Efficacy symptoms and conditions

Are there any meds that are safe? I was taking 10mg norvasc. I started taking 20/25 mg lisinopril. I was doing ok on the norvasc but the added lisinopril has almost killed me. They had cut my norvasc down to 5 mg then to 2.5 mg when I started the lisinopril. 4 days ago I stopped the lisinopril and added back 2.5 mg norvasc. Back to 5 mg. The side effects seem to be letting up. Now im wondering is all of my meds are killing me. I can't live without them. My BP sores. Im so scared of what I should do. Im afraid of all my meds.

Has anyone been in contact with any doctors, hospitals, or researchers who are willing to recognize that Singulair targets a receptor CysLT1, with known genetic variations? As you know, I have been posting that I know of researchers who are doing work about how the genetic variations can determine the efficacy of Singulair. If genetic variations cause differences in efficacy, then, of course, these variations can also cause unpleasant to very serious side effects. These seems to be some kind of disconnect. How can the genetic component be recognized in the area of efficacy and ignored in the area of adverse drug reactions?

My daughter is 6 and has been on singulair for 2 years. Anytime we miss a pill she ends up with a fever of about 100 and is exhausted. Within a couple of days of her medicine it's gone again. The doctors think it's a complete coincidence but I don't agree.

I have been on Singulair longer than I can recall... at least 10 years, maybe longer. My 7 year old son has been on it since he was probably 12 months old. Neither one of us have had any problem reported here. No depression, no sleeplessness (until I weaned him from naps, he slept up to 13 hours a day), no leg cramps, nothing. We are two of the happiest, most well adjusted people you could know. And, best of all, we haven't had any asthma attacks. Bottom line, different drugs react differently in different people. Don't let the post here stop you from trying a medication that for some could mean the difference between life and death depending on how asthmatic they are. As with any drug recommended by your doctor, try it. If you experience adverse reactions, stop it ASAP. It's that simple.

16 days ago on Jan 17, 2009 by chris555, #16131
Sorry to disappoint you, but I have no vested interest in Merck or any other pharmaceutical company for that matter. What I have a vested interest in is providing some balance to those parents who come to this blog site and are scared to death. That is what happened to a very good friend of mine. After reading the posts here, she was so panicked she took her 12 year old off Singulair. A kid who had no problems on it by the way. A few days later my friends kid was rushed to the ER and almost died from an asthma attack. That is what I have a problem with. People here telling others the side effects will creep up, that kids should stop their medication right away, etc.

Reply 8 minutes ago on Feb 03, 2009 by concernedcitizen, #16701
To chris555:

Merck warns on it's Singulair website that Singulair is not an effective replacement for fast acting inhalers in the event of sudden symptoms. Originally when Singulair was developed it's purpose was to prevent damage and inflammation that is caused by excessive number of eosinophils in respiratory tissue. There is no evidence at all that Singulair is effective as the only treatment for asthma to prevent or treat acute asthma attacks. And, Merck makes this very clear in the warning notice.

The efficacy and safety of Singulair has a genetic component. That means that it is entirely possible that some people are not compatible with the way in which Singulair works. Adverse side effects are very possibly the result of compatibility problems.

Sadly, Merck has succumbed to the disease of "corporate greed." Meaning that they care more about profitability and the shareholders than they do about the patients. For this callousness, some day this corporation will suffer the punishment. Merck has always known that the cysLT1 receptor is a gene with more than several variations. If they told doctors to watch out for side effects due to genetic variations, then they wouldn't be able to sell this drug like it's harmless - cherry chewable - candy. The adverse side effects are real. Patients started reporting them immediately when the drug was released. Singulair is dangerous to people with gene variations and it causes unnatural biochemical events to take place.

IMPORTANT SAFETY INFORMATION
SINGULAIR will NOT replace fast-acting inhalers for sudden symptoms. You should still have rescue medication available and continue to take your other asthma medications unless your doctor tells you to stop.

I have oesophageal ulcers and duodenitis, diagnosed by Gastroscopy exam. I have been prescribed 40mg daily for 8 weeks then follow-up Gastroscopy to check efficacy of drug regime. Seems reasonable to me to wait to see outcome. My reason for adding to this blog: Only been on these pills for a few days and am having headaches (though not severe); and have now become aware of duodenal pain;.

To get the real information in regards to what level of research that is going into this investigation is.go to the Institute for Safe medicine practices click on Quarter watch.
To people like chris555, I believe you are engaging people for sport and say very hurtful things,your day will come and it may just be in the unemployment line.I can only imagine that you must work for Merck or you would not feel so threatened by the good that has come from Parents advocating for their childrens safety.I want you to know, that all who knew our family and our child understand what took place and our reasons for trying to get the proper information where it should have been," on the label". When our child died no one knew about all the added side effects from post marketing reports,which is "a reliable way to track a drugs adverse events".Maybe you should do more research on the legitimate information of causal relationship. Don't be so afraid of a possible drop in revenue for the drug company that I believe you might be an employee of.K. M.

I have an 8y.o. daughter that has been on Singulair for about 3 years now. Since she started taking singulair she has been absolutely miserable! She cries at everything, is very moody, has leg pains, wont leave my side and is tired ALL the time. She has circle under her eyes, she looks like she hasn't slept a wink in days! She has been off her Singulair for about 5 days now and she is a totally different person. She has been "happy-go-lucky" and full of herself, she has even woke up happy (which hasn't happened in I dont know how long). She was put on Singulair by our Doctor b/c she had Pnemonia two times in a row. She has Allergies and Asthma and for the past 3 years has been on: Singulair (4mg), albuterol, flovent, Zyrtec, and Flonase. That is just too much for a little girl to be on. She hardly eats at all, gets headaches. I just see such a difference when she is not on it but, what will she take in place of this? My husband also takes Singulair (he is miserable all the time), he doesnt sleep at night and is always tired. Anyone have alternative to this drug?

I LOVE MY IUD. For those of you thinking about an IUD, I wanted to post a positive case study. I am sure there are more, but those people don't bother posting. Before I got my IUD, I did extensive research, not just internet or industrial propaganda, but peer reviewed medical journal articles. I decided on the IUD because of efficacy and minimal hormones. The IUD releases a steady amount of progestin that equates to about 20% that of the mini-pill (what breast feeding women take). Even less than 10% of a low dose pill.

I had the Mirena IUD inserted 7 months ago after being on the pill for way too long. I had random cramps for a few months on and off, and had to readjust to being on my OWN cycle vs. the pill. I do get PMS every month, but I attribute that to my own body's cycle, not the IUD. I have not gained a single pound, am on a normal cycle, have minimal bleeding during my period and no spotting in between cycles. My partner and I are thrilled to have this option. Only you know your body, decide for yourself.

for the people that have taken their children off singulair...
what are you using for a preventative med?
my daughter has really bad asthma and I don't know of any alternatives

I also want to add that he has been having nightmares a lot as well. And exhibiting some behavioral issues on and off at school.

Again I can not tell you how scary this is. I have no clue where to start or what to tell my congressman. What do I say? Do I make specific reference to Singulair or do I just medicines in general? No offense, but right now my concerns are selfish, and I need to find another alternative to Singulair. I cant bear to have my son experience what I have to deal with everyday with my depression.

He says things like
"I hate myself" and
"This is the worst day of my life"

I am so scared I plan to call his Dr first in the morning.

PLEASE READ CAREFULLY:

To all the parents who are wondering what else their child can take as an alternative to Singulair, please read an exact quote from a leading professor of Pharmacology and Pediatrics at the University of Florida:

"In response to your last comment, I think Singulair has modest efficacy, and if we take all of our patients off this drug, they won’t suffer. This is not an important drug for pediatric asthma, as are inhaled corticosteroids."

There you have it folks. Singulair is NOT an important drug for pediatric asthma and has an overall moderate efficacy. Inhaled corticosteroids have a much higher efficacy. I have communicated directly with this professor through email.
Any questions??

My son became soo aggressive 3 days after starting Singulair, that he was almost banned from soccer for life because of attacking another player on the field. It resembled what I had heard of 'roid rage'. When I questioned the doctor immediately, was told there was no connection. After months of the aggression, then came depression and self mutilation. My 15 yr old was secretly burning himself to 'punish' himself for things he done wrong or "disappointing" those around him. He now has permanent scars all over his arms from these burns. The depression took to drug abuse and my A student fell to an F student in 6 weeks. He completely lost his will to live and thrive. After 4 months of hell, the dr informed us that the FDA just warned physicians of this side effect. Im furious now that I read through the court documents and find that the drug company knew this all along. I know I am a luckier parent than some whose children committed suicide, but still wish that the FDA would get off their BUTTS and do something to take this drug off the market. I was told by a rep at the FDA that Merck will not take it off the shelf until they're made to because even if they had to pay parents millions for their child's suicide, they would still be pocketing more profit than our children's lives are worth in the court system. Not sure WHY we even HAVE an FDA, they won't do anything to protect us from these money hungry drug companies. A YEAR to do an 'INVESTIGATION" are you kidding me? If the CEO of Merck had to bury his child, it would come off the shelf THAT DAY.

I have been on Zocor 40mg for many years and doing fine with it, until my doctor thought it was not working that well, hence, switched me to Lipitor 10mg. After a few months I developed severe chest pain along with neck pain. It felt like it might have been a heart attack, but it lasted more than 24 hours. I was admitted to ER for 1 night in the hospital and released the following day. They checked my heart and found it was fine. They ran my blood work, chest x-rays, cat scan and checked my lungs. All O.K.!!! The next morning they told me I had Slight Diabetes and an Under Active Thyroid and thought Esophagus Spasms were the cause of my pain. OH yeah, I also told them it hurt more with each breath of air I took in rather than out. It did not matter to them. They gave me Protonix 40mg because they thought it would reduce acid reflux to the esophagus, thus reducing my pain. Furthermore, they gave me Synthroid 25MCG for my Under Active Thyroid. After about 10 days of these medication plus LIPITOR, I had a recurrence of the same pain. I decided to research and came across this Website. I stopped the Lipitor and the next day my pain was subsiding. By this evening, my pain is almost completely gone. I am scheduled to have an Endoscopy in about a week from now and I am hesitant. Are the pharmaceuticals and physicians in cahoot with each other. I can't believe I was required to take all these tests and even more tests before the pain started (EKG, Heart Monitor, Nuclear Stress Test, Heart Scan and Angiography). Did I forget to mention I was diagnosed with High Blood Pressure and put on X-Forge a few months before all this started, but I was taken off it because of side effects (dizziness, lethargic, and so on). I did research on X-Forge and it said to NEVER use it as a first method of treatment for high blood pressure. I also was having pain under my right armpit. WHY DO WE HAVE TO SUFFER LIKE THIS BEFORE ACTION IS TAKEN TO PREVENT THIS FROM HAPPENING TO SOMEONE ELSE. Well, I guess it's just the price we have to pay before we decide to do things OUR WAY!! GOOD LUCK TO ALL OF YOU! THANKS FOR THE POST! PS. Can't wait to see what my Endocrinologist has to say about me next month $$$$$$$$$$$$$$$$$$$$.

Posting again because I'm still FURIOUS at how the medical community seems to dismiss the fact that Singulair can be a terrible drug for children and adults of all ages.

DO NOT LET YOUR DOCTORS AND PEDIATRICIANS LEAD YOU TO BELIEVE THAT SINGULAIR IS NOT THE CAUSE OF THESE BEHAVIORAL AND PSYCHOLOGICAL ISSUES. IF THEY DON'T LISTEN TO YOU, FIRE THEM!!!!!!!!!
I have communicated directly with the leading professor at the University of Florida - School of Pharmacology and Pediatrics. His exact quotation to me was "The efficacy of Singulair is modest. If we took all of our patients off it right now they would not suffer" Spread the word to ALL people you talk to on the street, at work, and wherever you may go. While this drug may work for some it is BAD for MANY!!!! Too many people are being misdiagnosed because of the side effects of Singulair.

See my other posts under matthewct1. This is no joke!

hi, im not sure what to do. my 3 1/2 year old daughter was today given the prescription for singulair. i voiced my concerns to the doctor after my friend telling me its no good due to the side effects.she said that there are risks and side effects with any drug you take but for some reason i don't feel right about this. don't doctors know better than this. anyway Would like to know if all the people who take singulair suffer some sort of side affects or is it minimal? or going by this side it looks like its probably best not to give it to her at all.

Visited new physician, blood test showed recent spike in LDL level (+60 points). Test was non fasting, and not repeated. At follow-up visit, doc directed me to take Lipitor, and when I expressed concern about taking drug before trying diet and other tactics for lowering LDL, doctor brooked no discussion. I specifically expressed concern regarding dizziness, as I had had very severe neurological problems after taking a high level of an OTC at a doc direction for an unrelated problem. My concern was dismissed out of hand (I've never seen it in 20 years.) No return visit was scheduled at this time to check on efficacy. (A medical student was in the exam room, I never spoke with the doc alone, and the doc left the room and I never saw her again.

Without other immediate options for medical care, I filled the prescription for 20 mg of Lipitor. At about the second week, I began to experience severe neurological problems (dizziness, sense of no orientation of my body in space, trouble keeping upright, etc.) I received a card for a cardiology appointment shortly after the visit, and decided to hang on until the visit. The cardio doc said to me, "why are you here?" I told her that the appt. had been scheduled by the other doc's office, but told her what I knew. She took bp - told me it was fine (actually, it was prehypertensive), and then told me my high LDL was genetic, and I'd have to be on drugs for the rest of my life (56). Did not ask for family history, and ignored recent severe leg infection as a possible cause for the spike in LDL.

Having been offered no alternative, I decided to stop Lipitor on my own after 19 days on it. (I decided I would rather drop dead than feel as I did.) Not much improvement immediately. It took 30 days off it to have a day on which I felt well. I am into my second week since then, and have an occasional bad spell, but I am hopeful I'll have a full recovery from the neurological problems. I've been on my own low fat diet for the LDL, but don't know what effect that is having, and have no intention to visit a doctor to find out.

Interestingly, the FDA's Medwatch only allows reporting of severe side effects, and I didn't stay on Lipitor long enough to meet the definition (become disabled).

I spent the weekend reading about the development of Singulair. The early studies recognized that the first phase of the acute asthma response bronco-constriction was probably not caused by leukotrienes. They identified histamines and prostaglandins as the probable sources. I don't think that changed because the Singulair literature states that it should not be considered as a treatment for that. Leukotrienes were a source of inflammation caused by eosinophils and mast cells present in greater numbers (than normal) in airway tissue. So, it was beneficial to find a way to decrease that.

The cysLT1 receptor was identified as source of the signals that tell the cells to produce leukotriene. The receptor, a gene, consist of 337 (they think) amino acids. They modified a compound that would bind to that receptor thus blocking the cells ability to produce leukotrienes. This compound is very specific. It was formulated to bind to the "model" receptor. This compound will not even bind to cysLT receptor sub-types. (That is the good thing.) There is an enormous amount of research that discusses the genetic variability of the chemical reactions that occur in the leukotriene (calling it this for simplicity) pathway. We are also seeing that a number of researchers would like to use gene profiles to predict whether patients will respond favorably to different asthma/allergy drugs. ALL PATIENTS HAVE A RIGHT TO KNOW IF IT IS INHERENT THAT SOME PEOPLE WILL NOT RESPOND TO SINGULAIR OR RESPOND ADVERSELY.

There are many studies from the 1998 era that conclude that montelukast is not effective for everyone. Those researchers stated that it can be predicted that those people who are going to respond favorably will do that within the first 14 days or so. That conclusion would be consistent with a genetic component for efficacy and safety of Singulair. Those doctors concluded that those who did not respond within that time frame should not take Singulair for fear of harming them. That makes good sense.

The Italian researchers wanted to know if there was more going on than blocking leukotrienes in the action of montelukast. They set up a "test tube" study regarding montelukast, the cysLT1 receptor, and some t-cells that they selected. Why? Researchers always have something on their minds. They observed the death of these particular t-cells.

Montelukast is a quinoline. We basically know of quinilines and quinolones as compounds that were invented as broad spectrum antibiotics. They work because they interference with bacterial DNA so they cannot replicate themselves. Montelukast is a quinoline modified to bind with the cysLT1 receptor (a gene) and prevent that gene from activating. That's consistent with what a quinoline/quinolone does.

So what does montelukast do in blood plasma if it does not bind to the receptor because of genetic mis-match? (If montelukast does bind, then a chemical reaction has occurred and the liver will break down the by-products. Montelukast metabolized in 10-12 hours.) What happens if it doesn't bind? How long before it breaks down? Does it produce toxic by-products?

I want to know what happens to lymphocytes such as t-cells just because montelukast is a quinoline. Maybe nothing but what's up with the Italians researchers? I want to know if montelukast has the capability to interfere with lymphocytes who can clone themselves. That could be a good thing under circumstances when these lymphocytes are causing inflammation. But it could be a bad thing in the case of normal individuals with no problems.

I want to know if the bad side effects are due to the fact that the body has to break down and metabolize a quinoline that did not bind to the receptor for which it was created. The side effects of Singulair are strangely similar to what is observed in the quinolones such as levaquin. I have not as yet been able to compare montelukast as a quinoline to levaquin as a quinolone. I am hoping to find something on these categories. There may be no reason to worry that they cause similar damage. But frankly, I think that there is. There is some terrible chit happening to some people. The scariest is the neurological damage.

All of these questions would be in the everybody pharma knows to ask category. I don't know where the answers are. I haven't found them as of yet. Maybe there are no answers. We have to remember that Singulair and Vioxx were released in the same year. They have continued to be drugs under the current executive management of Merck. If the Vioxx marketing promoters had their ghost writers, why not the Singulair marketing promoters. The genetic component appears to be widely accepted but we haven't heard one thing about even that.

I think that it is sad that maybe the marketing of Singulair as one stop shopping for asthma/allergies may have destroyed the original concept. I really think from reading the original work that they knew that they couldn't engineer a drug for one size fits all. Everybody gets harmed when information is withheld.

Shame on the allergist who yelled at the mother who wanted to discuss issues. Does he know exactly who is allergic to Singulair and who isn't? Get him a dunce hat. Just because Singulair is marketed for allergies does not mean that you cannot be allergic to it. See the power of Madison Avenue? The ad agencies focus group these drugs to death. The ad agencies cleverly craft the product information. A good piece of legislation would be to prohibit consumer drugs ads.

Hopefully this will prove to the doubters that there are genetic reasons for the variation of efficacy and adverse side effective when taking Montelukast.

I have several areas of concern (concerned citizen is concerned). One of the main areas is the reliability of Montelukast due to differences in genetics among populations. The cysLT1 (Singulair) receptor is a GENE. As I said before, it would be possible to predict those patients for which Montelukast would and would not be effective and those patients whose gene expression profile would cause them to have unwanted side effectives.

I have been looking for a way to give reasonable proof of that which could be used to convince your doctors that Montelukast is not for everybody. I happened to locate a researcher who had invented and patented methods for predicting drug sensitivity and efficacy in inflammatory disease. I have quoted below from his patent application. He intended to provide a method for determining efficacy and drug sensitivity for pharmaceuticals which include leukotriene antagonists - Montelukast.

Quoted from:

Methods for predicting drug sensitivity in patients afflicted with an inflammatory disease
US Patent Issued on December 12, 2006

Methods are disclosed for predicting the efficacy of a drug for treating an inflammatory disease in a human patient, including: obtaining a sample of cells from the patient; obtaining a gene expression profile of the sample in the absence and presence of in vitro modulation of the cells with specific cytokines and/or mediators; and comparing the gene expression profile of the sample with a reference gene expression profile, wherein similarities between the sample expression profile and the reference expression profile predicts the efficacy of the drug for treating the inflammatory disease in the patient.

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The field of pharmacogenomics measures differences in the effect of medications that are caused by genetic variations. Such differences are manifested by differences in the therapeutic effects or adverse events of drugs. For most drugs, the genetic variations that potentially characterize drug-responsive patients from non-responders remain unknown.
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In another embodiment, the invention is directed to a method for predicting the efficacy in a human asthma patient of leukotriene antagonists including, but not limited to, montelukast (a.k.a., SINGULAIR™; Merck, Whitehouse Station, N.J.), zafirlukast (a.k.a., ACCOLATE™, AstraZeneca, Wilmington, Del.), and zileuton (a.k.a., ZYFLO™; Abbott Laboratories, Chicago, Ill.), comprising: obtaining a sample of cells from the patient; obtaining a gene expression profile from the sample in the absence and presence of in vitro modulation of the cells with specific mediators; and comparing the gene expression profile of the sample with a reference gene expression profile, wherein similarity in expression profiles between the sample and reference profiles predicts the efficacy in the human asthmatic patient of leukotriene antagonists.

Many of the cells involved in causing airway inflammation are known to produce signaling molecules within the body called "leukotrienes." Leukotrienes are responsible for causing the contraction of the airway smooth muscle, increasing leakage of fluid from blood vessels in the lung, and further promoting inflammation by attracting other inflammatory cells into the airways. Oral anti-leukotriene medications have been introduced to fight the inflammatory response typical of allergic disease. These drugs are used in the treatment of chronic asthma. Recent data demonstrates that prescribed anti-leukotriene medications can be beneficial for many patients with asthma, however, a significant number of patients do not respond to anti-leukotriene drugs.

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The genes selected are those that have been determined to be differentially expressed in either a disease, drug-responsiveness, or drug-sensitive cell relative to a normal cell and confer power to predict the response to the drug. By comparing tissue samples from patients with these reference expression profiles, the patient's susceptibility to a particular disease, drug-responsiveness, or drug-resistance can be determined.

http://www.patentstorm.us/patents/7148008-description.html

The inventor's website: Hakon Hakonarson M.D. The Children's Hospital of Philadelphia

http://stokes.chop.edu/research/profiles/?ID=251

I have to say this after reviewing two major areas:

1. the brain
2. mast cell homeostasis

I desperately wanted to be POLITICALLY CORRECT and say that side effects can be confined to the minority. God, how do you fight Merck?

In this case, it would seem that the real benefit of this drug is to those with the extreme type immune responses whose body chemistry has been altered by being hyper-sensitive to some type of "invader. Extreme can be defined as just not the average or beyond that.

So, if the truth comes out that essentially normal immune systems don't need Singular at all, then I have come clean. I certainly have doubts whether essentially normal systems need this at all.

I have communicated directly with Leslie Hendeles, a leading professor of pharmacology and pediatrics at the University of Florida who's direct quote to me was:
"In response to your last comment, I thing Singulair has modest efficacy, and if we take all of our patients off this drug, THEY WON'T SUFFER. This is NOT an important drug for pediatric asthma, as are inhaled corticosteroids."

Ironically, this is the same individual who was quoted in an ABC news article as saying:
"We have hundreds of children on Singulair and have never heard parents make complaints about psychiatric side effects. Moreover, there is no mechanism for this reaction … We will be telling our patients not to worry about this."

WAKE UP EVERYONE...THIS IS AN ADMITTEDLY OVERPRESECRIBED DRUG THAT HAS WORKED WELL FOR MANY, BUT HAS ALSO RUINED MANY LIVES.

The manner in which this drug is casually overprescribed by so many doctors is freakish. I firmly believe that this drug has caused countless misdiagnoses such as ADHD, Bipolar disorder and others. IT FUELS A GOOD PART OF THE ECONOMY TO PUT SO MANY PEOPLE ON THESE DRUGS. I BELIEVE THE PHARM INDUSTRY IS VERY CALCULATED IN THIS MANNER.

Question what your doctors tell you.
See my other posts under matthewct1. I dealt with a situation where my 5 yr. old son was on the road to being diagnosed with ADHD which couldn't have been further from the truth. Singulair changed him. Since he's been off Singulair everyone (teachers, pediatrician, family, etc.) unanimously agree that he does not show the ADHD symptoms like he did on Singulair.

I just saw this post and it makes me feel ashamed of our medical system which includes everybody.

about 12 hours ago on Apr 14, 2008 by jerseymomma, #7220
My boss has been in contact with all of the top law firms in the NJ & PA area. We want to make sure that we give you info thats actually going to help and not send you to some bloodsucker. When you file an injury suit, there is no money out of pocket. The lawyers only get paid if you win your trial or the case settles (so if you loose-- u dont loose anything either). And as a heads up, if this is something that can be proven to a jury, the suits take fooorrrrever. I think that is the worst part for the families that I personally have dealt with regarding liability suits-- u want closure and you want answers but it takes so long to get them!

Let talks about the "everybody knows category" of the pharmaceutical industry.

1. Everybody knows that: There are many compounds that never go to market for various reasons. Even back then, no pharmaceutical company wanted to spend money on a drug that was not as chemically "reliable" (I chose that word to encompass many things) as possible in all of the known interactions that could be expected in clinical use. The categories are also "everybody knows."
2. Everybody knows that: Merck did a lot of testing for "reliability" on Singulair. But Merck also did a lot of testing on Vioxx. No conclusions can be drawn from this per se.
3. Everybody knows that: Even back then, important decisions were being made as to whether to market a drug that related to how body enzymes metabolized that drug (meaning utilize the drug and then break it down so that the body could eliminate the waste products.) Genetics differences between different people were a factor that were also put into the decision making process.
4. Everybody knows that: clinical variations in efficacy and side effects can be a result of different factors. Some might include 1. genetic differences 2. drug-drug interactions 3. improper use 4. diet - take the grapefruit juice example. Those are just some.

What we don't seem to do in this country is adequately monitor post marketing complaints? Why did it take five years to find out about Vioxx? If we did monitor more carefully, could we identify some thing that was overlooked or the technology has changed so that it is easier to identify what is wrong?

When there is a problem, there is no way that we should go back to the same company for an explanation of the problem. Everybody knows that many companies work on the same category of drugs. Sometimes those companies encountered some road blocks and they abandoned the drug category. The FDA ought to require everything from everybody to get to the bottom of the problem. And also hire independent evaluators.

The next part of what I have to say is just a hypothetical - a FICTION like a WHAT IF. This is just to make a point. What if another group got different results for the metabolism studies? What if another group decided that the drug was not reliable because a hydrogen bond at a certain location could be influenced by too many different factors to be able to accurately predict what would happen?

So why do people have to hire lawyers, when the FDA should be doing it's job? There are many specialities of law just like the doctors. Does getting to the bottom of this problem require the lawyer-chemists? Why is it their job?

Merck's own website states that Singulair is not an anti-histamine. I cannot imagine any General Practitioner receiving a clear picture of how Singulair actually works from this site. Nor, are they being presented with the truth about the side effects. The whole site is a bunch of marketing FLUFF that never gets to the point. At the very least, the GP's should be on the rampage with us for being deceived.

I plan to rant about this later. What a dumbed-down presentation (Merck's site)? What an insult?

http://www.singulair.com/montelukast_sodium/singulair/hcp/allergies/efficacy/index.jsp

I am starting a new post in the hopes that others will see what I am trying to say about the delayed reaction in those that took Singulair for allergies.

If it is consistent that Singulair does not stop allergy symptoms immediately, then the pathways that eventually stop allergy symptoms involve a change in the mast cell function, development and migration (or some combination).

I asked this question for a reason. Are allergy symptoms stopped immediatedly. My question below:

I have a question that will help me continuing looking for information. I can understand that in the case of asthma that Singulair would provide immediate relief. If it is used for seasonal allergies or other allergies without asthma, does it work right away or does it take a period of days or weeks to be effective? If it takes time, could you tell me how long it took in your situation?

My thinking was going in the right direction if the answer below is consistent of everyone or most.

about 2 hours ago on Apr 11, 2008 by catherineevans, #7045
My granddaughter was put on Singulair for allergy symptoms without asthma. Itching, red eyes, terrible congestion, etc. dark circles under her eyes all the time. When we first put her on this, we didn't see any consistent results for 2-3 weeks, then it seemed to 'kick in.' I don't know if this helps. By the way, she was 9, now she's almost 12 and was immediately taken off when this story came out 2 weeks ago.

Then after seeing one response, I gave my reason for asking.

I asked this question because I have a theory of how montelukast really works for allergies as compared to how it works for asthma.

Asthma is a hyper-sensitive state that gets going because the mast cell has a receptor (the leukotriene receptor that Singulair blocks) that sends a signal along a pathway that causes lung tissue to have that extreme response - the wheezing, the airway constriction.

On the mast cell is another receptor the histamine receptor that causes the secretions that make our noses runs and and stuff up. This is not the same immune response as the asthma response. When I saw a post that somebody's doctor said that Singulair is an anti-histamine, NO it is NOT.

So if Singulair does not block histamine immediately and your child's allergies did not go away immediately, then maybe Singulair is working through some other means such as changing normal mast cell homeostasis.
I know that this seems like "what does this mean?" I am really writing this hoping to God that there are people reading this site that know what I am talking about.

Thank you so much for responding. Your answer actually told me what I wanted to know and confirmed my hypothesis. More answers will help. I hope others respond.

PLEASE respond about the length of time that allergies disappeared if you took Singulair for allergies.

I am disheartened but not surprised that so many doctors are dismissing these reports of symptoms that patients have had after taking Singulair. The only reports that I have found to share with you are from Europe and Canada. All of these reports pre-date the recent news stories regarding Singulair and suicide.

In addition to those reports, the most important thing that I have posted is the reference to the fact that Merck itself recognizes that there are genetics differences among patients that are directly linked to the potential efficacy of Singulair (montelukast). I posted a British reports on that subject and a reference to Merck's clinical trial where they studied genetical differences and montelukast.

The best thing that we can do is to try to convince our doctors that this is not politics -- the major does not have to rule. Why do European countries publish frequent reports on all adverse drugs reactions not just those of the majority of the people? One size does not fit all.

The actual incident of headache in all users according to European reports is 18-19%. So when I read that headache, adverse drug reaction to a leukotriene receptor antagonist (Singulair) is then treated by ibuprofen (a Cox-2 inhibitor), which of course gets treated for stomach inflammation or GERD by Nexium or another drug-histamine receptor antagonist, then I wonder what the hell is left to inhibit? So if a patient does not fit the profile of the 80%, do we have to make that patient catatonic (meant figuratively)? I realize that this leaves out all of the receptors that aren't affected by any of these drugs but I am just trying to make a point.

So why does Merck list headache as just one of the side effects in a category of side effects just listed as greater than 1%? And why do so many people believe that there is no scientific proof of any of the complaints that we see here at this site?