How frequently does angioedema develop in asthmatic patients who are just starting montelukast (Singulair)?
—Ivanka Vassileva, MD, Lawton, Okla.

Although the true clinical association and incidence of hypersensitivity reactions with this drug are unknown, the incidence of angioedema in this setting is most likely very low. Hypersensitivity reactions, including angioedema and urticaria, have been reported with all the leukotriene inhibitors, but a review of pharmaceutical adverse-reaction databases shows only sporadic reports of hypersensitivity reactions attributed to montelukast. Case reports have suggested that montelukast is effective for treating urticaria and hypersensitivity reactions to nonsteroidal anti-inflammatory drugs.
—R. Steven Tharratt, MD, MPVM (117-19)