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What is Zafirlukast?

By Amanda Lacasse
Updated May 17, 2024
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Zafirlukast is an oral medication that controls asthma symptoms in adults and children older than 5 years. Also known by its brand name, Accolate®, zafirlukast tablets work by reducing inflammation in the bronchial tubes, thus decreasing swelling and making breathing easier. This drug is used in conjunction with inhalers such as the bronchiodilator albuterol and is meant to reduce the use of inhalers by keeping airway inflammation under control. Zafirlukast works by blocking the action of inflammatory leukotrienes, which contribute to asthma symptoms. This medication may also be used to treat hay fever or exercise-induced asthma.

Patients take these asthma tablets by mouth twice daily unless otherwise instructed by their physician. Zafirlukast should be taken on an empty stomach and works best when taken consistently. It is meant to treat chronic symptoms of asthma rather than acute, sudden attacks, for which patients will still need to use their inhaler. It may take up to two weeks for zafirlukast users to feel the effects of the drug.

Some people should not take zafirlukast. Contraindications include liver disease and allergies to other leukotriene-blocking drugs. Generally, pregnant women are advised not to take this drug, and new mothers using this medication should not breastfeed, because it passes into breast milk. Elderly patients may not be good candidates for this asthma treatment because of increased sensitivity to the drug's side effects, particularly nausea, diarrhea and headache. While these and other side effects — such as sore throat, insomnia and general malaise — may affect younger patients as well, they are usually less pronounced.

Zafirlukast has been known to cause liver disorders in rare cases, and patients are cautioned to contact their doctor immediately if they have symptoms such as abdominal pain, nausea, vomiting or jaundice. Other serious side effects, such as mood changes, swelling of the hands and feet, and coughing up blood, have also been reported. As with any drug, the risk of severe allergic reaction always exists and symptoms such as sudden rash, difficulty breathing and swelling of the tongue or throat should never be ignored.

Interactions with other drugs include certain antibiotics, blood thinners, calcium channel blockers and several anti-seizure medications. Taking aspirin with zafirlukast may increase the risk of side effects. Patients on low-dose aspirin therapy for prevention of heart attacks, however, are usually allowed to continue with this regimen.

Occasional liver function tests may be ordered by the prescribing physician to ascertain normal liver activity. People taking this drug are encouraged to use a peak-flow meter on a daily basis and to notify their doctor if the lung air flow measurements are in the yellow or red range. This may indicate a needed adjustment in prescribed asthma medications.

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