Asthma Management Handbook
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Table. Reviewing and adjusting preventer treatment for children aged 0–5 years

Initial treatment When to schedule review Management options and notes
Treatment response No treatment response †

Montelukast (children 2 years and over)

2–4 weeks

Continue montelukast treatment


Stop montelukast and start treatment with an inhaled corticosteroid, starting with a low dose

Inhaled corticosteroid (low dose)

4 weeks

Continue regular treatment at low dose

After ≥3 months, consider stopping treatment and reviewing in 4 weeks

Review the diagnosis, adherence and inhaler technique

Consider referral to a specialist (e.g. paediatric respiratory physician or paediatrician, if available) for assessment

Consider adding montelukast (in combination with inhaled corticosteroid)

  • Advise parents about potential adverse psychiatric effects of montelukast

† Symptom control not achieved with initial treatment after verifying treatment was taken as intended

‡ PBS status as at October 2016: Montelukast is not subsidised by the PBS for children aged 2–5 years with moderate-to-severe asthma, or when used in combination with another preventer.

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