How does it work?
Accolate tablets contain the active ingredient zafirlukast, which is a type of medicine called a leukotriene receptor antagonist.
Zafirlukast works by blocking the action of leukotrienes, which are chemicals released by the body as part of the inflammation response.
Leukotrienes act in many areas of the body. In the lungs they act in two ways, causing the airways to narrow. They cause the muscles lining the airways to contract, thereby making the airways narrower. In addition, leukotrienes cause inflammation of the lining of the airways, which results in increased mucus production and further narrowing of the airways.
By blocking the actions of leukotrienes, zafirlukast prevents the increased mucus production, inflammation and narrowing of the airways that occurs in asthma. This helps prevent asthma attacks from occurring. Zafirlukast is used as a regular treatment to prevent asthma attacks, rather than to treat them.
What is it used for?
- Asthma. Accolate tablets are taken on a regular basis to help prevent asthma attacks from happening.
How do I take it?
- One Accolate tablet should be taken twice a day (morning and evening).
- The tablets should be taken on an empty stomch, because food can stop the medicine being absorbed properly.
- The tablets should be taken on a continuous basis, even when you don't have any asthma symptoms, because it helps to keep the inflammation in the lungs under control and the airways open.
- This medicine should never be taken to treat an asthma attack - you should keep your normal reliever inhaler, eg salbutamol or terbutaline, ready for this. Consult your doctor if you need to use your reliever more frequently than normal, or if it becomes less effective at treating attacks.
- If you find that your asthma is improved after starting treatment with this medicine you should not stop taking any of your other medicines, in particular any corticosteroid inhalers or tablets. This medicine is not a substitute for corticosteroids. However, you may find that you need to use your reliever inhaler less frequently.
- In rare cases, people taking asthma medications may experience a rare condition known as Churg-Strauss syndrome. Consult your doctor if you experience any of the following symptoms while taking this medicine; flu-like symptoms, increasing breathlessness, pins and needles, numbness of the limbs or rash.
- This medicine may rarely cause liver problems. For this reason your doctor may want you to have blood tests to monitor your liver function (liver function tests) before starting treatment and regularly while you are taking this medicine. Consult your doctor promptly if you develop unexplained itching, yellowing of the skin or whites of the eyes (jaundice), unusually dark urine, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms while taking this medicine, as these could be signs of a liver problem. If you do experience liver problems while taking this medicine you should not be prescribed it again.
Use with caution in
- Elderly people.
- People with decreased kidney function.
Not to be used in
- Children under 12 years of age.
- People with decreased liver function.
- Liver cirrhosis.
- People with rare hereditary problems of galactose intolerance, the Lapp Lactase deficiency or glucose-galactose malabsorption (Accolate tablets contain lactose).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. It should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risks to the developing baby. Seek further medical advice from your doctor.
- This medicine passes into breast milk. The manufacturer states that this medicine should not be taken by women who are breastfeeding. Ask your doctor for further advice.
- Take this medication an hour before food or on an empty stomach.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Very common (affect more than 1 in 10 people)
- Airway infection (usually mild and affecting elderly people).
Common (affect between 1 in 10 and 1 in 100 people)
- Feeling sick and vomiting.
- Abdominal pain.
- Abnormal results in liver function tests.
- Pain in the muscles.
Uncommon (affect between 1 in 100 and 1 in 1000 people)
- Difficulty sleeping (insomnia).
- Nettle-type rash (hives).
- Pain in the joints.
- Fluid retention causing swelling (oedema).
- A general feeling of being unwell.
Rare (affect between 1 in 1000 and 1 in 10,000 people)
- Bleeding disorders, including heavy periods, bruising.
- Decreased numbers of blood-clotting cells called platelets in the blood (thrombocytopenia).
- Inflammation of the liver (hepatitis - see warning section above).
- Allergic reactions such as swelling of the lips, tongue and throat (angioedema).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Zafirlukast may enhance the anti-blood-clotting effect of the anticoagulant medicine warfarin. If you are taking this medicine in combination with warfarin your doctor may want to check your blood clotting time (INR) more frequently.
If zafirlukast is used in combination with theophylline it could increase the amount of theophylline in the blood. At the same time, theophylline may reduce the amount of zafirlukast in the blood.
Regular use of aspirin as a painkiller may increase the amount of zafirlukast in the blood and could increase the chance of its side effects. This is unlikely to occur with occasional painkilling doses.
The antibiotic erythromycin may reduce the amount of zafirlukast in the blood. If you are prescribed a course of this antibiotic you should tell your doctor if you think your zafirlukast has become less effective at controlling your asthma.
Other medicines containing the same active ingredient
There are currently no other medicines available in the UK that contain zafirlukast as the active ingredient.