Singulair - has anyone anything posit... - Asthma Community ...

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Singulair - has anyone anything positive to say?

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My two year old son has just been prescribed Singulair (4mg, 1 daily, for ten days) as a preventative treatment in an attempt to stop asthma attacks triggered by colds (which ultimately require a trip to the doctors for steroids).

Curious to know what Singulair is, I look it up the website singulair.com, the side effects horrified me.

After a few hours on google I found thousands of negative comments, even a website dedicated to how terrible it is...

I know the web is the number-one source for bad news about anything, but does anyone have anything good to say about Singulair? Please help!

The advice from my doctor is - the possible side effects from Singulair are a better option than the possible side effects from (a short 3 day course of) oral steroids. hmmm.

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15 Replies

Hi,

I had a few vivid dreams (nothing horrible, just felt very real) for q couple of weeks but after that I was fine and I've been on it a few months now.

I have found that my allergy levels are all normal now whereas some were off the chart before singulair.

I will just query the fact that your son is on it for 10 days though. My under (and I could be wrong I'm nota Dr) is that you have to be on it a few weeks for to take full effect.

Maybe someone else on here is familiar with it being used for short spurts?

The doctor is right; whilst Singulair has a load of reported side-effects, so does pretty much everything. The likely side-effects of steroids are worse than the likely side-effects of Singulair.

Fellow moderator Dr Cath (who also happens to be my wife!) used Singulaire for many a year without any problems, and found it excellent at controlling her exercise-induced asthma - so much so that she was able to run three London marathons whilst on it! I'm sure other members here will have good tales about it too.

However, I agree with Angelica that it seems odd that your child has been prescribed such a short course. I was under the impression it would take about three weeks for the effects to kick in. I will ask Dr Cath when she returns from work and see what she says.

in reply to

I will ask Dr Cath when she returns from work and see what she says.

She says it is perfectly normal treatment in younger children, and infinitely preferable to a course of steroids which she would always avoid where possible.

Peaksteve I like your signature line

:D

Character Map is a wonderful thing!

in reply to

Thanks for the info / advice.

The 10 day course was advised to be taken when the boy gets a cold, as so far this has been what has triggered his asthma attacks. So given his age and the fact he has an older sister regularly bringing home colds from pre-school, we could pretty much guarantee he'll be on them full time for the whole of the winter.

So far we have had 3 cold-triggered attacks in the past year, which have resulted in three three-day courses of oral steroids.

The problem is that we get conflicting opinions from the various nurses, doctors, pharmacists, paediatricians, we speak to regarding the dangers of steroid use, and so far the only noticeable effect we're seeing is that the steroids make him better.

The likely side-effects of steroids are worse than the likely side-effects of Singulair.

That's what we've been told, however to me the following...

Side effects of steroid tablets

Short term use

For a small number of people, a short-term course of steroid tablets, can lower the body's resistance to chickenpox, so you should contact your doctor if you or your child are taking steroid tablets and you/they come into contact with chickenpox. If your doctor thinks you are at risk they can give you an injection to protect you.

Other possible side effects from taking a short course of steroid tablets are mood swings (especially in children) and increased hunger.

There are very few other side effects from taking occasional (three to four) short courses of steroids per year. However it is important to keep the number of courses to a minimum by making sure you are using enough of your other regular inhaled medicines.

..sounds a more bearable option that the following...

SINGULAIR -POSSIBLE SIDE EFFECTS

What are the possible side effects of SINGULAIR?

SINGULAIR may cause serious side effects.

Behavior and mood-related changes have been reported. Tell your healthcare provider right away if you or your child have any of these symptoms while taking SINGULAIR:

agitation including aggressive behavior or hostility

bad or vivid dreams

depression

disorientation (confusion)

feeling anxious

hallucination (seeing or hearing things that are not really there)

irritability

restlessness

sleepwalking

suicidal thoughts and actions (including suicide)

tremor

trouble sleeping

Increase in certain white blood cells (eosinophils) and possible inflamed blood vessels throughout the body (systemic vasculitis). Rarely, this can happen in people with asthma who take SINGULAIR. This usually, but not always, happens in people who also take a steroid medicine by mouth that is being stopped or the dose is being lowered.

upper respiratory infection

fever

headache

sore throat

cough

stomach pain

diarrhea

earache or ear infection

flu

runny nose

sinus infection

I have nothing BUT good to say about it as it's done great things for me - though I am aware that it doesn't work for everyone, and that some ppl including children have had issues with side effects. I've never noticed anything though - maybe I'm a bit irritable sometimes but as my asthma can do nasty things to my sleep it may well be that as it comes and goes.

I didn't think short bursts of steroid tablets realistically tended to have serious side effects either (I thought you get the nasties with these generally if you take them for a while, though again some people will be the exception). Given the choice between Singulair and steroids though, I'd imagine doctors will generally go for the Singulair, even for short bursts as it seems steroid tablets are much more likely to have unpleasant side effects.

Also slightly surprised to hear of it being used in short bursts though. Mine started working in 3 days but I gather this isn't usual and I was told I needed to wait several weeks to get the full effect, so not sure if 10 days is going to do much good in itself unless they're just looking to see if it works and if it does will continue things.

Maybe you could ring the asthma nurses on here if you're worried? They're experts and have plenty of time to talk things through with you.

I do!

Have taken it for several years with ~ 6 months interlude with no problems. Have recently restarted it with GP and was told to give it a few weeks for the maximum effect. Every medication has a sizeable list of (generally rare but yes steroids may cause more) side-effects and this is balanced by the benefits of taking it.

It may be unusual to take a short course but for anyone interested there has certainly been trials and articles written for similar situations. I don't know if this is accepted practice or in guidelines. There are several forms for children - not sure which you have - granules and chewable tablets if he has any problems taking it.

Edit to add: Peaksteve I like your signature line

I've used Montelukast for good number of years and as Peaksteve has said above about Dr Cath, I also find it brilliant at controlling my exercise induced asthma,so much so that before I got it, I was prepared to bin my trainers which my GP wasn't keen on. It takes few weeks to take effect from what I recall, however I do notice if I forget to take it for 2 or 3 days, did it twice over the years so I know it works.

You can't compare an excerpt from the list of steroid side-effects that is specifically about short-term use with the complete list of recorded Singulair side-effects, which will include long-term use too.

A proper comparison with the list of side-effects you have above for Singulair would be this one, which is for Prednisolone (the most likely steroid to be given in asthma treatment):

Like all medicines, Prednisolone tablets can cause side effects, particularly when you first start taking it although not everybody gets them. Please tell your doctor or pharmacist if you notice any of the following effects or any effects not listed.

Stop taking Prednisolone tablets and contact your doctor straight away if the following allergic reaction happens: puffy, swollen face, tongue or body, which may cause shortness of breath, shock and collapse.

Tell your doctor straight away if the following happens:

inflammation of the pancreas (very severe abdominal pains)

Steroids including Prednisolone tablets can cause serious mental health problems. These are common in both adults and children. They can affect about 5 in every 100 people taking medicines like Prednisolone tablets:

feeling depressed, including thinking about suicide

feeling high (mania) or moods that go up and down

feeling anxious, having problems sleeping, difficulty in thinking or being confused and losing your memory

feeling, seeing or hearing things which do not exist. Having strange and frightening thoughts, changing how you act or having feelings of being alone.

Tell your doctor if the following occur:

Infections - lowered resistance to infections, such as a cold, existing eye infections may become worse or symptoms of a previous infection such as tuberculosis (TB) may happen more easily. This is especially important regarding chickenpox or measles.

Stomach and intestines – increased appetite, indigestion, a feeling of being full or bloated, very sore throat and white areas inside your mouth (oral thrush), feeling sick, weight gain, stomach ulcers.

Heart – high blood pressure.

Nervous system – unusual tiredness or weakness, nervousness, worsening of schizophrenia, increased pressure in the skull (causing painful eyes, changes in vision or a bad headache, especially behind your eyes).

Skin – reddish purple lines, thin skin, unusual bruising, acne, wounds that will not heal.

Muscle or bones – muscle weakness or wasting, pain in back, hips, ribs, arms, shoulders or legs. Osteoporosis (may be easier to fracture your bones or to tear your tendons).

Hormones - filling or rounding out of the face, periods become irregular or stop altogether, unusual increase in hair growth on body or face. Growth in infancy, childhood and adolescence may be reduced.

Kidney - urinating at night, water and salt retention.

Blood - blood clots, changes in the balance of minerals in the blood (detected by a blood test).

Eyes – cataracts, increased pressure in the eye (glaucoma), thinning of the tissues of the eye, pressure on the nerve of the eye.

Withdrawal symptoms – muscle or joint pain, conjunctivitis, fever, weight loss, runny nose and painful, itchy skin lumps.

As I said above, my wife (a GP) says that it is perfectly normal for a short-course of Singulair to be given to children, and in this case use of Singulair is infinitely preferable to the use of steroids. This is apparently a BTS (British Thoracic Society) recommendation, so there is clearly some good science/trials/tests behind the decision - especially when you consider that steroids are cheaper than Singulair, so it's not something that has been made on a cost decision.

With the greatest of respect (and I'm sometimes guilty of this too), having no medical training but having access to the Internet is a very dangerous thing. Trust that the doctor isn't actively choosing to give your child dangerous drugs, especially based on the comments in this thread from other Singulair users.

in reply to

You can't compare an excerpt from the list of steroid side-effects that is specifically about short-term use with the complete list of recorded Singulair side-effects, which will include long-term use too.

True. But it's all I had to go on (we get differing opinions depending on who we speak to) - statistically speaking it's a fair comparison though. We've had 4 incidents in past 18 months. 3 controlled with a three day course of Prednisolone (the first was when he was undiagnosed and spent a night in a children's ward on nothing but oxygen and that fixed him).

So according to some advice we have been given/read, if the next 18 months are the same then surely three to four short courses of steroids would be preferable to what would be a long term course of Singulair...?

especially when you consider that steroids are cheaper than Singulair, so it's not something that has been made on a cost decision.

I'm not sure I agree without knowing the difference in cost between either set of pills, but when you consider that a course of steroids usually comes after an out of hours visit to the doctors or a few hours in the local A&E on oxygen - writing a script for Singulair is probably saves the NHS a lot more money....

-----

Thanks to everyone for the helpful and kind replies. This whole thread came about after the boy's first cold kicked in a week ago since we had the Singulair advice... in the end we opted not to give it too him - that doesn't mean we won't next time, we'd left it too late and were a bit put off by all the initial negative stuff. As it happens we seem to have got away with it - however, over the past week he has been a grumpy little sod (in that way that two year old's are...), most likely a tired from the cold - but no doubt whatsoever if we'd given him the Singulair we'd be blaming it on that, and stressing-out that we were screwing up his brain at what is such an important stage of development.

in reply to

So according to some advice we have been given/read, if the next 18 months are the same then surely three to four short courses of steroids would be preferable to what would be a long term course of Singulair...?

No, not in any way. The possible side-effects of steroids (and as natbat1 says, they are all possible, even on short courses) are absolutely terrifying; much more so than the possible side-effects of Singulair.

I'm not sure I agree without knowing the difference in cost between either set of pills, but when you consider that a course of steroids usually comes after an out of hours visit to the doctors or a few hours in the local A&E on oxygen - writing a script for Singulair is probably saves the NHS a lot more money....

You have a point, but surely in this case it also saves you a trip to the OOH or A&E, and saves your son a lot of anguish.

in the end we opted not to give it too him

I do hope you've let the GP know that this is the case, as any future medical advice offered to you may be based on them thinking that Singulair has been administered before and has helped clear up the problem and not caused any other issues.

I too hope that your son is now well and doesn't need further meds, but (and I'll briefly pause here to put my moderators hat on) please don't seek medical attention and then fail to follow the treatment plan offered - if you have a problem with the prescribed medication, discuss it with the health care professional and seek alternatives rather than just not giving meds that have been prescribed. This site and message board are littered with examples of how things can go very wrong if even a mild asthma exacerbation is not properly treated.

I've had a really postive experience with singulair and didn't experience any side effects. It definately helped with control. Now when I first when on Theophillin that was awful and did't agree with me at first but settled after 2 weeks.

Hi ruddock,

I just wanted to add that as a parent who has had to give her young child some pretty nasty meds in the past, I do understand how hard a decision it can be to give yout child something that gives you cause for concern.

Big hugs and take care :-)

I've been on Singulair for about 2 months now and have found it's definitely made a difference with my allergy-type symptoms. I used to be really mucusy and it's cleared all that up. The instructions were to take it at night but my Nurse advised me to take it first thing in the morning. This has meant that I don't get any of the vivid dreams or other side effects and is also easier to ensure I take it on an empty stomach.

KateMoss profile image
KateMoss

I take both in high doses...

I have been on permanent prednisolone / steroids for well over 10 years

I have been taking Singulair for many years too, at 20mg per day.

All meds go through stringent testing and the lists of side effects are all the possible ones ever recorded, perhaps say 2 people in a thousand for each one...?? Many people get no side effects from meds, some get one or two but to get the whole lot, would be one in a million! Also, if you are taking lots of meds and they have similar side effects, do you know which one is causing a particular problem.

I have lots of side effects from the steroids but I am unable to come off them. I currently have serious problems with muscles and tendons etc.

Singulair - at double the recommended dose, the only side effect I can pin on it is weird vivid dreams............. the last one being huge hedgehogs digging holes in my veg patch (I do have hedgehogs in my garden)

Therefore for me, Singulair is much better that the pred! Though pred in short doses is OK for a flare up.

(though I am stuck on pred, but I get it down to a maintenance dose where I can)

Yes, the internet is a great source of information AND Misinformation! Your best source is the Patient Information Leaflet that comes with the meds.... there will always be one person out there on the web who has had a bad side effect and will shout about this on the internet, putting fear into worried people looking for information on a particular medication.

Kate

Hello,

I can understand why you are worried about using it, but every drug comes with a huge list off side affects as the drug compnays have to report ever single side affect that some one reports while on it. and while some will have side affect not all will.

My daughter has been on it since she was 6 months old (she is now 2 and 1/2) she has never had any side affetcs form it, but like some others i have never known it to be given in short courses (but i am not medical). When my daughter started it i was told it could take upto 4 weeks to have any affect. If she stops it ie if shes to poorly or refuses it) within 3 days she gets her wheeze back.

Even short courses pred can have long term affets to.

My daughter was put on long term anti bots in place off needing steriods which has stopped her need for steriods Luckly.....but a long term anti bots for her runs less risk of longg term affects off short courses off steriods. She ended up in intensive care on life support for 6 days due to swine flu and most likely underlying asthma (was not dignosed then though she was on treatment for asthma)

I hope your lo remains well and has no need for meds that you would rather not give.

Natasha

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