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Zafirlukast (Accolate) side effects:ahealthyme.com:"Headache, nausea and diarrhea may occur. If these continue or are bothersome, notify your doctor promptly. If you notice any of the following unlikely but serious side effects, seek immediate medical attention: persistent nausea, stomach pain, dark urine, fatigue, yellowing eyes or skin. If you experience any of the side effects mentioned above, use of this drug may need to be stopped. If treatment is stopped due to those effects, never take this drug again. There is an increased risk of liver problems occurring in females. Very unlikely but notify your doctor promptly if you develop: sore throat, bleeding, bruising, muscle aches, unusual weight loss. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist"
http://www.ahealthyme.com/viewmonograph?selectedDrugId=198066&selectedDrugDescription=Accolate+Oral+Tablet+10+mg

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Who should not take Zafirlukast (Accolate):drugs.com:"Before taking zafirlukast, tell your doctor if you have liver disease. You may not be able to take zafirlukast, or you may require a dosage adjustment or special monitoring during treatment if you have liver disease. Talk to your doctor before taking zafirlukast if you are taking warfarin (Coumadin), which is used to reduce the risk of blood clot formation. Taking these drugs together increases the risk of bleeding and special monitoring may be required. Zafirlukast is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. Zafirlukast passes into breast milk and may harm a nursing baby. Do not take zafirlukast without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience side effects from zafirlukast. You may require a lower dose of this medication. Zafirlukast is not approved for use by children younger than 7 years of age."
http://www.drugs.com/xq/cfm/pageID_0/htm_D04053A1.htm/bn_Accolate/qx/index.htm

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Special warnings while taking Zafirlukast (Accolate):gettingwell.com:"While taking Accolate, you should not stop--or even cut down on--any other asthma medication you are using unless your doctor recommends it. Remember that Accolate is not an airway-opening medication. You will still need an inhaler to stop an attack. If you have been taking an oral steroid drug and your doctor does decide to cut back the dosage, there is a remote chance that complications will follow. Inform your doctor of any new symptoms. Also call your doctor if you develop any of the following: pain in the upper right abdomen, nausea, fatigue, lethargy, loss of appetite, itching, flu-like symptoms, or jaundice (yellowing of the skin and eyes). These are signs of a liver problem--a rare side effect of Accolate that tends to develop more often in women. If tests show the problem to be serious, you'll have to stop using the drug. The symptoms will disappear once you stop"
http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/acc1001.shtml

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Possible food and drug interactions of Zafirlukast (Accolate):healthsquare:"A full stomach can reduce Accolate's effectiveness. Do not take with meals. If Accolate is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Accolate with the following: Aspirin (Ecotrin, Genuine Bayer, others), Astemizole (Hismanal), Blood-thinning drugs such as Coumadin, Carbamazepine (Tegretol), Cyclosporine (Sandimmune, Neoral), Erythromycin (E.E.S., E-Mycin, others), Heart and blood pressure medications called calcium channel blockers, including Calan, Cardizem, and Procardia, Phenytoin (Dilantin), Terfenadine (Seldane), Theophylline (Theo-Dur, others), Tolbutamide (Orinase),"
http://www.healthsquare.com/newrx/acc1001.htm

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Zafirlukast (Accolate) drug class and mechanism:focusonasthma.com:"Zafirlukast is an oral leukotriene receptor antagonist used for treating asthma. Leukotrienes are a group of chemicals manufactured in the body from arachidonic acid. Release of leukotrienes within the body, for example, by allergic reactions, promotes inflammation in many diseases such as asthma, a disease in which inflammation occurs in the lungs. Zafirlukast blocks the binding of leukotriene types D4 (LTD4), and E4 (LTE4). It was approved by the FDA in 1996."
http://www.focusonasthma.com/script/main/art.asp?articlekey=9182&rd=1

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Zafirlukast (Accolate) special precautions:medlineplus:"Before taking zafirlukast,tell your doctor and pharmacist if you are allergic to zafirlukast or any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin), aspirin, erythromycin, terfenadine (Seldane), theophylline (Theo-Dur), and vitamins. tell your doctor if you have or have ever had liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking zafirlukast, call your doctor"
U.S. National Library of Medicine
8600 Rockville Pike, Bethesda, MD 20894
custserv@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a697007.html#precautions

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Zafirlukast (Accolate) action and kinetics:nursespdr:"A selective and competitive antagonist of leukotriene receptors D4 and E4, which are components of slow-reacting substance of anaphylaxis. It is believed that cysteinyl leukotriene occupation of receptors causes asthma, including airway edema, smooth muscle constriction, and altered cellular activity associated with the inflammatory process. Zafirlukast inhibits bronchoconstriction caused by sulfur dioxide and cold air in clients with asthma. It also attenuates the early- and late-phase reaction in asthmatics caused by inhalation of antigens such as grass, cat dander, ragweed, and mixed antigens. Rapidly absorbed after PO use; bioavailabilty may be decreased when taken with food. Peak plasma levels: 3 hr. t1/2, terminal: About 10 hr. Over 99% bound to plasma proteins. Extensively metabolized in the liver, with about 90% excreted in the feces and 10% in the urine. Inhibits certain cytochrome P450 isoenzymes"
http://www.nursespdr.com/members/database/ndrhtml/zafirlukast.html

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Zafirlukast (Accolate) uses and instructions for use:personalmd:"USES- This medication is used for the prevention and treatment of chronic asthma. It is not intended for acute attacks. This drug may also be used to minimize breathing problems caused by exercising or sensitivity to aspirin. HOW TO TAKE THIS MEDICATION- Take as directed twice daily one hour before or two hours after a meal on a regular basis. While the drug should continue to be taken during an asthma attack, it will not stop the attack. It is meant to lessen the number and severity of attacks"
http://www.personalmd.com/drgdb/277.htm

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Zafirlukast (Accolate) clinical pharmacology:rxlist:"Zafirlukast is a selective and competitive receptor antagonist of leukotriene D4 and E4(LTD4 and LTE4), components of slow-reacting substance of anaphylaxis (SRSA). Cysteinyl leukotriene production and receptor occupation have been correlated with the pathophysiology of asthma, including airway edema, smooth muscle constriction, and altered cellular activity associated with the inflammatory process, which contribute to the signs and symptoms of asthma. Patients with asthma were found in one study to be 25-100 times more sensitive to the bronchoconstricting activity of inhaled LTD4 than nonasthmatic subjects. In vitro studies demonstrated that zafirlukast antagonized the contractile activity of three leukotrienes (LTC4, LTD4 and LTE4) in conducting airway smooth muscle from laboratory animals and humans. Zafirlukast prevented intradermal LTD4-induced increases in cutaneous vascular permeability and inhibited inhaled LTD4-induced influx of eosinophils into animal lungs. Inhalational challenge studies in sensitized sheep showed that zafirlukast suppressed the airway responses to antigen; this included both the early- and late-phase response and the nonspecific hyperresponsiveness"
http://rxlist.com/cgi/generic/zafirlukast_cp.htm

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Zafirlukast (Accolate) Approved by FDA for Children with Asthma Seven Years of Age and Older:Business Wire:"A new pediatric formulation of the popular asthma medication, ACCOLATE(R) (zafirlukast), has received approval from the U.S. Food and Drug Administration (FDA) for use in patients as young as seven years of age. The product will be available in a 10- milligram, nonflavored minitablet specifically designed for children. Recommended dosing is one 10-mg minitablet twice daily, even during symptom free periods. Since 1996, ACCOLATE has helped control symptoms for asthma sufferers 12 years of age and older. In the U.S., ACCOLATE has been prescribed more than 5 million times for the preventive and chronic treatment of asthma. ACCOLATE is now approved in 60 countries worldwide. "The new pediatric indication for ACCOLATE is very important because it offers a new, safe preventive asthma treatment option for children," said Kathy L. Lampl, M.D., Medical Director of Asthma & Allergy Associates, Rockville, Maryland. "Although there is no cure for asthma, parents can now help control their child's asthma with a convenient oral tablet given in the morning and evening."
http://www.findarticles.com/cf_bzwr/m0EIN/1999_Sept_20/55792065/p1/article.jhtml

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