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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Zafirlukast discontinued

The manufacturer of zafirlukast (Accolate®) has discontinued this product with effect from the end of March 2018. No further supplies are being made and it is predicted that minimal supplies will be available within the supply chain.

Commercial reasons are cited for this decision and it is stressed that there were no safety concerns with this medicine. Zafirlukast is a leukotriene receptor antagonist and as such the closest available alternative is montelukast.

Action: Clinicians should be aware of this product being discontinued. It would be prudent to run clinical system searches to identify any patients who are currently prescribed this product to allow a review and arrangements made to identify a suitable alternative.

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45 Comments to “Zafirlukast discontinued”

  1. My asthma was well controlled while I was taking zafirlukast and I didn't have side effects. Since running out I've been back on montelukast but stopped because of side effects. My asthma got worse so I needed steroid tablets. I've been off sick for a month because of stopping zafirlukast. I have asthma symptoms every day, no energy and am very tired. I've been on several asthma drugs over the last few years and this was the best at controlling my asthma. It is difficult getting through every day now. The discontinuation of this drug has severely affected my quality of life.

    Comment by Sophie Taylor — October 28, 2018 #

    1. I am still able to get a generic here in the USA.

      Comment by Trish — October 29, 2018 #

  2. Generic zafirlukast is available from PAR NDC 49884-554-02 for 20mg. I assume you were taking generic unless you were paying $112 a month deducible or more as Brand price is $277 dollars for 60 pills. Which I was paying and didn't notice the manufacturer change on bottle until now. So for 6 months I could have paid $5 instead of $177 a month for drugs. 🙁

    Comment by Arnold — September 18, 2018 #

    1. @Arnold,

      Thanks for the information, but the product seems to be unavailable here in the UK. Maybe if there if deemed to be a sufficient market for it, a company may import from abroad for UK consumers.

      Comment by Matthew Robinson — September 19, 2018 #

      1. Sorry to hear you can't even get generic.

        Comment by Arnold — October 1, 2018 #

  3. As I understand, Accolate BRAND by original manufacturer has been discontinued. However a "Brand" Accolate is available by PAR Pharma but looking at pill and ingredient list it is the same as there GENERIC Zafirlukast both are still available just "Brand" cost more so just order Generic. So we have only Generic and a Generic Pill sold under Brand Name only available.

    Comment by Arnold — September 18, 2018 #

  4. I was prescribed Accolate about fifteen years ago. I have never had a asthma attack since. Previously I'd been admitted twice to hospital suffering with severe problems with the usual wheezing and breathlessness. I have been asthmatic all my life and do believe that I wouldn't be writing this article if I hadn't been taking Accolate.
    I too started on Montelukast on Monday and by Friday evening could not get my breath and been like this all weekend - my quality of life has gone to zero. Shame on you manufacturers.

    Comment by Ron Kennedy — September 3, 2018 #

  5. I have been on zafirlukast for around 25/30 years. The montelukast just isn't as effective for me.

    Comment by Moira Swanson — August 28, 2018 #

  6. I was also taken off montelukast and then given zafirlukast, I have enough tablets to last me until next Tuesday. Went to see the Asthma Nurse last night. When I explained that my tablets are no longer being made, she more or less called me liar 😂, she didn't have a clue what to replace it with and told me to go to the pharmacist that provided me with the tablets and ask them what they recommend, what a joke!

    They were really good at the Chemist, he actually used the computer to try and find something, I was in there for about 40 minutes, he said to try Sodium Cromoglicate capsules, but when looking them up on the computer they seem to be used mainly for food allergies, the same as Nalcrom capsules. Would either of these help Asthmatics?

    Comment by Belinda Thornton — August 23, 2018 #

    1. @Belinda,

      Sodium Cromoglicate is used in asthma, but in inhaler form. You haven’t said why you were taken off montelukast, could that be an option again?

      Comment by Matthew Robinson — August 23, 2018 #

  7. I was also on zafirlukast but can't take montelukast as I'm allergic to lactose.

    Comment by Samantha Shaw — July 28, 2018 #

    1. @Samantha,

      It might be worth having a check if any of the alternative version of montelukast contain less or no lactose as the ingredients can vary. Especially when zafirlukast did contain 45mg of lactose as an ingredient according to the product literature.

      The original brand of montelukast (Singulair®) has 89mg of lactose per tablet. Some of the other companies have a slimly lower content of lactose. The other possibility is the 5mg chewable tablet; that contains no lactose as all.

      Comment by Matthew Robinson — July 28, 2018 #

  8. I had an allergic reaction to Montelukast back in 2009, so my prescription was changed to Zafirlukast then.

    I have had no major side effects.

    I was so annoyed that neither my GP practice or Boots the Chemist knew that my medication was being discontinued. I had to make an unnecessary appointment to see my GP, only to be put on Montelukast.
    I have now just one week left of Zafirlukast, from a previous prescription. I am not looking forward to the side effects and possible allergic reactions from going back to this previous medication to treat my asthma.

    Comment by Phil B — July 17, 2018 #

  9. I was changed to Zafirlukast approximately 14 years ago as Montelukast wasn't working well enough for me. Now back on Montelukast.

    Not Happy 🙁

    Comment by Michelle Frey — July 17, 2018 #

    1. Got exactly the same reaction even though assured it would work.
      Not been asthma free since.

      Comment by Carol Boon — October 4, 2018 #

  10. I have been taking Zafirlukast since 1990’s, exact date not known! I have years of keeping my Asthma/COPD under control. I am told the nearest medication is Montelukast and have started to take it but the side effects are dreadful especially dreams! I had no side effects with Zafrilucast! Why oh why has it stopped being made I suppose the expense! Actually I think it’s disgraceful to have stopped without getting feedback from patients.

    Comment by Jennifer Dyosd — July 17, 2018 #

    1. @Jennifer,

      I’m sorry to hear you are getting side effects from the montelukast. You need to speak to your nurse or doctor about this as there isn’t another alternative. Zafirlukast simply wasn’t selling enough to make any money which is why it was discontinued by the manufacturer.

      Comment by Matthew Robinson — July 17, 2018 #

      1. It wasn't selling enough because it is more expensive apparently my GPs have been trying to get me off it for years. But the other alternatives don’t suit me so like the other gentleman said we will all go down hill. I have COPD and emphysema so needed it to control the basic asthma.

        Comment by Diana Hall — September 23, 2018 #

        1. @Diana,

          You are correct, it was more expensive. But that's not the only reason it wasn't selling. Montelukast, the most direct alternative, only needs to be taken once daily and is generally accepted as being as a direct equivalent to zafirlukast. In the UK therefore montelukast has always been the market leader in this area.

          Comment by Matthew Robinson — September 23, 2018 #

    2. It is expensive. My GPs have been trying to get me off it several times over the years saying it wasn’t available. Then when I couldn’t take the alternative it would be available again and when I asked one GP actually said yes it was to do with cost so if nobody prescribed it then it will be taken off as not enough money being made.

      Comment by Diana Hall — September 23, 2018 #

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