On June 20, , I returned to my primary care physician PCP with a cough and wheezing but Albuterol was helping. Carnitine deficiency induced by pivoxil-containing agents may cause impaired fatty acid oxidation in mitochondria. There have been several published reports of eosinophilic conditions, including Churg-Strauss syndrome, associated with the use of zafirlukast. Typical clinical manifestations include asthma, hypereosinophilia, and neurological symptoms. Forgot your user name or password? Have you had any changes?