Posology : מינונים

2     DOSAGE AND ADMINISTRATION
General Recommendations
The therapeutic effect of SINGULAIR on parameters of asthma control occurs within one day. SINGULAIR tablets, chewable tablets and oral granules can be taken with or without food. Patients should be advised to continue taking SINGULAIR while their asthma is controlled, as well as during periods of worsening asthma.

No dosage adjustment is necessary for pediatric patients, for the elderly, for patients with renal insufficiency or mild-to-moderate hepatic impairment or for patients of either gender.

SINGULAIR should be taken once daily. For asthma, the dose should be taken in the evening. For seasonal allergic rhinitis, the time of administration may be individualized to suit patient needs.

Patients with both asthma and seasonal allergic rhinitis should take only one tablet daily in the evening.

Adults 15 Years of Age and Older with Asthma and/or Seasonal Allergic Rhinitis The dosage for adults 15 years of age and older is one 10-mg tablet daily.

Pediatric Patients 6 to 14 Years of Age with Asthma and/or Seasonal Allergic Rhinitis 
          The dosage for pediatric patients 6 to 14 years of age is one 5-mg chewable tablet daily.

Pediatric Patients 2 to 5 Years of Age with Asthma and/or Seasonal Allergic Rhinitis The dosage for pediatric patients 2 to 5 years of age is one 4-mg chewable tablet daily or one sachet of 4- mg oral granules daily.

Pediatric Patients 12 Months to 2 Years of Age with Asthma
The dosage for pediatric patients 12 months to 2 years of age is one sachet of 4-mg oral granules daily.

Patients who miss a dose should take the next dose at their regular time and should not take 2 doses at the same time.

Administration of oral granules:
SINGULAIR oral granules can be administered either directly in the mouth, mixed with a spoonful of cold or room temperature soft food (e.g., applesauce), or dissolved in 1 teaspoonful (5 mL) of cold or room temperature baby formula or breast milk. The sachet should not be opened until ready to use. After opening the sachet, the full dose of SINGULAIR oral granules must be administered immediately (within 15 minutes).
If mixed with food, or dissolved in baby formula or breast milk, SINGULAIR oral granules must not be stored for future use. SINGULAIR oral granules are not intended to be dissolved in any liquid other than baby formula or breast milk for administration. However, liquids may be taken subsequent to administration.

Therapy with SINGULAIR in Relation to Other Treatments for Asthma
SINGULAIR can be added to a patient’s existing treatment regimen.
Reduction in Concomitant Therapy:
Bronchodilator Treatments: SINGULAIR can be added to the treatment regimen of patients who are not adequately controlled on bronchodilator alone. When a clinical response is evident (usually after the first dose), the patient’s bronchodilator therapy can be reduced as tolerated.
Inhaled Corticosteroids: Treatment with SINGULAIR provides additional clinical benefit to patients treated with inhaled corticosteroids. A reduction in the corticosteroid dose can be made as tolerated. The dose should be reduced gradually with medical supervision. In some patients, the dose of inhaled corticosteroids can be tapered off completely.
SINGULAIR should not be abruptly substituted for inhaled corticosteroids.