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How long does montlelukast take to start working?

Celie1 profile image

I’m thinking of asking my nurse for montelukast as an add on for my current flare up. I’m due to finish pred and worried the SoB will flare up again. Wondering if montelukast will even things out a bit 🤔. Would I have to wait 8 weeks as with a steroid inhaler for it to work? 🤷🏻‍♀️🤷🏻‍♀️

31 Replies

I think it's about 6 weeks for being fully effective but I would imagine it'll be sooner for some effect to be noticed. It's worth a go though as it might be great but also rules it out if nothing else - one less to wait to try when you see someone!

It's not something used for flares though as it's a longer term thing - but it might be worth a go longer term anyway.

Celie1 profile image
Celie1 in reply to twinkly29

Thanks Twinkly😊,

I’m looking for some ‘armoury’ for when I come off the pred. in a few days time. 😬

As you say it’s worth a try, it might just what I need. Is there actually anything used for flares apart from pred?🤷🏻‍♀️

twinkly29 profile image
twinkly29 in reply to Celie1

Not that I know of - well apart from the right preventer meds which as you know take time to find as the right ones/concoction. Is it worth asking for a reducing course of pred to try and stave off an issue?

Celie1 profile image
Celie1 in reply to twinkly29

I don’t want to as I’ve had five 7 day courses, one, 5 day course plus 3, reducing weeks in 6 months and don’t really want to have to take any more. 😖

Of course if SoB comes back I’ll have no choice. Fingers crossed 🤞

Hope you’re doing ok 😊

twinkly29 profile image
twinkly29 in reply to Celie1

I know but repeated courses makes it harder to come off them so the likelihood on needing a wean is higher - and it goes wrong again then you'll have to start again with the higher doses. Though I do understand what you're saying.

But maybe discuss with the nurse to see what she thinks - even just as a future thoughts thing, like if it was planned in so you had say 5 days high dose then another 5 reducing or something? I totally made up that example by the way but it would be more gradual without being a load more if that makes sense?

Celie1 profile image
Celie1 in reply to twinkly29

I didn’t realise that. 😳

I think the reason it’s got worse is that I was given only 5 days for March’s flare up, instead of the usual 7 days (or in my case 14!) but the reducing dose went on for two weeks. She knew I’d already had lots of pred and was trying not to give me too many, but she also wanted to wean me off slowly. However it didn’t work, but hindsight is a wonderful thing. 🤷🏻‍♀️ Difficult to know what to do with people who won’t fit in a box 😆

I’ll see what the nurse says this week and go from there. Thanks again😊

twinkly29 profile image
twinkly29 in reply to Celie1

Yes it is hard especially when they do the oh but you've had lots thing. Well yes but it's not like you're doing it for fun!! Even 7 days "proper" then a few reducing might be better than repeated courses because it's not enough or because of your body struggling after so many courses. But see what she says and I'll cross my fingers your body copes this time anyway!

Celie1 profile image
Celie1 in reply to twinkly29

Yes I think so, but it’s difficult to insist on more especially when part of you agrees that you don’t really want any more 😏. The only other time someone gave me a 5 day course and instructions to use ventolin 4 times a day, I ended up in hospital a week later 😖.

Had a conversation with a different nurse today and been given a reducing dose, just in case 😅, but hopefully won’t need it - feeling much better 😁. You don’t always realise how bad you felt until you feel better again 😆

Also trying Montelukast see if it helps longer term and I’ve got an asthma plan yay!

Thank you as always for your support 😊

twinkly29 profile image
twinkly29 in reply to Celie1

Oh brilliant on both counts! Well done nurse and well done you for keeping at it - not easy to keep fighting the battle!

Celie1 profile image
Celie1 in reply to twinkly29


Montelukast is a short lived (14 hours) drug and its slow acting and has a "cumulative effect" (GP's words not mine)

Have you tried spiriva? ... I found that worked really quickly (I also take Montelukast)

Celie1 profile image
Celie1 in reply to Chip_y2kuk

Thank you for your reply Chip 😊

I’m already on Spiriva, since early March although I’m not sure it’s working for me, but needed something extra 😏.

The nurse has told me the same today about Montelukast, but I’ll give it a go and see if works for me long term.

I’ve just started taking Montelukast for allergic asthma, it seemed to make an immediate difference.

Celie1 profile image
Celie1 in reply to Banania

Thanks for your reply 😊.

That’s good to know. I know mine is non eosinophilic, don’t think allergic either but not finished with testing yet. I’ll try the Montelukast and see if it works for me over the long term.

Lysistrata profile image
LysistrataCommunity Ambassador

Montelukast was the first drug that worked for me 10 years ago. I started to notice a difference after about 4 days, especially in my exercise tolerance and shortness of breath. I was getting shattered at that point just doing a slow short walk to work and was told it was just anxiety by the consultant, though my GP didn't buy that and prescribed the montelukast to try.

I've been on and off it since then - it's not as dramatic as it was to start with and I do need other meds, but I have generally found it improves my exercise tolerance. Have had consultants saying 'oh you don't need that, you take too many meds' but it does make a difference to my quality of life so I push to stay on it.

Celie1 profile image
Celie1 in reply to Lysistrata

Thanks for that. 😊. Hope you’re ok at the moment.

My asthma can go from being perfectly controlled on usual med for up to 8 months say, with no ventolin and then suddenly for whatever reason, (usually an infection) I start getting SoB on a walk after which, just simple things like sorting the washing, or carrying a bit of shopping can really be difficult, so I know what you mean 🙁. I think the worst thing is is that it takes so long after pred etc. to just feel able to breathe normally again.

4 days sounds like a good result, but if it works long term I’ll be chuffed. 🤞I’ll definitely push to stay on it if it works.

Lysistrata profile image
LysistrataCommunity Ambassador in reply to Celie1

I really hope it does work for you, crossing fingers!

I can't remember if I said before, but I'm also non-eosinophilic and non-allergic. My current consultant (not the one who said it was just anxiety, though tbh I can see him saying that too) told me it was a useless drug and wouldn't work for me anyway, because I don't have allergic asthma. But it does help my quality of life and makes me spend less time in limbo, which I feel is too often overlooked by doctors in favour of acute episodes.

I.will.say this cons is very much 'this drug works this one doesn't' based on trials, and doesn't accept individual differences if there isn't something measurable behind it like eosinophils.

Montelukast is also licensed for exercise-induced asthma, in any case. I wouldn't exactly say I have that, but I do seem to find if I am struggling already that my exercise tolerance is lower (and it's often quite sudden, so not just lack of fitness). And montelukast helps with that.

Celie1 profile image
Celie1 in reply to Lysistrata

Thank you 🤗 It’s great that it works for you.

My nurse seems very good at listening and working with individual unicorn ness if that’s a word😆😂. So says things like, ‘although it might not work as you’re asthma is non eosinophilic but we can try and see’. So feel on the same wavelength

I personally saw a difference right on the first day! But it probably varies from person to person.

Celie1 profile image
Celie1 in reply to Boswell08

Thanks for replying. Yes definitely an individual thing but I’m hopeful 😊, even if I have to wait a few weeks for it to work.

Hi Celine, I’ve been taking Montelukast, 10 mg for years. Whether I’m on a dose of pred or not. It helps my allergies not sure if it controls asthma or not. But my Doc and friends who take it swear it helps the tightness in our chests. Hope this helps and hope you do well! (Take it at night)

Celie1 profile image
Celie1 in reply to Maltesemama

Hi, Maltesemama,

Thanks for your reply and for good wishes 😊.

It helps to know what other people’s experiences are. I can only try it and find out if it works for me. Do you take it last thing at night or early evening?

Hope you’re ok at the moment

Maltesemama profile image
Maltesemama in reply to Celie1

Hi again! Not much more to add, but my Doc keeps me on it (10 mg). I’ve had no side effects all these years, before Montelukast was developed I took Singular. This drug came along as a generic. Take it at or just before bedtime. (I just took mine and it’s 8 PM). 😀. Good luck with everything Celie1Charles50X, I’m doing OK, just coming off a round of Prednisone. I do take Wixella 2 x a day (500). My fave!

Celie1 profile image
Celie1 in reply to Maltesemama

Hi Maltesemama,

Thanks again for the reply.

I’ll try to take it a bit earlier like you I think. Hopefully no side effects 🤞

Best wishes 😊

I think Montelukast is the worst thing ever. Made me so short of breath, and aggressive. The doctor then gave me (Guaifenesin 400mg) it's the generic form of Mucinex. And that thinned all the mucus in my lungs, and made me breathe way better than Montelukast ever did.

Lysistrata profile image
LysistrataCommunity Ambassador in reply to Charles50X

It obviously wasn't right for you, but it doesn't mean it will be like that for everyone or that it's 'the worst thing ever' overall. Plenty of people tolerate it well. People just need to be aware of the possible side effects in case it does affect them, but for the majority of adults montelukast will not cause major issues like you experienced.

Celie1 profile image
Celie1 in reply to Charles50X

Hi, thanks for replying.

Sorry it didn’t work for you. I suppose everyone responds differently.

I did ask the nurse about a mucolytic, but she doesn’t think it will work in my case. I’ll bear that in mind though for later maybe. We’re going to try this first and I’ll cross my fingers.

My GP said it can take up to a month to see any improvement whilst starting Montelukast but if it does work for you, you should notice a definite change. It works for me, but does affect my sleeping. Nothing bad and in fact seems to stop those dreams that just get stuck on the same theme going round and round. I can see why there are restrictions on prescribing for teenagers though.

Celie1 profile image
Celie1 in reply to Tryphena134

Hi,Thanks for your reply.

My nurse agrees that it’s likely to take a few weeks, although some people I think seem to respond more quickly from the answers I’ve had. As long as I don’t expect miracles then anything else should be a bonus 😆.

I’ve heard some people have sleep problems. Does this depend how late you take it?Have you tried different times of the evening?

I found it effected me mentally at first which seems to be quite common if you look it up , so I took a quarter and then half but eventually a whole tablet which suddenly I found fantastic, I knew I could really breathe on a long walk and could sleep on my back without fear for the first time . So yes , I think it’s great but I had to actually ask my doc as my practice is not that good on recommending such things. I learned all about it on here 👍🏻👌

Hi, Thanks for your reply.

That might be worth considering, if I have that kind of side effect. How long did you take the lesser amounts for before moving onto a stronger dose?

It’s great that you had such a positive response! 🤗

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