Zafirlukast is a leukotriene (loo-koe-try-een) inhibitor. Leukotrienes are substances in the body that are associated with the inflammation and constriction of airway muscles and the accumulation of fluid in the lungs, all of which occur during an asthma attack.

Zafirlukast is used to prevent asthma attacks.

Zafirlukast may also be used for purposes other than those listed in this medication guide.

Take zafirlukast exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Take this medication on an empty stomach 1 hour before or 2 hours after a meal.

Do not stop taking zafirlukast without first talking to your doctor. It may be some time before you begin to notice effects from this medication.

Continue taking any other asthma medications, as directed by your doctor.

Zafirlukast will not stop an asthma attack that has already begun. Keep another medication on hand to treat attacks.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

Store zafirlukast at room temperature away from moisture and heat.

Before taking this medication, tell your doctor if you are taking any of the following medicines:

• aspirin;

• erythromycin (Ery-Tab, E-Mycin, E.E.S., others);

• warfarin (Coumadin); or

• theophylline (Theo-Dur, Theolair, Elixophyllin, Slo-Phyllin, others).

You may not be able to take zafirlukast, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with zafirlukast. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Avoid items or activities that are known allergens or that make your symptoms worse. Clean areas where dust or pet fur may aggravate your condition.

Discuss with your doctor the use of alcohol while taking zafirlukast. Alcohol and zafirlukast can both affect the liver.

Seek emergency medical attention.

The symptoms of an overdose of zafirlukast are unknown.

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take the next regularly scheduled dose as directed. Do not take a double dose of this medication.

Contact your doctor immediately if you experience nausea, unexplained fatigue or tiredness, itching, yellowing of the skin or eyes, flu-like symptoms, or upper left stomach pain. These may be early signs of liver problems.

Zafirlukast will not stop an asthma attack that has already begun. It is used to prevent asthmatic attacks.

Use zafirlukast on a regular basis for best results. It may take several weeks to get the maximum effect of this medication.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

Discuss with your doctor the use of alcohol while taking zafirlukast. Alcohol and zafirlukast can both affect the liver.

Before taking zafirlukast, tell your doctor if you

• have liver disease; or

• drink alcohol.

You may not be able to take zafirlukast, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

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 not expected to be harmful to 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 5 years of age.

Your pharmacist has more information about zafirlukast written for health professionals that you may read.

Zafirlukast is available with a prescription under the brand name Accolate. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Accolate 20 mg—round white tablets

• Accolate 10 mg–round tablets