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Printable Side Effect Alert
   
 

THE FDA ENCOURAGES PARENTS WHOSE CHILDREN  EXPERIENCED ADVERSE EVENTS WHILE ON SINGULAIR TO REPORT, OR HAVE THEIR CHILD'S DOCTOR REPORT, THESE EVENTS TO THE FDA MEDWATCH PROGRAM.

FILE A MEDWATCH REPORT

Adverse Event Reports are used by the FDA to identify and evaluate safety issues with medications. Adverse event reporting by consumers and medical professionals led to the identification of hostility and sleepwalking as side effects of Singulair, and  the addition to Singulair's label (prescribing information) of a precaution about  neuropsychiatric side effects. 

The FDA continues to investigate Singulair. Consumers and medical professionals should continue to report ALL adverse reactions to Singulair (even those already listed on Singulair's label) in children AND adults.

Adverse Event Reports (with personal information omitted) become part of the public record. Agencies such as The Institute for Safe Medication Practices review the FDA AERS reports and issue their own alerts and recommendations.

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SINGULAIR'S LABEL HAS BEEN UPDATED

SINGULAIR'S label (prescribing information) was updated in August 2009 with a new "precaution" about neuropsychiatric side effects:

"Neuropsychiatric events have been reported in adult, adolescent, and pediatric patients taking SINGULAIR. Post-marketing reports with SINGULAIR use include agitation, aggressive behavior or hostility, anxiousness, depression, dream abnormalities, hallucinations, insomnia, irritability, restlessness, somnambulism, suicidal thinking and behavior (including suicide), and tremor. The clinical details of some post-marketing reports involving SINGULAIR appear consistent with a drug-induced effect. Patients and prescribers should be alert for neuropsychiatric events. Patients should be instructed to notify their prescriber if these changes occur. Prescribers should carefully evaluate the risks and benefits of continuing treatment with SINGULAIR if such events occur."

See the "Precautions" section of Singulair's Prescribing Information.

FDA Patient Safety News Video: Neuropsychiatric Events with Certain Asthma Drugs (Singulair, Zyflo, Zyflo CR, Accolate) "If these symptoms develop clinicians should consider discontinuing the medication."

After son's suicide, campaign by Queensbury pair leads to warning label on Singulair

Parents United for Pharmaceutical Safety and Accountability is pleased that the FDA acknowledged Singulair's neuropsychiatric side effects, validating the assertions of parents whose children suffered adverse reactions to this drug. However, we are  disappointed that the FDA requested only a "Precaution” on Singulair’s label instead of requiring a “black box” warning and a Medication Guide for consumers.

Singulair is commonly prescribed for CHILDREN, and has side effects that are recognized by federal health agencies as warning signs and risk factors for suicide. It should carry the strongest warning the FDA can issue.

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IF YOUR CHILD HAD AN ADVERSE REACTION TO SINGULAIR PLEASE PARTICIPATE IN OUR SURVEY. Parents United for Pharmaceutical Safety and Accountability has received inquiries from parents wanting to know how long it takes for side effects to resolve after Singulair is discontinued, if there are withdrawal symptoms, and if there are any long term or permanent side effects. We are working to generate interest in research to answer these questions and we need your help to succeed. 

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If you are the parent of a child with asthma or allergies and are considering giving your child Singulair, or if you have already made this decision, EDUCATE YOURSELF with the information on our website. Adverse Reactions to Singulair offers an in depth explanation of Singulair's side effects. Guidelines for Parents gives tips for interacting with your child's physician, and What Everyone Should Know explains why self-education is so important. 

If you are a healthcare provider, we urge you to learn everything you can about Singulair before you write another prescription, especially for a child. We also urge you to follow the National Asthma Education and Prevention Program (NAEPP) clinical practice guidelines, and ask that you learn from our experience and incorporate our Guidelines for Physicians  into your practice. 

And if you are the parent of a child that has had an adverse reaction to Singulair and you have experienced loss of any type, we hope you find comfort in the fact that you are not alone, and that others are working tirelessly to help change a system that allows children's mental and physical health to fall through the cracks.

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IMPORTANT THINGS TO KNOW:

* Singulair has NOT been proven the safest and most effective drug to treat asthma or allergies: 

The National Asthma Education and Prevention Program (NAEPP)
recommends that for all age groups, inhaled corticosteroids are the most effective medication for long-term control. Leukotriene receptor antagonists (including Singulair) are considered adjunct (additional) therapy with inhaled corticosteroids, and omalizumab for severe asthma.* (Inhaled corticosteroids are not side effect free.)

Diagnosis and management of rhinitis: An updated practice parameter
Intranasal corticosteroids have been clinically proven the most effective treatment for allergic rhinitis. Adverse reactions usually are limited to the nasal mucosa, with rare systemic effects.***

* Singulair is not effective for everyone. Clinical research has determined that differential response is due in part to genetic variability.

* Approved by the FDA in February 1998, SINGULAIR is approved for use in children:

• 12 months of age and older with asthma
• 2 years of age and older with seasonal allergic rhinitis (since 2002)
• 6 months of age and older with perennial (year round) allergic rhinitis (since 2005)
• 15 years and older for exercise induced bronchoconstriction (since 2007)

• Singulair's 10mg strength is not approved for use in children under 15.

* SINGULAIR's label has been updated multiple times to include bad/vivid dreams, irritability, restlessness (added in 2001), agitation including aggressive behavior, insomnia, hallucinations (added in 2002); tremor (added in March 2007), depression (added in April 2007), suicidal thinking and behavior (added in October 2007), and anxiousness (February 2008). Hostility and somnambulism (sleep walking) (added August 2009).

* SINGULAIR is one of the most popular medicines in America; about 28 million prescriptions were filled in 2008.

* Neither risk factors for, nor the actual incidence of, adverse reactions to Singulair is known! After a medication is approved and enters the market, adverse reactions that may not have been reported in clinical trials are identified through voluntary reports to pharmaceutical companies and the FDA's 
MedWatch program. Pharmaceutical companies are required to notify the FDA when they receive adverse event reports, but physicians are not required to report their patients' adverse  reactions. Only those adverse reactions that are reported are considered when re-evaluating the risk/benefit ratio of a medication. READ MORE

* There is no regulated system to immediately communicate updated medication information to consumers, physicians, and pharmacists. Physicians and pharmacists may not be aware of Singulair's updated side effects or the FDA's safety review.
CLICK HERE for more information.

* Consumers and healthcare providers can sign up for
FDA MedWatch e-mail updates to receive updated information about medications/medical products.

* Consumer Medication Information (CMI) voluntarily provided by pharmacies is NOT regulated or approved by the FDA and may not contain a comprehensive list of side effects. CLICK HERE for more information. This news report is also informative: Drug fact sheets may omit facts consumers need.

* A reliable source of accurate medication information is the
National Library of Medicine's DailyMed website, a database that includes FDA approved labels for over 4400 prescription drugs. For the most current side effect information, visit the website of the medication manufacturer and read the patient and prescribing information.

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EVERYONE should be disturbed that a drug with neuropsychiatirc and serious physical side effects is frequently prescribed for children as young as 6 months of age to treat conditions for which it has NOT been proven the safest and most effective treatment option. Since we cannot predict who will suffer an adverse reaction, we must assume that everyone who takes Singulair is at risk.

PLEASE help us raise awareness of Singulair's side effects so that children (and adults) will not continue to suffer needlessly.

REPORT an ADVERSE REACTION (to any medication) to FDA MedWatch

REPORT a MEDICATION ERROR to
Consumermedsafety.org

SHARE your child's RECOVERY STORY with other parents, who may be wondering how long it takes side effects to resolve.

SHARE the information on our site with others, including your and your child's physicians and pharmacists; your childcare provider; your child's preschool director; school principal, nurse, teacher, and guidance counselor; your family and friends.

DISTRIBUTE our Singulair Side Effect Alert and the FDA's Updated Information on Leukotriene Inhibitors: Montelukast (marketed as Singulair), Zafirlukast (marketed as Accolate), and Zileuton (marketed as Zyflo and Zyflo CR) to local physicians or physician groups, hospitals, school district superintendents, daycare facilities, preschools, early intervention programs, mental health organizations, social service agencies, your state department of public health or public welfare, etc. Hang our "Singulair Side Effect Alert" on community or church bulletin boards and anywhere else parents will see it. Ask your childcare provider or preschool director to make copies and distribute to parents.

ASK your physician and pharmacist to sign up for
FDA MedWatch e-mail updates, concise, timely information about drugs and medical devices directly from the FDA.

ASK your physician use
DailyMed to check medication information.

DEMAND CHANGE. 
Contact your representatives in Congress and the Senate and ask them to take action to prevent unnecessary suffering from medication side effects.

JOIN our Facebook Cause:
Raising Awareness of Singulair's Side Effects.
Feature the cause in your profile and invite your friends to do the same.




*The EPR 3 Guidelines on Asthma were developed by an expert panel commissioned by the National Asthma Education and Prevention Program (NAEPP) Coordinating Committee (CC), coordinated by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.

**Developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma and Immunology; and the Joint Council of Allergy, Asthma and Immunology, published in the Journal of Allergy and Clinical Immunology, August 2008.

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Disclaimer: Parents United for Pharmaceutical Safety and Accountability is a volunteer patient advocacy group. Consult a licensed healthcare professional before making any medical decisions. Do not stop administering an asthmatic child's medications without the supervision of the child's healthcare provider. The information on this site is intended for educational purposes and should not be construed as medical advice. It is accurate to the best of our knowledge. If you discover an inconsistency, please bring it to our attention.