Montulair 4/Montulair 10 Special Precautions

Concomitant use: Avoid with aspirin or NSAIDs in aspirin-sensitive patients.
Do not abruptly substitute for inhaled or oral corticosteroids, reduce dose of inhaled corticosteroid gradually.
Hematologic: Eosinophilic conditions, including systemic eosinophilia and vasculitis consistent with Churg-Strauss syndrome, have been reported in patients with asthma who are receiving Montelukast. May be associated with reduction of oral corticosteroid therapy.
Psychiatric: Serious neuropsychiatric events have been reported, including suicidal thoughts or completed suicides, and in some cases occurring after discontinuation of therapy, in adult, adolescent, and pediatric patients with and without a previous history of a psychiatric disorder. Alternative therapy should be considered; monitoring required and discontinuation may be required.
Respiratory: Do not use for the reversal of bronchospasm in acute asthma attacks, including status asthmaticus; may continue use with appropriate rescue medication during acute exacerbation of asthma.