Asthma Management Handbook
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Table. Reviewing and adjusting preventer treatment for children aged 6 years and over

Initial treatment

When to schedule review

Management options and notes

Treatment response (symptoms well controlled)

No or partial response †

Montelukast or cromones

2–4 weeks

Continue treatment

Set review date (e.g. 3 months)

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

Inhaled corticosteroid (low dose)

4 weeks

Continue regular treatment at low dose

Set review date (e.g. 3 months)

 

Consider one of the following options:

  • Add montelukast in addition to inhaled corticosteroid (children 6–14 years)§
  • Increase the dose of inhaled corticosteroid; reassess in 2–4 weeks
  • Switch to combination long-acting beta2 agonist/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

‡ Before considering a change in the treatment regimen:

  • review the diagnosis, adherence and inhaler technique

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

§ PBS status as at October 2016: Montelukast treatment is not subsidised by the PBS for people aged 15 years or over.

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