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This drug improves asthma and hay fever symptoms by blocking substances and their relative functions in the body called leukotrienes. Montelukast works by blocking substances and their relative functions in the body that trigger allergic and asthmatic reactions. Montelukast can cause different side effects at varying degrees such as gastrointestinal disturbances, hypersensitivity or allergic reactions, sleep disorders, stomach upset, diarrhea, cough, dizziness, headache, nausea, vomiting, heartburn, hives and hoarseness of voice. Montelukast can cause different side effects at varying degrees such as gastrointestinal disturbances, hypersensitivity or allergic reactions, sleep disorders, stomach upset, diarrhea, cough, dizziness, headache, nausea, vomiting, heartburn, hives and hoarseness of voice. The first asthma controller medication. It should be taken regularly as prescribed even when you are not experiencing asthma symptoms.