bosch Pharmaceuticals (Pvt) Ltd.
Brancol	Lotus Pharmaceuticals (Pvt) Ltd
Brecare	Efroze Chemical Industries (Pvt) Ltd.
Bronkeez	Standpharm Pakistan (Pvt) Ltd.
Bronokast	Mass Pharma (Private) Limited
Bronsecur	Pfizer Laboratories Ltd.
Caramont	Caraway Pharmaceuticals
Cingol	Askari Pharmaceuticals.
Clear Tablet	Goodman Laboratories
Conkast	S.J. & G. Fazul Ellahie (Pvt) Ltd.
Dilair	Helix Pharma (Private) Limited
Dune	Scotmann Pharmaceuticals
Easyast	Shaheen Pharmaceuticals
Evertop	Everest Pharmaceuticals
Evertop	Everest Pharmaceuticals
Ezichron	Alfalah Pharma (Pvt) Ltd.
Fasmont	Fassgen Pharmaceuticals
Freehale	High - Q International
Indokast	Indus Pharma (Pvt) Ltd.
Inspra	Martin Dow Pharmaceuticals (Pak) Ltd.
Irmax	Navegal Laboratories
Kast	Semos Pharmaceuticals (Pvt) Ltd.
Kastol	Tread Pharmaceuticals Pvt Ltd
Lakas	Focus & Rulz Pharmaceuticals
Lekotin	Pharmacare Laboratories (Pvt) Ltd.
Leykast	Medley Pharmaceuticals
Lok	Biogen Pharma
Lowcost	Jinnah Pharmaceuticals
Lucast	Agp (Private) Ltd.
Lukrx	Siza International (Pvt) Ltd.
Lulast	Hygeia Pharmaceuticals
Lungair	Nabiqasim Industries (Pvt) Ltd.
Mac	Glitz Pharma
Medikast	Medisave Pharmaceuticals
Mekast	Genome Pharmaceuticals (Pvt) Ltd
Mingair	Popular Chemical Works (Pvt) Ltd.
Mntk	Macter International (Pvt) Ltd.
Monaka	Noa Hemis Pharmaceuticals
Monaz	Shawan Pharmaceuticals
Monekast	Neo Medix
Monest	Bio Labs (Pvt) Ltd.
Monik	Aries Pharmaceuticals (Pvt) Ltd
Monkast	Danas Pharmaceuticals (Pvt) Ltd
Monokast	Vision Pharmacueticals
Mont-Heim	Pakheim Internanational Pharma
Montair	Consolidated Chemical Laboratories (Pvt) Ltd.
Montana	P.D.H. Pharmaceuticals (Pvt) Ltd.
Montaza	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Montbreez	Breeze Pharma (Pvt) Ltd
Montec	Pharmatec Pakistan (Pvt) Ltd.
Montef	Efroze Chemical Industries (Pvt) Ltd.
Montekarl	Raazee Theraputics (Pvt) Ltd.
Montel	Star Laboratories (Pvt) Ltd.
Montelair	Himont Chemical (Pvt) Ltd.
Montelo	Novartis Pharma (Pak) Ltd
Montelusaf	Saaaf Pharmaceuticals
Montero	Rotex Medica Pakistan (Pvt) Ltd
Montes	Trison Research Laboratories (Pvt) Ltd
Monteser Tablet	Wisdom Therapeutics
Montewns	Wns Field Pharmaceuticals
Monticare	Aims Pharmaceuticals
Monticare	Adcare Pharma
Montiget	Getz Pharma Pakistan (Pvt) Ltd.
Montika Film Coated	Sami Pharmaceuticals (Pvt) Ltd.
Montilak	Hamaz Pharmaceutical (Pvt) Ltd.
Montilu	Standard Drug Co.
Montinig	Goodman Laboratories
Montitex	Sapient Pharma
Montone	Pearl Pharmaceuticals
Monty	Leads Pharma (Pvt) Ltd
Monxe	Xenon Pharmaceuticals (Pvt) Ltd.
Moor	Zephyr Pharmatec (Pvt) Ltd.
Moutemak	Makson Pharmaceuticals
Mucosoft	Novins International
Mukast	Ambrosia Pharmaceuticals
Mulka	Max Pharmaceuticals
Mykast	Mega Pharmaceuticals (Pvt) Ltd
Myteka	Hilton Pharma (Pvt) Limited
Nabkast	Dyson Research Laboratories
Ob-Kast	Obsons Pharmaceuticals
Oliocast	Olive Laboratories
Ontel	Macquins International
Openair	Chas. A. Mendoza
Parlokast	Paramount Pharmaceuticals
Parlokat	Paramount Pharmaceuticals
Pelbim	Meezab International
Polergin	Rogen Pharmaceuticals
Prevasma	Mkb Pharmaceuticals( Pvt) Ltd
Pulmease	Kaizen Pharmaceuticals Pvt Ltd.
Pulmikast	Hansel Pharmacueutical Pvt (Ltd)
Purgo	Nexus Pharma (Pvt) Ltd
Rayair	Ray Pharma (Pvt) Ltd
Regulair	Werrick Pharmaceuticals
Remikair	Remington Pharmaceutical Industries (Pvt) Ltd.
Remont	Regent Laboratories Ltd.
Repsil	Libra Pharmaceuticals (Pvt) Ltd
Respicare	Genix Pharma (Pvt) Ltd
Respicare Chew	Genix Pharma (Pvt) Ltd
Respirel	Candid Pharmaceuticals
Seasol	Elko Organization (Pvt) Ltd.
Season	Wilsons Pharmaceuticals
Singokast	Qintar Pharmacuticals
Singulair	Obs
Sokast	Saffron Pharmaceutical Company
Solo	Atco Laboratories Limited
Sontel	Schazoo Zaka
Spree-T	Tabros Pharma
Springkast	Prays Pharmaceuticals
T-Kast	Lowitt Pharmaceuticals (Pvt) Ltd
Tair	Wilshire Laboratories (Pvt) Ltd.
Tangular	Tagma Pharma (Pvt) Ltd.
Telkair	Kinsa Pharmaceuticals
Telukast	Friends Pharma (Pvt) Ltd
Unilocast	Tg Pharma
Vent-Ease	Medipak Limited
Ventek	Searle Pakistan (Pvt.) Ltd.
Ventomax	Highnoon Laboratories Ltd.
Verkast	Florence Farmaceuticals (Pvt) Ltd
Vividone	Pulse Pharmaceuticals
Wel-Dilate	Valor Pharmaceuticals
Whizix	Merck Private Ltd.
Zemont	Z-Jans Pharmaceutical (Pvt) Ltd.

 

Montelukast 4 mg Powder
Montemax	Wns Field Pharmaceuticals
Sontel	Schazoo Zaka

 

Montelukast Chewable Tablets 4 mg
Amisped	Sanofi Aventis (Pakistan) Ltd.
Bronsecur	Pfizer Laboratories Ltd.
Lungair	Nabiqasim Industries (Pvt) Ltd.
Montika	Sami Pharmaceuticals (Pvt) Ltd.
Pulmease	Kaizen Pharmaceuticals Pvt Ltd.

 

Montelukast Chewable Tablets 5 mg
Amisped	Sanofi Aventis (Pakistan) Ltd.
Easyast	Shaheen Pharmaceuticals
Montika	Sami Pharmaceuticals (Pvt) Ltd.
Singokast	Qintar Pharmacuticals
Ventomax	Highnoon Laboratories Ltd.