Prednisone with Montelukast Interaction Details
Brand Names Associated with Prednisone
- Cortan®
- Deltasone®
- Orasone®
- Prednisone
- Prednisone Intensol
- Rayos®
- Sterapred®
- Sterapred® DS
Brand Names Associated with Montelukast
- Montelukast
- Singulair®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 10, 2023
Interaction Effect
Severe peripheral edema
Interaction Summary
In drug interaction studies, montelukast at doses of greater than or equal to 100 mg daily at steady-state did not have a clinically significant effect on the pharmacokinetics of oral predniSONE. The first case report of marked peripheral edema associated with the concomitant use of predniSONE and montelukast has been described. A 23-year-old patient with a history of asthma and allergies was treated with predniSONE and montelukast. He subsequently developed peripheral edema on day 10 of predniSONE therapy. When predniSONE was withdrawn from the treatment regimen, the edema resolved .
Severity
Moderate
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Concomitant therapy with predniSONE and montelukast may result in severe peripheral edema. Use caution when administering these two drugs together.
Mechanism Of Interaction
Corticosteroid-induced renal tubular sodium and fluid retention
Literature Reports
A) The first case report of an interaction between montelukast and predniSONE is described in a 23-year-old male. The man developed severe peripheral edema after being treated with both predniSONE and montelukast for asthma. The man presented with acute respiratory symptoms. He had a history of exercise-induced and perennial asthma, house dust mite allergy and rhinoconjunctivitis. The patient was treated with salmeterol, fluticasone propionate, cetirizine, and a predniSONE burst of 40 mg/day for one week, then tapering to 20 mg/day for another week. Severe asthma symptoms recurred after predniSONE therapy was discontinued. Additional bursts of predniSONE 60 mg/day for one week followed by 40 mg/day for another week was required. Oral montelukast 10 mg/ day, given at night was administered as well. The patient subsequently developed severe peripheral edema without dyspnea on the tenth day of predniSONE treatment. The patient gained 13 kg but laboratory tests (creatinine clearance, urinalysis, 24-hour urine protein determination, routine biochemistry, complete blood count, differential, and erythrocyte sedimentation rate) were all within normal limits. PredniSONE therapy was discontinued. The patient's asthma became controlled, and the edema and excess weight had resolved. The patient did not experience any relapses in the following three months. The patient tolerated predniSONE when used without montelukast. The patient also tolerated montelukast when used without predniSONE. The author suggests that corticosteroid-induced renal tubular sodium and fluid retention may have occurred when montelukast was added to the patient's therapy .
Prednisone Overview
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Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function properly); lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines. Prednisone is also sometimes used to treat the symptoms of certain types of cancer. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
Montelukast Overview
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Montelukast is used to prevent wheezing, difficulty breathing, chest tightness, and coughing caused by asthma in adults and children 12 months of age and older. Montelukast is also used to prevent bronchospasm (breathing difficulties) during exercise in adults and children 6 years of age and older. Montelukast is also used to treat the symptoms of seasonal (occurs only at certain times of the year), allergic rhinitis (a condition associated with sneezing and stuffy, runny or itchy nose) in adults and children 2 years of age and older, and perennial (occurs all year round) allergic rhinitis in adults and children 6 months of age and older. Montelukast should be used to treat seasonal or perennial allergic rhinitis only in adults and children who cannot be treated with other medications. Montelukast is in a class of medications called leukotriene receptor antagonists (LTRAs). It works by blocking the action of substances in the body that cause the symptoms of asthma and allergic rhinitis.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.