Wait! Your allergies aren't that bad!

FDA probes possible suicide link to Singulair

Montelukast (Singulair) was one of Merck's most profitable drugs last year, raking in $4.3B USD.

Merck has updated the drug's labeling four times in the past year to include information on a range of reported side effects: tremors, anxiousness, depression and suicidal behavior.

This is obviously serious and needs to be monitored. Reports at this point are anecdotal, but should someone you know takes this medication and exhibits and serious change in behavior, their physician needs to be notified immediately.

Merck officials stressed that the FDA's inquiry is based on reports, not clinical studies — which are the standard tool for evaluating drug safety. The company said none of the 11,000 patients enrolled in 40 Singulair trials has committed suicide.

Singulair (montelukast) and two other medications - zafirlukast (Accolate) and zileuton (Zyflo) - are leukotriene inhibitors used in asthma and allergic rhinitis. Honestly, I don't know if I have ever written any Zyflo or Accolate due to possible liver complications.

Singulair is a "third tier" choice for me. Start on OTC medications for allergies, including loratadine (Claritin) and cetirizine (Zyrtec), with addition of a nasal steroid - fluticasone (Flonase) or other - with montelukast (Singulair) written last due to cost. Failing that, I get an allergist and skin testing involved.

I think Merck will probably be vindicated that there is no large threat with montelukast (Singulair), but it will probably take a year to find out.