Is Singulair Available Without a Prescription?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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No, and it looks like it won’t be. Here are the reasons a panel of experts just voted to tell the FDA not to allow Singulair to be sold without a prescription. Singulair, now available as the generic montelukast, is a popular and effective allergy medication also used in asthmatics who have allergies. It is a leukotriene receptor antagonist which works differently than the other allergy meds (the non-sedating antihistamines like Claritin, Allegra or Zyrtec). So why the rejection?

1.  People will buy Singulair thinking it will help them with an acute asthma attack. The concern of members on this panel was that Singulair would be used by patients as a rescue medication, similar to their inhalers (steroid inhalers or inhaled bronchodilators). It should not be used that way.

2.  Remember that Singulair is NOT approved for use to reverse bronchospasm in acute asthma attacks. This means if you are having shortness of breath and wheezing from your asthma singulair will not help you in the short term.

3.  The people on this panel are worried you will choose and buy Singulair over your inhaled corticosteroid (Flovent or Pulmicort as examples) for asthma prevention. That could lead to a significant delay in appropriate treatment for exacerbations. That’s bad.

4.  What we DO like Singulair for is use in patients with both asthma and allergic rhinitis (runny nose from allergies). A daily dose may help you with both your allergies and to help prevent asthma exacerbations.

5.  Singulair is also good for prevention of exercise-induced bronchoconstriction (wheezing and shortness of breath worsened with exercise) at a dose of 10 mg at least 2 hours prior to exercise.

No over the counter status for Singulair any time soon.

Dr O.

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