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Compare Zafirlukast vs. Montelukast

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Zafirlukast (Accolate) and montelukast (Singulair) are both leukotriene receptor antagonists used to control asthma, but they have some key differences. Zafirlukast is taken twice a day on an empty stomach, while montelukast is taken once a day and can be taken with or without food. Montelukast is also used for treating year-round and seasonal allergies and preventing exercise-induced asthma, whereas zafirlukast is not. Montelukast is available in various forms, including chewable tablets and granules, while zafirlukast is only available as a tablet. Additionally, montelukast has been associated with serious mental health side effects, such as aggressive behavior and suicidal thoughts, which are not commonly reported with zafirlukast. Both medications are available in generic forms, making them more affordable options.

drug combination

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  • Zafirlukast (Accolate)
    Montelukast (Singular)
  • Zafirlukast (Accolate)
    Montelukast (Singular)

  • Summary of Zafirlukast vs. Montelukast

    Summary for Leukotriene receptor antagonist
    Prescription only

    Zafirlukast (Accolate) is used to help control symptoms of asthma in people age 5 years and older. It's a tablet that you take by mouth two times every day. This medication helps improve lung function over time; it's not a rescue inhaler so it isn't used when you're having an asthma attack. The most common side effect of zafirlukast (Accolate) is headache. It's available as both a brand-name and generic medication.

    Summary for Leukotriene receptor antagonist
    Prescription only

    Montelukast, the generic for Singulair, is used to help control asthma over time and prevent breathing problems during exercise in both adults and children. It's also used to help relieve allergy symptoms. Montelukast (Singular) comes as tablets, chewable tablets, or oral granules and is usually taken by mouth once a day. Common side effects include upper respiratory infection and headache, and it has a boxed warning for serious mood and behavior changes.

  • Indications of Zafirlukast vs. Montelukast

    Indications for
    •Asthma (long-term treatment)
    Indications for
    •Long-term treatment of asthma - age 12 months and older
    •Prevent breathing problems during exercise - age 6 years and older
    •Relieve seasonal allergy symptoms - age 2 years and older
    •Relieve year-round allergy symptoms - age 6 months and older

  • Pros and Cons of Zafirlukast vs. Montelukast

    Pros and Const for Leukotriene receptor antagonist
    Pros
    •Helps control asthma symptoms in the long run
    •A tablet that's taken by mouth (not an inhaler)
    •Can use in children as young as 5 years old
    •Available in a lower-cost generic form
    Cons
    •Not a first-choice option to help control asthma long-term
    •Taken twice a day
    •Must take at least 1 hour before or 2 hours after meals
    •Not recommended if you have liver problems
    Pros and Const for Leukotriene receptor antagonist
    Pros
    •Only need to take once a day
    •Helps prevent asthma symptoms and allergies
    •Available in child‑friendly forms (chewable tablets, oral granules)
    Cons
    •Not for treating sudden asthma attacks
    •Might cause serious mood or behavior changes
    •Not always a first‑choice option for allergies

  • Common Side Effects of Zafirlukast vs. Montelukast

    Common Side Effects for
    •Headache (13%)
    Common Side Effects for
    •Upper respiratory infection
    •Fever
    •Headache
    •Sore throat
    •Cough
    •Stomach pain
    •Diarrhea
    •Earache or ear infection
    •Flu
    •Runny nose
    •Sinus infection

  • Warnings of Zafirlukast vs. Montelukast

    Common Side Effects for
    •Not a rescue inhaler for asthma attacks
    •Liver damage
    •Depression, changes in mood, and trouble sleeping
    •Conditions related to high levels of white blood cells
    •Higher risk of bleeding if taken with warfarin (Coumadin)
    Common Side Effects for
    •Mood or behavior changes
    •Not for asthma attacks
    •High white blood cell counts
    •Chewable tablets not for people with phenylketonuria (PKU)

  • Prices with our coupons for Zafirlukast vs. Montelukast

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    Learn more about Montelukast

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