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Leukotriene receptor antagonist

Montelukast with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Montelukast (Montelukast). Most antibiotics do not interfere meaningfully with Montelukast at 4mg, 5mg, 10mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Leukotriene receptor antagonist agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Montelukast at 4mg, 5mg, 10mg.

Practical guidance

According to the prescribing information for Montelukast, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Montelukast is co-administered. Adjusted 4mg, 5mg, 10mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Montelukast during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Montelukast is metabolised and may need a temporary 4mg, 5mg, 10mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Montelukast regimen.

Will antibiotics make Montelukast stop working?

Most antibiotics do not affect Montelukast efficacy. Rifampicin and a few others can lower Montelukast levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

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