zafirlukast Nursing Considerations & Management

Drug Name

Generic Name : zafirlukast

Brand Name: Accolate

Classification: Antasthmatic, Leukotriene receptor antagonist

Pregnancy Category B 

Dosage & Route

Available forms : Tablet—10, 20 mg

  • 20 mg PO bid on an empty stomach.
  • 10 mg PO bid on an empty stomach.
Therapeutic actions
  • Zafirlukast selectively antagonizes the leukotriene D4 receptor. It inhibits bronchoconstriction caused by various inhaled antigens or irritants. It is not used in acute asthma attacks.
  • Prophylaxis and long-term treatment of bronchial asthma in adults and children > 5 yr
  • Unlabeled use: Chronic urticaria
Adverse effects
  • GI disturbances, headache, myalgia, generalized pain, fever, dizziness, raised LFT, respiratory tract infections, hypersensitivity reactions, Churg-Strauss syndrome.
  • Potentially Fatal: Severe hepatotoxicity. 
  • Hypersensitivity, hepatic impairment, cirrhosis, acute asthmatic attacks. Lactation.
Nursing considerations
  • History: Hypersensitivity to zafirlukast; impaired renal or hepatic function; pregnancy, lactation; acute asthma or bronchospasm
  • Physical: T; orientation, reflexes; R, adventitious sounds; GI evaluation; LFTs, renal function tests
  • Administer on an empty stomach 1 hr before or 2 hr after meals.
  • Ensure that drug is taken continually for optimal effect.
  • WARNING: Do not administer for acute asthma attack or acute bronchospasm.
Teaching points
  • Take this drug on an empty stomach, 1 hour before or 2 hours after meals.
  • Take this drug regularly as prescribed; do not stop taking it during symptom-free periods; do not stop taking it without consulting your health care provider.
  • Do not take this drug for acute asthma attack or acute bronchospasm; this drug is not a bronchodilator; routine emergency procedures should be followed during acute attacks.
  • Avoid use of over-the-counter medications while using this drug; many of them contain products that can interfere with drug or cause serious side effects. If you think that you need one of these products, consult your health care provider.
  • You may experience these side effects: Dizziness (use caution when driving or performing activities that require alertness); nausea, vomiting (eat frequent small meals); headache (analgesics may be helpful).
  • Report fever, acute asthma attacks, severe headache.