Comprehensive medication guide to Montelukast including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic montelukast on most commercial plans; typically Tier 1 (preferred generic) on most formularies with no prior authorization required. Brand-name Singulair may require prior authorization or be non-formulary.
Estimated Cash Pricing
$15–$145 retail for generic montelukast 10 mg (30-day supply); as low as $4–$13 with GoodRx or SingleCare coupons. Brand-name Singulair costs approximately $289 per month retail.
Medfinder Findability Score
85/100
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Montelukast is a prescription leukotriene receptor antagonist (LTRA) sold under the brand name Singulair. It was first FDA-approved in 1998 by Merck, and generic versions have been widely available since August 2012, when the original patent expired. Approximately 9.3 million U.S. patients receive dispensed prescriptions for montelukast annually, making it one of the most commonly prescribed medications in the country.
Montelukast is FDA-approved for four indications: chronic asthma treatment (patients 12 months and older), exercise-induced bronchoconstriction prevention (6 years and older), seasonal allergic rhinitis (2 years and older), and perennial allergic rhinitis (6 months and older). It is also used off-label for chronic urticaria (hives).
Montelukast is available as 10 mg film-coated tablets for adults, 5 mg and 4 mg chewable tablets for children, and 4 mg oral granule packets for infants and toddlers. It is taken once daily and is not a rescue medication — it does not stop an asthma attack that has already started.
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Montelukast is a highly selective leukotriene receptor antagonist that binds with high affinity to the CysLT1 (cysteinyl leukotriene type 1) receptor. Leukotrienes — particularly LTD4 and LTE4 — are inflammatory chemicals released by mast cells and eosinophils in response to allergens and other triggers. When leukotrienes bind to CysLT1 receptors on airway smooth muscle and immune cells, they trigger airway edema, smooth muscle contraction, and mucus production.
By selectively blocking the CysLT1 receptor, montelukast prevents leukotrienes from triggering this inflammatory cascade. Unlike inhaled corticosteroids, which broadly suppress airway inflammation, montelukast targets a specific pathway — making it effective without the systemic immunosuppression associated with steroids. It does not exhibit agonist activity at any of the receptors it binds.
Montelukast is rapidly absorbed after oral administration and is extensively protein-bound (>99%). It is metabolized by CYP3A4 and CYP2C8 in the liver, with a half-life of approximately 2.7–5.5 hours. It is eliminated primarily through the bile and feces, not the kidneys.
10 mg — film-coated tablet
For adults and adolescents 15 years and older. Take once daily in the evening for asthma. Timing flexible for allergic rhinitis.
5 mg — chewable tablet
For children 6–14 years. Must be chewed before swallowing. Contains aspartame — not for patients with PKU.
4 mg — chewable tablet
For children 2–5 years. Must be chewed before swallowing. Contains aspartame — not for patients with PKU.
4 mg — oral granule packet
For infants 6 months and older (perennial AR) or 12–23 months (asthma). Can be mixed with soft food, baby formula, or breast milk. Use within 15 minutes of opening.
Generic montelukast has a findability score of 85/100 — it is generally widely available nationwide. The adult 10 mg film-coated tablet is manufactured by dozens of generic companies and is stocked at virtually every major pharmacy chain. It is not listed on the FDA's drug shortage database as of 2026.
Pediatric formulations — particularly the 4 mg oral granule packets and 4 mg/5 mg chewable tablets — are manufactured by fewer companies and may experience localized stock gaps at individual pharmacies, especially during peak allergy season (spring and fall). In these cases, patients may need to call multiple pharmacies or look beyond their usual location.
If you're having trouble finding montelukast in stock, medfinder calls pharmacies near you on your behalf to identify which ones can fill your prescription. Results are texted to you — no hold music, no driving around.
Montelukast is not a controlled substance and has no DEA scheduling requirements. Any licensed prescriber in the United States can prescribe it without special DEA registration or state PDMP requirements. This makes it broadly accessible through primary care, telehealth, and urgent care settings.
Primary care physicians (family medicine, internal medicine)
Allergists and immunologists
Pulmonologists
Pediatricians
Nurse practitioners (NPs) and physician assistants (PAs) in all 50 states
Montelukast is widely available via telehealth. Because it is a non-controlled prescription medication, it can be prescribed during a standard virtual visit on platforms like Teladoc, MDLive, or Sesame Care. This makes it accessible for patients who have difficulty accessing in-person care.
No. Montelukast is not a controlled substance. It is not listed in any DEA schedule and has no recognized abuse potential or addiction risk. This means it can be prescribed by any licensed prescriber — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — without the special requirements that apply to controlled substances (e.g., state PDMP checks, prescription quantity limits, or in-person visit requirements).
Because it is not controlled, montelukast can be prescribed via telehealth, refills can be called in by phone, and pharmacies can accept e-prescriptions without restriction. This makes it one of the most accessible prescription medications for patients seeking care remotely or in underserved areas.
The following side effects were commonly reported in clinical trials:
Headache
Upper respiratory infection
Cough
Abdominal pain, diarrhea
Ear pain or infection (especially in children)
Sore throat, fever, runny nose, sinus infection
In March 2020, the FDA added a black box warning for serious neuropsychiatric events:
Suicidal thoughts or actions — stop medication immediately; call 988 or go to ER
Depression, aggression, agitation, anxiety, hallucinations, nightmares, insomnia
Anaphylaxis and severe hypersensitivity reactions
Churg-Strauss syndrome (rare; eosinophilic vasculitis)
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Zafirlukast (Accolate)
Another LTRA taken twice daily. FDA-approved for asthma in patients 5 years and older. Less convenient than once-daily montelukast but same drug class. Must be taken on an empty stomach.
Fluticasone nasal spray (Flonase)
OTC intranasal corticosteroid. First-line for allergic rhinitis; more effective than montelukast for nasal symptoms. Does not treat asthma.
Cetirizine (Zyrtec)
OTC second-generation antihistamine. First-line for allergic rhinitis. Once daily; mild drowsiness. Does not treat asthma.
Budesonide inhaler (Pulmicort)
Inhaled corticosteroid. First-line controller for persistent asthma. More effective than montelukast for asthma control; does not treat allergic rhinitis nasal symptoms.
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Phenobarbital
moderateCYP enzyme inducer; reduces montelukast AUC approximately 40%. Clinical monitoring for reduced efficacy recommended. No dose adjustment required.
Rifampin (Rifadin)
moderatePotent CYP inducer (CYP3A4, CYP2C8); significantly decreases montelukast blood levels. Monitor for loss of asthma/allergy control during and after rifampin therapy.
Gemfibrozil (Lopid)
moderateCYP2C8 inhibitor; may increase montelukast blood levels. Clinical significance uncertain; monitor for increased side effects.
St. John's Wort
moderateHerbal CYP3A4 inducer; may reduce montelukast efficacy. Patients often don't consider herbal supplements as medications — always ask.
Aspirin/NSAIDs
minorNo direct pharmacokinetic interaction, but patients with aspirin-sensitive asthma should continue to avoid aspirin and NSAIDs while on montelukast — it does not fully protect against NSAID-triggered bronchospasm.
Montelukast (generic Singulair) remains a widely used and generally effective medication for asthma and allergic rhinitis in both adults and children. Since the patent expiration in 2012, generic versions are widely manufactured and typically affordable — especially with discount card programs. The adult 10 mg tablet is among the most accessible generic medications in the U.S. market.
However, the 2020 FDA black box warning for neuropsychiatric side effects has appropriately shifted prescribing patterns, particularly for allergic rhinitis where first-line alternatives (nasal corticosteroids, antihistamines) are often more appropriate and carry lower risk. Prescribers and patients should carefully weigh benefits and risks, especially for patients with a history of psychiatric conditions.
If you're having difficulty finding montelukast at your local pharmacy — particularly for pediatric formulations — medfinder can call pharmacies near you to find where it's in stock. medfinder covers all medications, not just montelukast, and texts you results directly.
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