1. How long is the course of treatment with montelukast sodium? A: It is not clearly defined in the instructions or in the literature. As a long-term controlled drug recommended by GINA and ARIA, it is generally advocated that it should be taken for a long time, and the specific course of treatment can be determined according to the patient’s treatment effect. ①Cough variant asthma (CVA) after diagnosis, the general course of treatment is 3-6 months. ②For typical asthma, the course of treatment should be at least 1 year. Treatment of asthma with montelukast sodium should be used for at least 1 month and continued if it is effective. Long-term adherence to treatment is advocated: at least six months, with no upper limit According to the international guideline criteria, no less than 2 years for infants and children with asthma; no less than 4 years for adults, and lifelong maintenance of treatment for elderly and pre-existing emphysema patients with asthma. If the patient’s bronchial excitation test is negative, the drug can be discontinued after 1~2 weeks of further adherence. If the patient has a negative bronchial excitation test, the drug can be stopped after 1 to 2 weeks. ③For the treatment of allergic rhinitis, the course of treatment is also decided mainly according to the condition, which can be 2 weeks, or 1 month, or may be longer. ④For the treatment of asthma and rhinitis, the minimum duration of treatment should not be less than 1 month. 2. According to GINA guidelines, is there any dose variation of montelukast sodium in step therapy for asthma? No, except for mild interstitial asthma, montelukast sodium can be used in all 3 classes, all once daily, and the doses are based on age groups, i.e.: 10 mg once daily in children and adults over 15 years of age; 5 mg once daily in children 6 to 14 years of age; 4 mg once daily in children 2 to 5 years of age; 1 mg once daily in pediatric patients 12 months to 24 months of age. In pediatric patients aged 12 to 24 months, 4 mg once daily; in infants younger than 12 months, there is a relative lack of clinical information. In Europe, montelukast sodium can be used in infants over 6 months of age. 3. Does repeated/prolonged use of montelukast sodium lead to reduced efficacy? Is there any rebound from discontinuation of the drug? No such phenomenon has been observed, and no such phenomenon has been reported in the clinical literature. 4. Can the dose of montelukast sodium be increased? What is the effect? What is the maximum duration of use of montelukast sodium? The clinical use of the drug generally follows the usage of the instructions, and it is not recommended to violate the rules (increase or decrease the dosage, etc.), and can be used for a long time. The instructions do not specify a specific duration of treatment, and no definitive duration has been seen in the literature, but as a GINA-recommended controlled substance it should generally be used for a long period of time, the exact duration of use depending on the clinical response of the patient to treatment. The experience of some physicians is that it is generally used for one month at first and then continued if it is effective. The longest-standing patient has been on it for four years with good results. 5.What is the significance of montelukast sodium for asthma treatment? The more important and basic significance of montelukast sodium in the treatment of asthma is to prevent and reduce the number of acute asthma attacks. 6.When to start the reduction of treatment? For most asthma control medications, improvement in asthma begins within days of initial treatment, but maximum effect is possible only after 3-4 months. In patients with severe, clinically inadequate asthma, the time to maximum effect of asthma control medications may be longer. Dose reduction should be considered only when asthma control has been achieved and maintained for at least 3 months.