孟鲁司特走下神坛

Core Viewpoint - Montelukast, once regarded as a "cough remedy," is now under scrutiny due to its psychiatric side effects, leading to a shift in its usage from a widely accepted treatment to one requiring careful evaluation and cautious application [1][10] Regulatory Changes - The National Medical Products Administration (NMPA) has revised the drug's labeling to include warnings about potential severe adverse reactions such as depression and suicidal tendencies, advising immediate cessation and medical consultation if symptoms arise [2][3] Market Dynamics - Despite the warnings, Montelukast remains widely used for common symptoms like cough and rhinitis, with the original drug "Singulair" achieving sales exceeding 2 million boxes on a single platform [1][9] - There are over 60 approved Montelukast products in China, including various formulations such as tablets and chewable tablets [8] Clinical Usage and Misuse - Montelukast is often misused in clinical settings, with a study showing that only 13.88% of prescriptions adhered to the approved indications, while 86.12% were off-label, primarily for conditions like chronic obstructive pulmonary disease and bronchitis [6][7] - The drug is not recommended for common cold coughs or non-allergic coughs, contrary to its prevalent use in these contexts [5][6] Patient and Physician Perspectives - Many patients and families face dilemmas regarding the use of Montelukast due to its side effects, with some physicians unaware of its psychiatric risks, leading to continued prescriptions [7][10] - There is a growing concern among parents about finding alternative treatments, as the tightening of prescription practices shifts the focus from "to use or not to use" to "what to use instead" [9][10] Alternative Treatments - Experts suggest safer alternatives for allergic conditions, including non-prescription medications and nasal corticosteroids, but face challenges in changing public perception regarding the safety of these alternatives [10]