Leukotriene Pathway Modifiers for Long-Term Control of Asthma
These medicines are available as pills and chewable
How It Works
Leukotriene pathway modifiers improve
lung function and reduce
Why It Is Used
The U.S. National
Education and Prevention Program (NAEPP) recommends leukotriene pathway
modifiers as an alternative treatment for people who have mild or persistent .
Preferred medicines are inhaled corticosteroids with or without long-acting
These medicines may be used along with
corticosteroids to control
mild persistent and moderate persistent . They
may be especially helpful for people whose is triggered by exercise,
, or allergies.
Different types of medicines are often
used together in the treatment of . Treatment for
depends on a person's , his or her type of , and how well the
treatment is controlling symptoms.
- Children up to
little differently than those 5 to 11 years old.
4 are usually treated a
- The least amount
of medicine that controls the symptoms is used.
- The amount
of medicine and number of medicines are increased in steps. So if is not
controlled at a low dose of one controller medicine, the dose may be increased.
Or another medicine may be added.
- If the
control for several months at a certain dose of medicine, the dose may be
reduced. This can help find the least amount of medicine that will control the
has been under
- Quick-relief medicine is used to treat
if you or your child needs to use quick-relief medicine a lot, the amount and
number of controller medicines may be changed.
Your doctor will work with you to help find the number and
dose of medicines that work best.
How Well It Works
Research shows that compared
placebo, leukotriene pathway modifiers:
- Reduced symptoms in adults.footnote 2
- Improved lung function in children. There are
conflicting reports on whether they improved symptoms.footnote 3
But leukotriene pathway modifiers do not work as well
as inhaled corticosteroids. And adding leukotrienes to inhaled corticosteroids
is probably not as effective as adding long-acting beta2-agonists to inhaled
corticosteroids.footnote 2, footnote 3
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask yourabout the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Common side effects of this medicine include:
- Vomiting and diarrhea.
In rare cases, zafirlukast and zileuton cause
liver damage. If the is being affected by zafirlukast or zileuton, will show increased liver enzyme levels in the blood, usually
within the first 2 months of treatment.
Montelukast causes fewer
side effects than other leukotriene pathway modifiers. It is less likely to
affect the . So liver function monitoring is not needed.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
People who take
zafirlukast and medicine (called a ) that prevents blood clots need to
have their clotting times checked regularly. When used with blood-thinning
medicine, zafirlukast can increase the risk of bleeding. Zafirlukast also may
cause problems when taken with other medicines, such as
medicines, , and some seizure medicines. Before you take zafirlukast, make sure your doctor knows
that you are taking any of those medicines.
People who are taking zafirlukast or
zileuton need to have several times during the first 6
months of treatment. People who are taking theophylline along with zileuton may
need to take less theophylline.
People who take leukotriene
pathway modifiers may be more likely to take their medicine regularly, because
it can be taken orally and has a more immediate effect on symptoms than some
other medicines such as inhaled corticosteroids.
pathway modifiers are not used to treat
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines,, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- National Institutes of Health (2007). National Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of (NIH Publication No. 08â€“5846). Available online: ://www.nhlbi.nih.gov/guidelines/asthma/index.htm.
- Dennis RJ, Solarte I (2011). in adults (chronic), search date April 2010. BMJ Clinical Evidence. Available online: ://www.clinicalevidence.com.
- Turner ST, et al. (2012). and other recurrent wheezing in children (chronic), search date June 2010. BMJ Clinical Evidence. Available online: ://www.clinicalevidence.com.
Current as of:
December 6, 2017