Has anyone used Zafirlukast (brand name: Accolate) taken twice a day for 90 to cure Capsular contracture of the breasts?

Question

Has anyone used Zafirlukast (brand name: Accolate) taken twice a day for 90 to cure Capsular contracture of the breasts? If you have hasd success I would like to know. Also I am most likely a stage 4 and one surgeon wants me to have a Mammogram prior to explant, but the breast is so hard and dense that it would be impossible to perform a mammogram, any suggestions? Thanks!

Jon M. Grazer, MD, MPH, FACS · Answer

Accolate has been used in the past for capsular contracture of the breasts in the past. The use of this drug for capsular contracture is off label. It is not a good drug, as it has many liver side effects and is now rarely used in pulmonary medicine.Singulair (montelukast) has been currently used for capsular contracture, but is still off label use. The dosage and length of treatment has not been established. Improvement of 1 to possibly 2 grades of improvement have been reported. Additionally, if there is improvement it is not known how long it will last.Grade 4 capsular contracture most often requires complete capsulectomy.Yours,Jon M. Grazer,  MD, MPH, FACSPlastic SurgeryNewport Beach, CA

David Finkle, MD · Answer

Capsular Contracture (CC) is our body's response to a foreign object being placed in the body.  It is like scar tissue that encompasses the implant and our body is trying to "wall off" or isolate this foreign invader.  This reaction occurs whenever we have anything placed in our body, think knee replacement, heart valve, even a splinter in our hand.  Most of the time we don't even notice the CC that develops around the implants.CC is graded by Plastic Surgeon's using Dr Baker's scale of  I-IV:Grade I----soft, no deformity noticeable Grade II---firm, but not a visible deformityGrade III--firm with a visible and noticeable deformityGrade !V--firm, hard, visible deformity and painfulGrades I and II  and some early III's are the most common and can respond to oral medications.  Accolate or Zafirulakast can and does work in about 50% of the women.  However, this medication has been linked to some rather severe potential side effects including liver failure.  So, we usually recommend it's medical cousin, Montelukast (trade name Singulair).  This is a proven anti-asthma drug that works like Accolate without the troublesome side effects.  Singulair was very expensive until just recently when the generic drug Montelukast was released.  I have been using 10 mg/once day for 90 days with good success.Another medication that works well for reducing CC is OTC Vitamin E.   I recommend 2,000 IU (International Units) day for 90 days. Look for the 1,000 IU capsules, that is the largest size that is made.  Don't get the 200 IU size, you would have to take 10 a day!  Large dose Vitamin E is harmless without any side effects and you don't need a prescription.   I almost always combine Vitamin E with Montelukast for the best results.However, when you get to a high grade CC like a III or a IV, these drugs will not help.  You will need some type of surgery to relieve the condition.  Capsule removal, implant removal and a remove and replace procedure.Good Luck!

Has anyone used Zafirlukast (brand name: Accolate) taken twice a day for 90 to cure Capsular contracture of the breasts?

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Has anyone used Zafirlukast (brand name: Accolate) taken twice a day for 90 to cure Capsular contracture of the breasts?

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Everything you need to know about Capsular Contracture Treatment

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