How does Accolate work?

Medically reviewed by Dr. Jamie Winn
Aug 9, 2023

Asthma is typically caused by chronic inflammation in your airways and can lead to coughing, wheezing, shortness of breath, and chest tightness. It is estimated that 8.3% (26.5 million) of people in the United States have asthma, with 6.1 million being children. There are many different treatments out there to help reduce the inflammation associated with asthma. Some can include inhaled steroids and long-acting bronchodilators. Accolate (zafirlukast) is another treatment option to help prevent asthma attacks. It works differently from steroids and bronchodilators in that it stops certain inflammatory cells from closing the airways in your lungs to help relieve symptoms of asthma. Keep reading to find out more about how Accolate works and other important information you need to know.

What is the mechanism of action of Accolate?

Accolate is the brand name for the generic drug zafirlukast. It belongs to the drug class called leukotriene receptor antagonists (LTRAs). It works by blocking certain substances called leukotrienes. Leukotrienes can cause swelling and tightening of your airways. By blocking the action of leukotrienes, Accolate reduces the inflammation and swelling in your lungs making it easier to breathe.

Accolate FAQs

What does Accolate treat?

Accolate is FDA-approved for the prevention and chronic treatment of asthma symptoms in adults and children 5 years of age and older. The typical dose for adults and children 12 years of age and over is Accolate 20 mg twice a day on an empty stomach. It should be taken at least 1 hour before or 2 hours after a meal. The typical dose for children aged 5 to 12 is Accolate 10 mg PO twice a day on an empty stomach. It should also be taken at least 1 hour before or 2 hours after a meal.

Accolate works over a long period of time to prevent asthma attacks but will not help to relieve a sudden asthma attack. Your healthcare provider may also prescribe a rescue inhaler such as Proair HFA (albuterol) for emergency relief of an acute asthma attack.

What are the side effects of Accolate?

The most common side effects of Accolate include:

Headache
Abdominal pain
Nausea
Sore throat and infections
Diarrhea
Vomiting
Generalized pain

Sometimes, Accolate can cause more serious side effects, including:

Serious, life-threatening allergic reactions including hives, rash, swelling of your tongue, face, and throat, and difficulty breathing
Liver problems and cirrhosis with symptoms such as nausea, vomiting, loss of appetite, stomach pain, jaundice (yellowing of the skin and eyes), and dark urine
Mood changes such as worsening depression, agitation, and suicidal thoughts
Blood vessel inflammation with symptoms such as severe itching, rash, trouble breathing, tingling or numbness in hands or feet
Flu-like symptoms
Severe sinus pain

Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking Accolate. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Accolate?

When Accolate is taken with other medications, it can change how they work or make some side effects more likely or severe. You should ask your healthcare provider if any of the prescription drugs, nonprescription over-the-counter (OTC) drugs, vitamins, or supplements you take may interact with Accolate, including:

Warfarin
Carbamazepine
Erythromycin or clarithromycin
Blood pressure medications such as calcium channel blockers
Phenytoin
Theophylline

Are there any precautions with the use of Accolate?

Before beginning Accolate, make sure your healthcare provider is aware of your medical conditions, including:

A known hypersensitivity to zafirlukast or any of the inactive ingredients in the formulation
Liver disease
Depression or other mood disorders
Trouble sleeping
Blood vessel problems
Bleeding disorder or are taking a blood thinner such as warfarin
Are pregnant or plan on becoming pregnant as it is not known if Accolate may cause harm to your unborn baby
Are breastfeeding as Accolate is found in breast milk and should not be used by women who are breastfeeding

How quickly does Accolate start working?

Accolate is considered a maintenance or preventative medication. You have to take it for a while before you start to see the full benefit of it. Typically, you should see symptom improvement within 2 weeks of starting Accolate, but it could take up to 6 weeks to feel the full effects. It is important to take it every day, even if you are not having any symptoms.

How long does Accolate stay in your system?

With a half-life of 8 to 16 hours, Accolate will stay in your system for approximately 40 to 80 hours.

How should I store Accolate?

Accolate 10 mg and 20 mg tablets should be stored at a controlled room temperature between 68°C - 77°F (20°C - 25°C) in the original container. Protect it from light and moisture and keep it out of the reach of children.

What do I do if I miss a dose of Accolate?

If you miss a dose of Accolate, take it immediately after remembering. However, if it’s almost time for your next dose, skip the dose you missed and take it at its next scheduled time. Do not double your dose or take extra to make up for a missed dose.