Home Drug Guide Zileuton

Drug Guide

Generic Name

Zileuton

Brand Names Zyflo, Zyflo CR

Classification

Therapeutic: Antiasthmatic

Pharmacological: Leukotriene synthesis inhibitor

FDA Approved Indications

  • Asthma prevention and chronic management

Mechanism of Action

Zileuton inhibits 5-lipoxygenase, an enzyme involved in the synthesis of leukotrienes, which are mediators of airway inflammation, bronchoconstriction, and mucus production in asthma.

Dosage and Administration

Adult: Typically 600 mg four times daily for immediate-release; 1200 mg twice daily for controlled-release.

Pediatric: Dose varies; consult specific guidelines for age and weight.

Geriatric: Use with caution; start at lower dose and monitor hepatic function.

Renal Impairment: No specific dose adjustment generally required.

Hepatic Impairment: Use with caution; monitor liver function closely; contraindicated in active liver disease.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Primarily hepatic via hydroxylation.

Excretion: Metabolites excreted mainly in urine.

Half Life: Approximately 2.5 hours for immediate-release; longer for controlled-release formulation.

Contraindications

  • Active liver disease or elevated liver enzymes.
  • Hypersensitivity to zileuton.

Precautions

  • Monitor liver function tests regularly.
  • Use with caution in patients with active hepatic impairment.
  • Assess for history of hepatic dysfunction before starting therapy.

Adverse Reactions - Common

  • Hepatotoxicity (Less common but serious)
  • Headache (Common)
  • Nausea and abdominal pain (Common)

Adverse Reactions - Serious

  • Liver failure, hepatitis (Rare, but severe)
  • Allergic reactions including rash, eosinophilia (Rare)

Drug-Drug Interactions

  • Theophylline (may affect levels)
  • Warfarin (may increase bleeding risk)
  • Propranolol (may increase plasma levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor liver function tests before initiation and periodically during therapy.

Diagnoses:

  • Risk for hepatic injury
  • Ineffective airway clearance

Implementation: Educate patient about signs of liver injury, importance of adherence, and timing of doses.

Evaluation: Regular monitoring of liver function and assessment of asthma control.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any symptoms of liver problems (jaundice, dark urine, abdominal pain).
  • Do not consume alcohol excessively.
  • Inform provider of all medications and over-the-counter drugs.

Special Considerations

Black Box Warnings:

  • Hepatotoxicity risk; liver function monitoring is mandatory.

Genetic Factors: N/A

Lab Test Interference: May cause elevated liver enzymes, affecting liver function tests.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, abdominal pain.

Treatment: Supportive care; no specific antidote.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable for the duration of the labeled shelf life.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.