Singulair

[jroz]

Hello! Looking for guidance on taking Singulair while breastfeeding. Hale's App is now listing Singulair as an L4 for the Black Box Warning. What are the current recommendations now for taking this while breastfeeding a newborn?
Thank you!

[admin]

jroz:

While the levels in milk are low, I do not like this drug much. I took it and my blood pressure went up 20 points in 2 days. Went off it and tried it again in two weeks, and again, it went up 20 points overnight. I could not find anything in the literature to support this, but it was quite real.

Further, see the black box warning re pediatric use.

I'd suggest real caution.

Tom Hale Ph.D.


Montelukast is a leukotriene receptor inhibitor used in the treatment of asthma and allergic rhinitis.[1] Montelukast milk levels have been reported in seven exclusively breastfeeding women with infants 1.4-8.2 months of age (mean 4.3 months).[2] Milk levels were determined at 0, 1, 2, 4, 8, and 12 hours postdose. Montelukast levels in milk averaged 5.32 µg/L. The relative infant dose was 0.68% and the absolute infant dose was 0.79 µg/kg/day. There were no adverse events reported in these breastfed infants.

The FDA has just added a Black Box warning over the pediatric use of montelukast, which included side effects such as serious behavior and mood-related change, and suicide in users.

[jroz]

Thank you Dr. Hale. So to clarify, you would tell a mother NOT to breastfeed if she is taking Singulair? Thank you for your guidance.

[admin]

jroz:

No, I would not tell her NOT to breastfeed, only that it is risky.

Tom Hale Ph.D.

[jroz]

Thank you Dr. Hale for the clarification!