Effective July 1, 2021 MO HealthNet will require a manual review of montelukast prescriptions for MO HealthNet participants by the pharmacy helpdesk when prescribed to participants with a history of suicidal thoughts, suicidal actions, and history of neuropsychiatric events. This change is due to the addition of the black box warning in the montelukast label (FDA Announcement). Health care professionals should consider the risks and benefits of montelukast when deciding to prescribe or continue patients on the medicine. Counsel all patients receiving montelukast about mental health side effects, and advise them to stop the medicine and contact a health care professional immediately if they develop any symptoms including but not limited to those listed in the FDA Announcement link above. Be aware that some patients have reported neuropsychiatric events after discontinuation of montelukast.