Should Singulair be sold over the counter?

The WSJ Health Blog wrote that Merck is considering selling their asthma medication Singulair over the counter.

It’s Merck’s best-selling drug, with revenues in excess of $1.3 billion. But internist Matthew Mintz has some reservations about the proposal.

His issue is that Singulair merely treats the symptoms, rather than the problem that can exacerbate asthma:

Singulair works in the same way that antihistamines work: by treating the symptoms. Inhaled corticosteroids (ICSs) work by blocking inflammation which is what causes the release of leukotrienes in the first place. Singulair is not anti-inflammatory, ICS’s are. Singulair treats the symptoms, whereas ICS’s treat the problem. This is why study after study proves that ICS’s are superior to Singulair, and why guidelines place ICS’s as first line treatment and Singulair as alternative.

His concern is that, if the drug is increasingly used when placed over the counter, chronic asthmatics may have their symptoms controlled, but in fact, their lung function may be gradually worsening over time.

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