You are on page 1of 3


(zah fur' luh kast)


Pregnancy Category B

Drug classes
Leukotriene receptor antagonist

Therapeutic actions
Selectively and competitively blocks receptor for leukotriene D4 and E4, components of
SRS-A, thus blocking airway edema, smooth muscle constriction, and cellular activity
associated with inflammatory process that contribute to signs and symptoms of asthma.

• Prophylaxis and long-term treatment of bronchial asthma in adults and children >
5 yr

Contraindications and cautions

• Contraindicated with hypersensitivity to zafirlukast or any of its components;
acute asthma attacks; status asthmaticus; pregnancy, lactation.
• Use cautiously with hepatic or renal impairment; as oral steroid use is decreased;
patients who previously required corticosteroid therapy to control asthma.

Available forms
Tablet—10, 20 mg

20 mg PO bid on an empty stomach.
10 mg PO bid on an empty stomach.

Route Onset Peak
Oral Rapid 3 hr

Metabolism: Hepatic; T1/2: 10 hr

Distribution: Crosses placenta; enters breast milk
Excretion: Urine and feces

Adverse effects
• CNS: Headache, dizziness, myalgia
• GI: Nausea, diarrhea, abdominal pain, vomiting, liver enzyme elevation
• Other: Generalized pain, fever, accidental injury, infection; Churg-Strauss
syndrome (eosinophilia, vasculitic rash, pulmonary and cardiac complications)
when oral steroid dose is reduced

• Increased risk of bleeding with warfarin; these patients should have PT done
regularly and warfarin dose decreased accordingly
• Potential for increased effects and toxicity of calcium channel-blockers,
• Decreased effectiveness with erythromycin, theophylline
• Possible severe reaction when oral steroid dose is reduced while on zafirlukast;
monitor patients very closely
• Bioavailability decreased markedly by presence of food; administer at least 1 hr
before or 2 hr after meals

Nursing considerations
• History: Hypersensitivity to zafirlukast; impaired renal or hepatic function;
pregnancy, lactation; acute asthma or bronchospasm
• Physical: T; orientation, reflexes; R, adventitious sounds; GI evaluation; renal
and liver function tests

• Administer on an empty stomach 1 hr before or 2 hr after meals.
• Ensure that drug is taken continually for optimal effect.
• Do not administer for acute asthma attack or acute bronchospasm.

Teaching points
• Take this drug on an empty stomach, 1 hr before or 2 hr after meals.
• Take this drug regularly as prescribed; do not stop taking it during symptom-free
periods; do not stop taking it without consulting your health care provider.
• Do not take this drug for acute asthma attack or acute bronchospasm; this drug is
not a bronchodilator; routine emergency procedures should be followed during
acute attacks.
• Avoid use of over-the-counter medications while using this drug; many of them
contain products that can interfere with drug or cause serious side effects. If you
feel that you need one of these products, consult your nurse or physician.
• These side effects may occur: Dizziness (use caution when driving or performing
activities that require alertness); nausea, vomiting (eat frequent small meals);
headache (analgesics may be helpful).
• Report fever, acute asthma attacks, severe headache.

Adverse effects in Italic are most common; those in Bold are life-threatening.