Leukocyte Modifiers for Asthma
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þ Accolate (zafirlukast):
 - dose is 20 mg BID; can increase to 40 BID but not in the elderly or with
   liver disease
 - leukotriene receptor antagonist
 - takes about 2 days to work
 - only give if 12 years or older
 - take on empty stomach
 - theophylline and erythromycin decrease concentration
 - ASA increases concentration
 - increases Coumadin half-life
 - may cause headache, somnolence, gastritis, pharyngitis.

þ Zyflo (zileuton)
 - dose is 600 mg QID
 - 5-lipogenase inhibitor
 - interacts with theophylline
 - may increase liver enzymes

þ Montelukast (Singulair)
 - Medical Letter Article
   <Singular.TXT>
 - from Merck
 - a new leukotriene receptor antagonist for the prophylaxis &
   chronic treatment of asthma.
 - Unlike zafirlukast (Accolate) montelukast (Singulair) has once a day dosing
   and minimal drug interactions with theophylline or warfarin.
 - Also, the drug can be used in children as young as six years old.
 - Zafirlukast (Accolate) will be deleted from the formulary in
   three months. (Mercy Pharmacy Update, May 1998)