Singulair and uti

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.

My 4 year old daughter has been on Singulair daily for approximately 2 months. We started noticing some minor changes in her behavior early on (shyness, separation anxiety, anger, moodiness) but chalked it up to starting a new pre-school and arguing with her older sister. Then about two weeks ago, she started having an obsessive-compulsive type behavior about wiping herself. My first inclination was that she had some type of infection (yeast, UTI, bladder, etc) but all of the tests came back negative. My doctor told us to stop the Singulair, so we have been off for about a week now, but the OCD symptoms haven't lessened. I would say that some of the other behaviors are improving somewhat, but I am not seeing a "whole new kid" effect after being off for one week. Has anyone had a similar experience with OCD type behaviors? I am beside myself with concern! Thanks for any help.

My 4 year old dd has been taking Singulair for about a year. I stopped giving it to her during the winter months as she has seasonal allergies. But now that she is back on it I have noticed that she has frequent daytime urination, nightmares and muscle pains. We have had her checked for UTI's and diabetes and everything is fine. The dr. just says that her bowel is still growing. But when we stopped giving it to her in the winter she was fine. Now all of a sudden she is back to frequent daytime urination. I am going to discontinue and see what happens. I am really glad to find this sight!

Started taking this a month ago for severe dog/cat/dust mite allergy. At first, no side effects and no improvement. 30 days later some improvement - but doesn't last very long into the day - now headaches, abdominal pain, can't sleep at night, lethargic during the day, feel the urge to urinate all day - no uti doctor said, water weight gain / yet less appetite, possible constipation, dizzy, spacey, forgetful, tingling in lips/hands and feel extremely aggressive / irritable at times during the day. SO - tonight, I'm stopping this medicine! The only thing it seemed to do was improve my allergies slightly (I'm severely allergic) - and that only lasted the morning...by evening, it was like I never took the pill (I took it 10pm every night). Oh yeah, nightmares...and I wouldn't mind ALL of the side effects / IF - it had worked great...but NO. I had high hopes for this medication which my allergist suggested/did not insist on...but am disappointed with the effects and the side effects. I read here that in 2 days off it I'll be like new...can't wait. NEVER had a migraine before I took this drug, was always a SOUND sleeper...not irritable - I'm 41 female and in otherwise excellent health. I did gain weight/but it is water weight (I can tell) and I assume it will go as soon as it came...within a week or so of taking the first NASTY pill. I welcome back my allergies with open arms...good bye Singulair.