Patient/caregiver was educated on contraindications for using Singulair as follows:

  1. Singulair use carries risk of worsening of mood and clinical symptoms of mood disorders. Individuals can present with complaints such as, feeling low and depressed, anxiety, panic attacks, trouble sleeping, gross appetite changes, impulsiveness, agitation, aggression, and suicidal thoughts. Singulair must be taken with caution in individuals with history of anxiety and mood disorders, as singulair use can contribute to worsening symptoms of mood disorder.
  2. Singulair is extensively metabolized in the liver to inactive metabolites, which are eliminated in the feces. If liver function is deficient, the metabolism of singulair could be compromised. This can lead to increased blood levels of the medication for longer period of time, resulting in increased risk for side-effects and consequent toxicity with the medication. Dose reduction could be ordered accordingly, in individuals with history of compromised liver function. Close monitoring of liver function with periodical liver function studies ordered, can help prevent development of toxicity with singulair intake, in individuals with compromised liver function.
  3. Do not take Singulair, if you ever manifested any allergic response to intake of Singulair. Discuss your history of allergic response to this medication with your physician, without fail.