Montelukast isn’t expensive compared to other asthma medications-but is it worth what you’re paying? If you’ve been handed a prescription for montelukast and seen the price tag at the pharmacy, you’re not alone. Many people wonder: is this drug really helping, or am I just paying for a brand name with no real advantage?
What Montelukast Actually Does
Montelukast, sold under the brand name Singulair and as a generic, is a leukotriene receptor antagonist. It doesn’t open your airways like albuterol. Instead, it blocks chemicals called leukotrienes that cause inflammation and tightening in your lungs during an asthma attack. Think of it like turning down the volume on your body’s allergic response.
It’s taken once daily, usually at night. It’s not for sudden asthma flare-ups. You take it to prevent them. It’s also used for allergic rhinitis-runny nose, sneezing, itchy eyes-especially when those symptoms happen along with asthma.
Studies show montelukast reduces asthma exacerbations by about 30% in children and adults over six months of consistent use. That’s not a cure, but it’s meaningful. Fewer emergency visits. Fewer nights waking up coughing. Less reliance on rescue inhalers.
How Much Does Montelukast Cost?
In Australia, as of November 2025, the cost depends on whether you’re using the brand or the generic, and whether you’re on the Pharmaceutical Benefits Scheme (PBS).
With PBS subsidy, the out-of-pocket cost for a 28-day supply of generic montelukast (10 mg tablets) is $7.30 for concession card holders and $31.60 for general patients. Without PBS, the same supply can run $40-$60 at a private pharmacy.
Compare that to other controller medications:
| Medication | Typical Form | PBS Cost (General Patient) | PBS Cost (Concession) |
|---|---|---|---|
| Montelukast (generic) | 10 mg tablet, daily | $31.60 | $7.30 |
| Fluticasone (Flovent) | Inhaler, 1 puff daily | $31.60 | $7.30 |
| Salmeterol/Fluticasone (Seretide) | Combination inhaler, 1 puff daily | $31.60 | $7.30 |
| Budesonide/Formoterol (Symbicort) | Combination inhaler, 1-2 puffs daily | $31.60 | $7.30 |
| Omalizumab (Xolair) | Injection, every 2-4 weeks | $31.60 | $7.30 |
Notice something? Most asthma controller meds cost the same under PBS. That’s because Australia’s subsidy system caps prices for essential medicines. The real difference isn’t in the price tag-it’s in how the drug works, how easy it is to use, and how well it fits your life.
Why People Choose Montelukast Over Inhalers
Not everyone can use an inhaler properly. Kids, elderly patients, people with arthritis, or those who panic at the thought of inhaling medication often struggle. Montelukast is a pill. No coordination needed. No timing pressure. Just swallow it.
Parents of children with asthma love it. No more fighting over inhaler use before school. No more forgetting to shake the inhaler or hold breath after puffing. One pill at bedtime, and the child sleeps through the night.
It’s also a good option if you have exercise-induced asthma. Some people take montelukast before a workout and avoid needing a rescue inhaler altogether.
And for people with both asthma and allergies, it’s a two-for-one. It reduces nasal congestion and sneezing, which often trigger asthma symptoms. You’re treating two problems with one pill.
When Montelukast Might Not Be Worth It
But here’s the catch: montelukast doesn’t work for everyone. About 30-40% of adults and 20-30% of children don’t respond significantly to it. If you’ve tried it for 6-8 weeks and still wake up coughing or need your inhaler more than twice a week, it’s not working for you.
It’s also not as strong as inhaled corticosteroids. If your asthma is moderate to severe, montelukast alone won’t cut it. You’ll still need a steroid inhaler. In those cases, montelukast is just an add-on-and add-ons cost extra.
And then there’s the mental health risk. The FDA and TGA have issued warnings about neuropsychiatric side effects: depression, anxiety, nightmares, suicidal thoughts. These are rare-less than 1 in 1,000-but they’re serious. If you or your child start feeling unusually down, agitated, or have trouble sleeping after starting montelukast, talk to your doctor. Don’t ignore it.
For people with mild, well-controlled asthma, montelukast might be overkill. If you only need an inhaler once a month, why take a daily pill with potential side effects? Simpler is better.
Is the Generic Just as Good?
Yes. The generic version of montelukast is chemically identical to Singulair. It’s made by the same manufacturers, under the same quality controls. The only differences are the color, shape, and inactive ingredients-like fillers or coatings-that don’t affect how the drug works.
There’s no clinical evidence that brand-name montelukast is more effective. The only reason to pay more for Singulair is if you have a rare allergy to one of the generic’s fillers-which is extremely uncommon.
In Australia, pharmacists automatically substitute generic montelukast unless the doctor writes “dispense as written.” Most people don’t even know they’re getting the generic. And they shouldn’t care.
Who Benefits Most From Montelukast?
Montelukast makes the most sense for:
- Children aged 2+ with mild persistent asthma who struggle with inhalers
- Adults with allergic rhinitis and asthma together
- People who can’t coordinate inhaler use due to age, dexterity, or anxiety
- Those with exercise-induced asthma who need prevention, not rescue
- Patients already on low-dose inhaled steroids who need a little extra control
It’s less ideal for:
- People with moderate-to-severe asthma without a steroid inhaler
- Those with a history of depression or mental health conditions
- Anyone who doesn’t take it daily-it only works with consistent use
- People who respond well to inhalers and have no trouble using them
What to Do If You’re Paying Too Much
If you’re paying more than $31.60 for a month’s supply without a concession card, check if you’re eligible for PBS. You might not know you qualify. If you’re over 65, on a pension, or have a healthcare card, you’re covered.
If you’re not on PBS, ask your pharmacist about the “Safety Net.” Once you spend a certain amount on PBS medicines in a year, your co-payment drops to $7.30 for the rest of the year. Many people don’t realize this kicks in automatically.
Also, compare prices. Some pharmacies offer generic montelukast for as low as $28 out-of-pocket even without PBS, especially if you buy in bulk or use loyalty programs.
Final Answer: Is Montelukast Worth the Price?
Yes-if it works for you.
At $7.30 to $31.60 a month under PBS, montelukast is one of the cheapest asthma controllers available. It’s easy to take. It helps many people sleep better, breathe easier, and avoid the ER. For kids, it’s often the only practical option.
But it’s not magic. It won’t fix severe asthma. It won’t help if you skip doses. And it carries a small but real risk of mood changes.
If you’ve tried it and feel better, it’s worth every cent. If you’ve tried it and feel no difference-or worse-then it’s not worth the cost, even if it’s cheap. Talk to your doctor. Try a different approach. Your asthma control shouldn’t depend on luck. It should depend on what actually works for you.
Is montelukast safe for long-term use?
Yes, montelukast is approved for long-term use in both children and adults. Clinical trials have shown safety over 12 months and beyond. However, ongoing monitoring is recommended, especially for mood changes. If you’ve been on it for years without side effects, it’s likely safe to continue-but always discuss regular check-ups with your doctor.
Can I stop taking montelukast if I feel better?
Don’t stop without talking to your doctor. Asthma is a chronic condition. Even if you feel fine, your airways may still be inflamed. Stopping montelukast suddenly can lead to rebound symptoms, including worse asthma attacks. Your doctor may suggest a gradual reduction if your asthma is well-controlled for at least three months.
Does montelukast cause weight gain?
Weight gain is not a commonly reported side effect of montelukast. Unlike oral steroids, which can increase appetite and fluid retention, montelukast doesn’t affect metabolism in a way that leads to weight gain. If you’ve noticed weight changes, look at diet, activity level, or other medications you’re taking.
How long does it take for montelukast to work?
Some people notice less nighttime coughing or fewer allergy symptoms within a day or two. But full asthma control usually takes 1-4 weeks. Don’t judge its effectiveness after just a few days. Give it at least a month before deciding if it’s working.
Can I take montelukast with other asthma meds?
Yes, montelukast is often used with inhaled corticosteroids, long-acting beta agonists, or even short-acting rescue inhalers. It’s designed to complement-not replace-other controller medications. Your doctor will decide the right combination based on your asthma severity and triggers.
If you’re unsure whether montelukast is right for you, ask your doctor for a trial. Track your symptoms, rescue inhaler use, and sleep quality for four weeks. Then decide-not based on price, but on results.
joe balak
November 3, 2025 AT 02:44Montelukast works. My kid’s been on it for 3 years. No more midnight coughing. No more ER trips. Cheap. Simple. Done.
Bonnie Sanders Bartlett
November 3, 2025 AT 23:23I’m a parent of a 6-year-old with asthma and allergies. We tried the inhaler. He’d cry, refuse, hold his breath. Montelukast? He takes it like candy before bed. No drama. No stress. Worth every cent.
Nishigandha Kanurkar
November 4, 2025 AT 13:42Have you ever wondered why the FDA didn’t ban this outright? The mental health side effects are buried in tiny print. They don’t want you to know. Big Pharma doesn’t care if your kid becomes depressed-as long as they keep buying pills. This isn’t medicine. It’s a chemical trap.
Melissa Delong
November 6, 2025 AT 11:02Actually, the PBS pricing is misleading. The government subsidizes it because they don’t want people dying from asthma. But the real cost? The long-term neurological damage. You think $31 is cheap until your child starts sleepwalking and screaming at 3 a.m. Then you realize you paid for silence, not safety.
Tamara Kayali Browne
November 7, 2025 AT 01:51Let’s be clear: montelukast has a 40% non-response rate in adults. That means nearly half the people taking it are wasting money, time, and risking side effects. If your asthma is mild, you’re better off with a saline rinse and an albuterol inhaler. This isn’t a miracle drug-it’s a placebo with a pill form.
George Clark-Roden
November 8, 2025 AT 11:53I get it. I’ve been on montelukast for eight years. I don’t feel like I’m being ‘controlled’-I feel like I’m being given back my life. I used to wake up gasping. Now I sleep. I run. I breathe. But I also know someone who had nightmares so bad they had to quit. It’s not magic. It’s not evil. It’s a tool. And like any tool, it works for some, breaks others. I’m not here to tell you what to do. I’m here to say: your experience matters more than the pamphlet.
Abha Nakra
November 9, 2025 AT 21:12In India, montelukast costs less than $1 a month. We don’t have PBS, but generics are everywhere. My nephew takes it. His asthma improved. No side effects. The problem isn’t the drug-it’s how we make it complicated. Price isn’t the issue. Access and education are.
Tatiana Mathis
November 11, 2025 AT 03:11It’s fascinating how people reduce complex medical decisions to price tags. Montelukast isn’t just a pill-it’s a behavioral lifeline for families who can’t manage inhalers. For a child with arthritis, for an elderly person with shaky hands, for a parent who’s exhausted from nightly asthma battles-it’s not about cost. It’s about dignity. The real question isn’t ‘is it worth it?’ It’s ‘what’s the alternative?’ And sometimes, the alternative is worse.
Michelle Lyons
November 12, 2025 AT 17:33Did you know the original patent holder for montelukast was bought by a company that also owns a chain of psychiatric hospitals? Coincidence? I think not. They profit more from the side effects than the treatment. Read the FDA’s whistleblower reports. They’re not hiding it. They’re just waiting for you to stop asking.
Iván Maceda
November 13, 2025 AT 19:12🇺🇸 We pay $31.60? In America, that’s a steal. In my town, it’s $120 without insurance. And don’t get me started on how the government lets Big Pharma charge $200 for a 30-day supply of the brand. We’re being robbed. But I still take it. My daughter can’t breathe without it. So I pay. And I hate it.
Hope NewYork
November 14, 2025 AT 21:18Montelukast? Yeah I tried it. Felt like a zombie for 2 weeks. Couldn’t focus. My dog started avoiding me. I quit. Now I use eucalyptus oil and breathe deep. Works better. And no FDA warnings. Just sayin’.
Marshall Washick
November 16, 2025 AT 04:34I’ve been on montelukast since I was 12. I’m 32 now. I’ve never had a night where I woke up choking. I’ve never missed work. I’ve never needed an ER visit. I also have mild depression. But I didn’t get it from this pill. I got it from life. I’m not saying it’s perfect. But for me? It’s the reason I’m still here. And I’m grateful.
Vrinda Bali
November 17, 2025 AT 12:29Let me tell you something about the pharmaceutical industry. Montelukast was developed from a compound originally studied for cancer. When it failed there, they repackaged it as an asthma drug. The clinical trials? Short-term. The long-term data? Suppressed. They don’t want you to know that the real reason it’s cheap is because it’s old-and no one’s making money off it anymore. So they push it hard on children. Because children can’t argue back.
Lori Johnson
November 19, 2025 AT 11:14My cousin’s kid was on montelukast. Started having panic attacks. Mom didn’t connect it until she read the label. Took him off. Within a week, he was smiling again. Why do doctors still prescribe this like it’s aspirin? It’s not. It’s a chemical that messes with your brain. And we’re giving it to toddlers.
Cornelle Camberos
November 20, 2025 AT 01:58It is imperative to recognize that the assertion that montelukast is ‘worth the price’ is predicated upon an assumption of medical efficacy and safety that is not universally substantiated by longitudinal, peer-reviewed, double-blind studies. The FDA’s black box warning, while statistically rare, constitutes a material risk that cannot be ethically minimized by cost-benefit analysis. Therefore, the prescription of montelukast, absent comprehensive neuropsychiatric screening, constitutes a violation of the principle of non-maleficence.