Table 2. Second-line Medications for Exercise-induced
Bronchoconstriction (EIB)
a
Generic (Brand) Dosage Form Dose
Administer daily
Inhaled corticosteroids
See Table 3
Leukotriene modifiers
Montelukast
(Singulair
®
)
10 mg tablets
4 mg, 5 mg chewable tablets
4 mg oral granules packet
6-14 yrs old: 5 mg chewable tablet qHS
≥15 yrs old: 10 mg tablet qHS
Zafirlukast
(Accolate
®
)
10, 20 mg tablet 5-11 yrs old: 10 mg bid taken ≥1 h
before or 2 h aer meals
≥12 yrs old: 20 mg bid taken ≥1 h
before or 2 h aer meals
Zileuton
(Zyflo CR
®
)
600 mg tablet ≥12 yrs old: 1200 mg bid
Administer 15 minutes prior to exercise
Mast cell stabilizing agents
Cromolyn
(Intal
®
)
MDI: 800 mcg/inh
Nebulizer: 20 mg/2 mL
ampule
MDI: 2 inh given 15 minutes prior to
exercise
Nebulizer: 1 ampule given 15 minutes
prior to exercise
Nedocromil
(Tilade
®
)
MDI: 1.75 mg/inh ≥6 yr old: 2 inh given 15 minutes prior
to exercise
Anticholinergic agents
Ipratropium
(Atrovent HFA
®
)
MDI: 17 mcg/inh 2 inh given 15 minutes prior to exercise
Max dose: 12 inh/day
a
A second-line medication is administered if patients continue to have symptoms despite first-line
medication.
Treatment
