19/06/2026
Did you know?
Montelukast is often prescribed once daily in the evening or before bedtime, especially when used for asthma, because asthma symptoms tend to worsen at night (a phenomenon called nocturnal asthma).
Here are the main reasons:
π Why take montelukast at bedtime?
1. Asthma symptoms are often worse at night
* Airways naturally become more reactive and constricted during the night.
* Inflammatory chemicals called leukotrienes contribute to nighttime asthma symptoms such as coughing, wheezing, and shortness of breath.
2. Better symptom control overnight
Taking montelukast in the evening helps ensure adequate drug levels during the night when symptoms are most likely to occur.
3. Recommended by prescribing information
* For asthma, the manufacturer recommends taking it in the evening.
* For allergic rhinitis (hay fever) alone, montelukast may be taken at any time of day, as long as it is taken consistently.
π Does it have to be taken at bedtime?
* For asthma: Evening dosing is generally preferred.
* For allergic rhinitis only: It can be taken at a time that is most convenient for the patient.
* If a patient experiences drowsiness or dizziness, bedtime dosing may also help minimize the impact of these side effects during the day.
π¨ββοΈ Pharmacist's Pearl
Montelukast is a preventive medication, not a rescue medication. It should be taken regularly as prescribed, even when symptoms are controlled, and it will not relieve an acute asthma attack.
β οΈ Also counsel patients and caregivers about potential neuropsychiatric adverse effects (e.g., agitation, anxiety, depression, abnormal dreams, sleep disturbances, or suicidal thoughts), and advise them to contact their healthcare provider if these occur.
