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Asthma/Tonsilitus After Montelukast


I have been on Montelukast since last September. Beginning at the end of December, I decided to go off of it, because I was only taking it for seasonal allergies and my allergies were usually only bad in August/September. In January I had what seemed to be the flu, but what turned into tonsillitis. I have had tonsillitis for about 2 weeks now with swollen tonsils, puss coming out of the tonsils on both sides, redness on the back of the throat, as well as post-nasal drip. I have been tested for strep throat twice, with negative results on both. I also have been tested for mono with no positive results either.

I'm wondering if in some odd way, going off of Montelukast, caused the severe tonsillitis. I started one anti-biotic (Azythromicin) several weeks ago with no improvement. My doctor then prescribed me another (Cephalexin), and I've had no improvement again. Do you see any connection with the severe tonsillitis and the stopping of Montelukast?

Hi Veronica,

Upper respiratory infections while on montelukast are uncommon, let alone much afterward. I believe your problem is the same as what my daughter encountered: abscessed tonsils. The infections becomes encapsulated in the tonsil, and the antibiotics don't penetrate. She was on 6 weeks of antibiotics prior to surgery, and during the surgery, when the tonsils were removed, they were still fully infected.

Today there is less of a rush to do surgery than in the past, unless the tonsils and adenoids get to this level of infection. If you are not being seen by an EENT specialist for this, I would go for a consult for a thorough evaluation, based upon your history and present symptoms.

Hope this helps. Let me know what results for the follow-up.




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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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