Zafirlukast
Indications
Registered South African indications:
- Asthma
Cautions
Contraindications
- Hypersensitivity to the active ingredient or any of its excipients
- Pregnancy
- Breastfeeding
- Hepatic impairment, including hepatic cirrhosis
- Children below 12 years
Cautions
- Renal impairment
- Elderly
- Acute asthma
- Brittle asthma
- Galactose intolerance
- Lapp lactase deficiency
- Glucose-galactose malabsorption
Adult dosage
Forms avail. in SA and covered in this monograph: tab
Chronic asthma
- Oral (tab): 20mg, 12hrly; Max: 40mg/24hrs
Should not be taken with meals
Do not crush/ cut/ chew/ dissolve tablet
Paediatric dosage
Not established for use in children below 12 years (see Contraindications)
Special populations
Pregnancy
- Contraindicated
Breastfeeding
- Contraindicated
Renal Impairment
- Caution
Hepatic Impairment
- Contraindicated
Elderly
- Caution
Adverse reactions
Central Nervous System Disorders
- Headache
- Hypoaesthesia
- Dizziness
- Insomnia
- Nightmares
- Malaise
Gastrointestinal Disorders
- Nausea and vomiting
- Abdominal pain
Hepatobiliary Disorders
- Elevations in transaminase levels
- Hyperbilirubinemia
- Hepatitis
- Hepatic failure
Genitourinary Disorders
- Menorrhagia
Musculoskeletal and Connective Tissue Disorders
- Myalgia
- Arthralgia
Skin and Subcutaneous Tissue Disorders
- Rash
- Urticaria
- Pruritus
- Blister
Immune, Blood and Lymphatic System Disorders
- Hypersensitivity
- Angioedema
- Thrombocytopenia
- Agranulocytosis
- Eosinophilia
- Churg-Strauss syndrome
- Infection
Interactions
- CYP450 inhibitors
- Erythromycin
- Terfenadine
- Theophylline
- Warfarin
- Aspirin
Monitoring
None routine. Specific cases may require
- Hepatic function
Mechanism of action
Zafirlukast is a competitive, highly selective antagonist of cysteinyl leukotriene receptors. Cysteinyl leukotrienes are potent inflammatory eicosanoids. Cysteinyl leukotrienes act as pro-asthmatic mediators in the airway by affecting smooth muscle contraction, airway oedema and altering cell activity associated with the inflammatory process, including eosinophil influx to the lung.
Dosage forms
- Tablet
Formulation
Tablet 20mg
- Accolate (AstraZeneca) originator
References
1. SAMF_12th Edition_Page 556 2. https://www.medicines.org.uk/emc/medicine/2269 (31/03/2016_AstraZenrca_Accolate_20mg tab) 3. https://drive.google.com/drive/folders/0B0xnChtF7vduYUJGTmdtWmQ1Tjg (23/07/2004_AstraZeneca_Accolate_ 20mg tab) 4. https://www.drugs.com/pregnancy/zafirlukast.html (last accessed 30/01/2017)
Brands & products
1 product · stale NAPPI snapshot · refreshed 5/28/2026 · 159 days oldtabletGeneric· 1 product
from R13.24/unit| Product | Strength | Pack | Sched | SEP | Unit | Disp fee | NAPPI |
|---|---|---|---|---|---|---|---|
| Accolate | 20 mg | 56 | S3 | R741.68 | R13.24 | R193.57 | 892580003 |
- Accolate
Medical aid coverage
data not yet integrated- Comprehensive Series—
- Executive Plan—
- KeyCare Series—
- Priority Series—
- Saver Series—
Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.
- BonClassic—
- BonComprehensive—
- BonEssential—
- BonFit Select—
- BonSave—
- BonStart—
Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.
- Beryl—
- Emerald—
- Onyx—
- Ruby—
- Sapphire—
- Tanzanite One—
Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.
- Aquarium Option—
- Efficiency Option—
- Marine Option—
Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.