Skip to main content
HomeDrug Comparisons
Drug bottle and Pill

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

See more from our pharmacists

  • Zafirlukast (Accolate)
    Montelukast (Singulair)
  • Zafirlukast (Accolate)
    Montelukast (Singulair)

  • 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 (Singulair) is an oral medication used for allergies. It's also used for the long-term treatment of asthma and prevention of exercise-induced asthma. This medication can't be used for a sudden asthma attack, since it takes a longer time to work compared to some inhalers. It's usually an add-on treatment for asthma that might be hard to control.

  • Indications of Zafirlukast vs. Montelukast

    Indications for
    •Asthma (long-term treatment)
    Indications for
    •Seasonal allergies
    •Year-round allergies
    •Asthma
    •Exercise-induced asthma

  • 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
    •Available as chewable tablets or granules for some children and their condition
    •Good option for children or those who have difficulty with inhalers
    •Available as a lower-cost generic
    Cons
    •Might cause serious mental health disturbances (including aggressive behavior, hallucinations, distress, and vivid dreams)
    •Can't use for an emergency asthma attack like rescue inhalers
    •Must take at least 2 hours before exercise to prevent exercise-induced asthma

  • Common Side Effects of Zafirlukast vs. Montelukast

    Common Side Effects for
    •Headache (13%)
    Common Side Effects for
    •Headache
    •Fever
    •Influenza-like symptoms
    •Sore throat
    •Cough
    •Runny nose
    •Sinus inflammation
    •Belly pain
    •Heartburn
    •Diarrhea

  • 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
    •Mental health disturbances
    •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

    Learn more about Zafirlukast
    Learn more about Montelukast

Browse medications

View All

Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.