Montelukast (Singulair) in Hale's Medications & Mothers' Milk (2023)

[Lactation Clinic]

Montelukast is classified as L4 in Hale's Medications & Mothers' Milk 2021 and 2023 due to FDA's warning. I am not quite sure about the current recommendation, how we can manage 'breastfeeding and pumping' if the mother takes this medication because her physician prescribes it and said the use of Montelukast is not significantly related to suicidal actions, etc. Thank you so much for your suggestions.

[alicia]

We changed the Montelukast back to a L3. It was an L4 because the FDA 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. She should be able to take this medication and do full breastfeeding. The benefits should outweigh the risks. It is very low transfer into the breastmilk. Untreated asthma is dangerous. Monitor baby for irritability, drowsiness, and diarrhea.
Alicia Nelson RN
Infant Risk Center