Asthma Medication Rant

Like many other ‘eczema’ sufferers/atopic individuals out there, I also have asthma and have had it since childhood.  My asthma is very well controlled with the help of the wonderful pill Singulair.  I almost never have to use my rescue inhaler and my daily activities aren’t limited – I can generally do high intensity exercise with no trouble breathing.

Singulair used to only be available in a brand name form, but recently (within in the past year), drug companies have been given the green light to go ahead and produce this medication in a generic form, with the same active ingredient, montelukast sodium.

This past fall, I received the generic and when I tried it, my eczema got worse and I got puffy eyes.  When I stopped taking the medication, these effects went away.  I don’t think this was just a fluke because I then tried it again and got the same results.

At the time, I filed a claim with the FDA and also called the drug manufacturer to get a list of the ingredients.

This is what is in generic montelukast sodium tablets:

Each 10 mg film-coated montelukast sodium tablet contains the following inactive ingredients: hydroxypropyl cellulose, hypromellose, iron oxide red, iron oxide yellow, lactose monohydrate (128.6 mg), magnesium stearate, pregelatinized starch, sodium lauryl sulfate, sodium starch glycolate, and titanium dioxide.

Basically mostly a bunch of colors and fillers, but the one thing that worries me is seeing Sodium Lauryl Sulfate, or SLS, in the list.  According to the Environmental Working Group, SLS is suspected to be an environmental toxin and has strong evidence of being a human irritant.  I don’t have the focus to get all science-y in my blog like one of my overseas TSW buddies, Miss Kitty Fantastico, although I’m sure this subject is just begging for some graphs and diagrams, but hell, let’s briefly give you a bit more evidence why this SLS stuff probably sucks for all of us.

Let me present a few studies to you where healthy controls were compared with atopic controls being exposed to SLS.  Atopic folks were found to have a statistically significant response with irritant dermatitis.  Here is another article that is pretty comprehensive and cites other scientific research.

So, okay, these types of studies are all over the place, we know that SLS isn’t the greatest thing to be using in our products like shampoos and hand soaps, ESPECIALLY if we have a compromised skin barrier due to eczema or contact dermatitis.

But if I’m actually ingesting this stuff, how does that bode for me?  I find it very ironic that, on the Material Safety Data Sheet for SLS, it says, “Hazardous in case of ingestion.”  Then we read under the Toxicological Information, in part:

Special Remarks on other Toxic Effects on Humans:
Acute Potential Health Effects: Skin: Causes mild to moderate skin irritation. May cause allergic reaction (dermatitis) Eyes:
Causes moderate eye irritation. Inhalation: Material is irritating to mucous membranes and upper respiratory tract. May cause
allergic respiratory reaction. Ingestion: Causes gastrointestinal tract irritation with nausea, vomiting, hypermotility, diarrhea,
and bloating. May also affect behavior (ataxia, somnolence), and cardiovascular system. Chronic Potential Health Effects:
Skin: Prolonged or repeated skin contact may cause allergic dermatitis. Ingestion: Prolonged or repeated ingestion may affect the liver. Inhalation: Prolonged or repeated inhalation may cause allergic respiratory reaction (asthma).
Oh great!  Nausea, vomiting, diarrhea, and bloating?  Not my idea of a fun evening.  Maybe I should be glad I *only* had puffy eyes and rash.  And does anyone else find it ironic that in the last sentence it mentions this chemical may cause asthma, but it’s an ingredient in the very medication used to TREAT asthma??  No wonder you can find accounts all over the internet of people that took the generic Singulair and had their asthma actually get worse.  Do I believe everything I read on the internet…. no, but one can certainly see why lots of people might be reacting to this medication.
My insurance recently told me the lovely decision that “We no longer will cover brand-name Singulair because of the cheaper generic version available.”  After spending enough time on the phone to grow a couple gray hairs and insisting to every customer service rep and pharmacist that the brand name is medically necessary for me and that my doctor is aware it’s a drug that needs to be D.A.W. (dispensed as written – meaning, Don’t give me the generic stuff, this girl needs the real thing), the only thing I can do now is file a letter of appeal to the healthcare company.
If the letter of appeal has no effect, I have two choices.  I can pay out of pocket for brand-name Singulair, which by my calculation, is over $3.00 for a pill PER DAY.  At this rate I could be forced into poverty, but boy, will my lungs be clear and healthy, which will bode well for me when I become homeless and have to live under a bridge on the freeway and be subjected to repeated onslaughts of car exhaust.  [Please keep in mind this post is written slightly tongue-in-cheek, so don’t feel like I’m a charity case with a “poor me” attitude… I’m not 🙂 ].  My other choice is to simply stop taking ANY pill form of asthma medication and just rely on my inhaler if I need it.
I’m of the mindset “If it ain’t broke, why fix it”, and being that I’ve taken brand name Singulair for nearly 10 years, I’m naturally suspicious of what could happen if I cease taking it.  Now back relating to TSW, I have read some hopeful things on the forums and such about people whose asthma got MUCH better once they healed from their steroid usage.  I believe this is perfectly credible.  I saw my own suspected food ‘sensitivities’ and seasonal allergies completely disappear now that I’m healing nicely from TSW.  However, I had asthma well before using any sort of topical steroids, so for me personally, I feel like they are not intertwined, but who knows.  Maybe the only way to tell is to do a test for a week or more where I take ZERO asthma pills, and then go back to the Singulair while I still have the buffer of about a month’s supply left, which is likely what I’ll do.
I’d love to hear anyone else weigh in if you’ve reacted to generic montelukast as well, if you’ve also experienced the hassle of trying to get insurance coverage for Singulair, or if you just have any thoughts or recommendations on this situation in general!
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25 thoughts on “Asthma Medication Rant

  1. joey says:

    sls’s are used ad foaming agents in soap and shampoos afaik.

    • Yes they are used as foaming agents, you are right. Both Sodium Lauryl Sulfate and Sodium Laureth Sulfate. This was the first time I was aware that an SLS was in an oral medication. My asthma pill doesn’t need to foam… so no need for SLS logically!!

  2. Lisa says:

    HI HI excellance!
    SLS is also used in some bowel movement stuff with physllum.
    i think i have a bottle of natural thing from exact but i think it says it has SLS in it.
    i guess i will stop taking it if i find myself having some issues… with going.

  3. I was prescribed Singulair for my eczema before it went generic. My insurance wouldn’t cover it.. I think I paid $300 for a bottle or something absurd like that. It is really interesting that you had a bad reaction to generic.

    • You were given Singulair just for eczema? That’s interesting to me since I’ve only seen it touted for allergies and asthma. Did it seem to help your eczema or not really (was this before you were going thru TSW)? Seriously yes, the price is so absurd.

      I was reacting to EVERYTHING when I was unwittingly in TSW before I ‘discovered’ ITSAN, so maybe I would be okay with the generic now, but I just don’t want to take that gamble in case I react once more! To me, my health is worth the caution and extra money 🙂

      • Yes, it was given to me for eczema.. pre-TSW when I was insanely chasing the cause of my spreading, worsening eczema. I was in the small minority of people who had weird behavior changes and I went a little crazy so I stopped taking it. It might have helped but who knows.

        You have to do what you need to do during this period.. don’t need to suffer unnecessarily!

      • Yes, it was given to me for eczema.. pre-TSW when I was insanely chasing the cause of my spreading, worsening eczema. I was in the small minority of people who had weird behavior changes and I went a little crazy so I stopped taking it. It might have helped but who knows.

        You have to do what you need to do during this period.. don’t need to suffer unnecessarily!

  4. Jennifer Pacione says:

    Ok this again is me! I have been saying to my doctor that my whole reason for starting ts 3 yrs ago was when I started using singular! He of coarse said no way. Ha. I even called my mail order drug company about the ingredients. I thought I might be reacting to the dyes. I don’t remember sls. I am also stopping the singular and seeing if I improve… Thank you for this post! Love you all! So let’s check back in a week or 2!

    Jennifer

    Sent from my iPad

    • Hey Jennifer!! Were you taking the GENERIC singulair as well (montelukast)? What I actually should do is track down the ingredients in the brand name stuff and compare. I’m sure some of the fillers and dyes are the same but there has to be some difference. Keep me posted on what happens with you stopping the med for sure!

  5. Ooh, I got a mention – thanks! : )

    Great blogging, keep up the good work my friend xxx

  6. Vee says:

    Oh wow, that’s nuts about the SLS!
    Good you looked into it and made to correlation. I actually don’t have asthma, never did, i don’t think i am one of those ‘atopic’ people. But i did read a lot of people noticed their asthma got better or went away after TSW!

  7. Chris Childs says:

    Hi, I’m new to the board and like most of you, have been going through it all. I’m about to venture into the allergist route and get shots for the next year to try and control my eyelid eczema. This seems to be the most problematic area right now (my hands are a mess too). Anyway, has anyone had success with this approach? I’ve already been down the chinese herbs, elimination diet, clear and free products (laundry, cosmetics, etc.), cyclosporine and cellcept, endless topical steroids and both protopic and elided. Forgot about the UV band phototherapy!!!!!!! Thanks, Chris

    • Hi Chris – Welcome! Sorry to hear you’re having to deal with chronic eczema as well. I personally have never had allergy shots, but maybe someone else will weigh in or there is other info out there on other blogs. I tried just about every single thing that you had listed! But not cyclo or UV therapy! For me, my eye area was a big problem area too, and my hands/fingers. But (this is apparent if you read some of my other posts) my deal was that my skin had grown dependent on topical steroids so it was super sensitive and flaring up all the time. I used them quite a bit around my eye area but that area absorbs a LOT of the drug as it is so thin. My skin is virtually normal now, about 9-12 months after going off all topical steroids including protopic and Elidel. Never thought I would heal, I used to look baaaad! Something to look into if you’re still using topical steroids or were a hard core user in the past. At any rate I hope you find something that works for you! Thanks for stopping by my blog.

      • Chris Childs says:

        Thanks, I will try and go off totally the topical steroids. I don’t use them as much as I used to but I still use them from time to time. I’m also trying the no coffee route again and back to zyrtec 1x per day. I’m glad that you’ve found relief and hope that I will soon with the shots. The only things that have helped me clear completely is heavy doses of prednisone and cellcept. Both have high risks as you know but I was desperate a few years back.

  8. Sharon says:

    This would explain A LOT!! I have suddenly had horrid problems with my skin – at first I thought it was due to another medication I had been taking (was the first one the dr looked at and went “oh noes”) but after stopping it I still have the problems. After running out of the GENERIC singular – I noticed that my skin was looking better but didn’t connect it until I started taking the meds again and my skin looked worse again.
    The scary thing – is my asthma has become worse which scares me to think that it could have been the very medicine I took to help it was actually causing it.
    I am so glad to know I’m not totally crazy (never claimed to be totally sane either) – that there really is a connection to this medication and these symptoms.

    Thanks!

  9. livi says:

    I don’t have eczema, but came across this post researching a skin rash 4 days after I started taking generic singulair. I used to take singulair and stopped for about 6 months. I just got a refill of montelukast on Monday and I started getting rashes immediately on my face and hands.

    • Hi Livi, thanks for weighing in. You are definitely not the first person to experience this besides me, it seems like it’s all over the internet. Hopefully your skin rash cleared up now that you linked it to the generic Singulair!

  10. Having bronchial asthma is not that easy 😦

  11. Fraser says:

    Hi, I’m trying to find some info on Singulair. I’ve gone through 10 months of TSW and am at a point where my skin is almost healed, but now the asthma has kicked in. I’ve never had to use longterm asthma medication since my asthma is only triggered by mould and cats. For some reason this has been lingering for 3 months and I’m desperate for relief. Do you think someone like me could take the pill for a few weeks/months, then go off it (can you go off it cold turkey?) and see if I’ve healed from the asthma. I think it could be happening because my adrenals are most likely weak…or it’s possible that there’s mould in our house. We are having the house tested so could just be I can’t get better because I’ve been breathing in the mould spores. I don’t know much about this drug but I do know I don’t want to go on any steroid inhalers. Can Singulair actually heal or reduce the inflammation in the airways and leave you asthma free for good (when you go off it), if the trigger or irritants are removed? Thanks!

    • Hi Fraser, this is a really good question, one that I couldn’t answer with certainty. But I DO agree that Singulair might give you some short term relief until the triggers are removed. There are also non steroid inhalers – I use one called ProAir, I believe it might be albuterol? I don’t think it is a steroid but I haven’t used it in a very long time as it’s only a rescue inhaler and I haven’t had any need for it in months. Everyone varies but I do think that asthma and allergies tend to get better after TSW. The Singulair question would be a good one for your physician as I don’t know the exact mechanism of how it works. Keep us posted though and good luck! Also congrats on making it through 10 months TSW!

  12. Jake K. says:

    Thank you for posting this. I am currently having the same problem with a few differences. I do not suffer from eczema. I was perscribed the generic for Singulair (montelukast sodium) about 90 days ago to control my allergy and exercise induced asthma. The brand of generic I was perscribed was made by a company called SANDOZ. This was a wonder drug for me. For the first time in about 6 years I was finally able to breath free with out the use of my rescue and steroid inhalers.

    Now here comes the twist in the story, where we take a turn for the worst. I switched my health insurance company. Which caused me to switch pharmacies. 2 days after my next 90 day refill, ALL of my symptoms were back with vengence. I mean worse than they were before I was perscribed Montelukast in the beginning. Well after doing some investigation, I found that the refilled perscription that I was now taking was made by a company called TEVA, which contains SLS (Sodium Lauryl Sulfate).

    Now that I have done some research on this inactive ingrediant, I have found that there are multiple cases on the internet of this product causing asthma symtoms in individuals already suffering from asthma. Allergic reactions….so on a so forth. But it was nice to actually come across a post that pertained to my exact situation.

    So OP, no you are not crazy. Why a drug manufacture would put something known to cause asthma symptoms in asthma medication is beyond me.

    After some research I have found that the folling manufactures of this drug DO NOT contain SLS

    SANDOZ
    ACCORD HEALTHCARE
    QUALITEST

    and some others.

    Do your reseach people, know what your putting in your body. When I brought this problem to my doctor and pharmasist, they basically called me crazy.

    Currently trying to find a pharmacy that covers the brand that I would like that corrdiantes with my health insurance, but thats another story for a different forum.

    Good luck OP and other readers.

    • Hey Jake, awesome for you to stop by and share that research you’ve done for yourself and your own story. Great testament to the fact that we know our own systems and deserve to know what we are putting in them/on them and how it will affect us and to not just blindly accept the diagnoses or advice of medical professionals. I find it really crazy that theoretically this is the “same drug” and yet there can be such a profound difference with the different manufacturers. I appreciate your take on this!

  13. Roxanna B says:

    I have severe asthma and have had all my life. I am 48 years old going for allergy testing next month. I believe that I am allergic to sulfates and sulfites found in wine, shampoo and toothpaste. I have been having increasing asthma attacks in the bathroom. Please advise if anyone else is dealing with this, I have been hospitalized for this reaction but am always diagnosed with the severe asthma.

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