Theophylline is a methylxanthine. Sustained-release methylxanthine medicines are used to control in the airways in the bronchial tubes. Short-acting methylxanthine medicines are used to control narrowing of the bronchial tubes. This may reduce symptoms. Erythromycin metabolite decreases Theophylline clearance by inhibiting cytochrome P450 3A3. Consider extracorporeal removal even if the patient has not experienced a seizure see OVERDOSAGE, Extracorporeal Removal. For most patients, steady-state will be reached after 3 days of dosing when no doses have been missed, no extra doses have been added, and none of the doses have been taken at unequal intervals.
Obeticholic Acid: May increase the serum concentration of CYP1A2 Substrates. Other quinolones also produce erosions of cartilage of weight-bearing joints and other signs of arthropathy in immature animals of various species. Maintain infusion rate if dosage is tolerated and symptoms controlled. Recheck serum concentrations at 24-hour intervals. If symptoms are not controlled and dosage is tolerated, consider adding additional medications to treatment regimen. Transient caffeine-like adverse effects and excessive serum concentrations in slow metabolizers can be avoided in most patients by starting with a sufficiently low dose and slowly increasing the dose, if judged to be clinically indicated, in small increments see Table V. Dose increases should only be made if the previous dosage is well tolerated and at intervals of no less than 3 days to allow serum Theophylline concentrations to reach the new steady state. cephalexin coupons canada 2016
Note: Serum theophylline concentrations may continue to increase after presentation of the patient for medical care. Marchlinski FE, Miller JM "Atrial arrhythmias exacerbated by theophylline: response to verapamil and evidence for triggered activity in man. Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health and perhaps your life at risk. minocin
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding. Theophylline Oral Solution USP is a clear red solution with a berry flavor. Each tablespoonful 15 mL contains 80 mg theophylline anhydrous. Nervous system side effects have included generalized seizures, most commonly in patients with elevated serum concentrations, although seizures have occurred at therapeutic concentrations. Theophylline may also cause nervousness and tremor at therapeutic dosages, which become worse as serum concentrations increase.
Prakash M, Washburne JD "Theophylline and urinary retention. This product allows a 12-hour dosing interval for a majority of patients and a 24-hour dosing interval for selected patients see DOSAGE AND ADMINISTRATION section for description of appropriate patient populations. Increasing the rate of theophzylline clearance by extracorporeal methods may rapidly decrease serum concentrations, but the risks of the procedure must be weighed against the potential benefit. Pediatrics The clearance of theophylline is very low in neonates see . Theophylline clearance reaches maximal values by one year of age, remains relatively constant until about 9 years of age and then slowly decreases by approximately 50% to adult values at about age 16. Renal excretion of unchanged theophylline in neonates amounts to about 50% of the dose, compared to about 10% in children older than three months and in adults. Both smoking and excessive caffeine consumption can alter the blood levels of theophylline, which may affect the dosing. Tobacco and marijuana smoke including secondhand exposure generally reduces, while caffeine increases, blood levels. In addition, caffeine is a stimulant and may add to the side effects of theophylline such as headache, insomnia, and increases in blood pressure and heart rate. It is best to avoid smoking and to limit caffeine consumption during theophylline therapy. Talk to a healthcare professional if you have any questions or concerns. If you start smoking or undergo smoking cessation, your doctor may need to monitor your blood levels more closely to determine if you need a dose adjustment of theophylline. You should stop taking theophylline and seek medical attention if you experience potential signs and symptoms of excessive drug levels such as nausea, vomiting, persistent headache, insomnia, and rapid heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. Theophylline clearance are continued. Phenobarbital may cause respiratory depression, particularly in elderly patients and patients with COPD. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Beta-2 blocking effect may decrease efficacy of Theophylline. Where should I keep my supply of ZYLFO? Larger dose of pancuronium may be required to achieve neuromuscular blockade. There are many triggers that may initiate the release of inflammatory substances.
Theophylline may antagonize non-depolarizing neuromuscular blocking effects; possibly due to phosphodiesterase inhibition. Before having surgery, tell your doctor or dentist that you are taking this medication. Certain conditions have been identified as causes of reduced theophylline clearance. Theophylline clearance may be further reduced by concomitant diseases prevalent in the elderly, which further impair clearance of this drug and have the potential to increase serum levels and potential toxicity. These conditions include impaired renal function, chronic obstructive pulmonary disease, congestive heart failure, hepatic disease and an increased prevalence of use of certain medications see with the potential for pharmacokinetic and pharmacodynamic interaction. Protein binding may be decreased in the elderly resulting in an increased proportion of the total serum theophylline concentration in the pharmacologically active unbound form. Elderly patients also appear to be more sensitive to the toxic effects of theophylline after chronic overdosage than younger patients. CarBAMazepine: May decrease the serum concentration of Theophylline Derivatives. Theophylline Derivatives may decrease the serum concentration of CarBAMazepine. Management: Seek alternatives to this combination when possible. Thyroid Products: May increase the metabolism of Theophylline Derivatives. Antithyroid Agents: May increase the serum concentration of Theophylline Derivatives. Some theophylline side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. carvedilol
Medscape: “Cord-Cutting Technique Smooths Cellulite for 3 Years. Case reports of Theophylline overdose in humans and animal studies suggest that phenytoin is ineffective in terminating Theophylline-induced seizures. The doses of benzodiazepines and phenobarbital required to terminate Theophylline-induced seizures are close to the doses that may cause severe respiratory depression or respiratory arrest; the healthcare professional should therefore be prepared to provide assisted ventilation. Elderly patients and patients with COPD may be more susceptible to the respiratory depressant effects of anticonvulsants. Barbiturate-induced coma or administration of general anesthesia may be required to terminate repetitive seizures or status epilepticus. General anesthesia should be used with caution in patients with Theophylline overdose because fluorinated volatile anesthetics may sensitize the myocardium to endogenous catecholamines released by Theophylline. Enflurane appears less likely to be associated with this effect than halothane and may, therefore, be safer. Neuromuscular blocking agents alone should not be used to terminate seizures since they abolish the musculoskeletal manifestations without terminating seizure activity in the brain. Demethylation to 1-methylxanthine appears to be catalyzed either by cytochrome P-450 1A2 or a closely related cytochrome. In neonates, the N-demethylation pathway is absent while the function of the hydroxylation pathway is markedly deficient. The activity of these pathways slowly increases to maximal levels by one year of age. Avoid eating foods that are high in fat within 1 hour before or after taking theophylline. Bismuth: Bismuth subsalicylate, given concomitantly with enoxacin or 60 minutes following enoxacin administration, decreased enoxacin bioavailability by approximately 25%. Thus, concomitant administration of enoxacin and bismuth subsalicylate should be avoided. Adalimumab: May decrease the serum concentration of Theophylline Derivatives. Alcohol Ethyl: May increase the serum concentration of Aminophylline. Spirometry. A test that measures lung function as you breathe in and out of a mouthpiece that is attached to a device called a spirometer. The difference between a dose of theophylline that helps improve symptoms and a dangerous dose one that causes serious side effects is small. Theophylline also has significant interactions with other prescribed medicines, which can make it less effective and potentially life-threatening. Absorption Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. purchase risperdal reacoes risperdal
Serum theophylline concentration measurements are readily available and should be used to determine whether the dosage is appropriate. Park GD, Radomski L, Goldberg MJ, Spector R, Johnson GF, Quee CK. Effects of size and frequency of oral doses of charcoal on theophylline clearance. Thus, blood samples taken 4 to 8 hours post-dosing should reference the peak serum level for most patients. Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. Gastrointestinal side effects have included anorexia, nausea, vomiting, and abdominal pain. Aminophylline may also cause locally-mediated gastrointestinal upset. Quinolone-class adverse reactions: Although not reported in completed clinical studies with enoxacin, a variety of adverse events have been reported with other quinolones. Monitoring: Frequent continued monitoring of serum theophylline after therapeutic levels have been achieved may not be required as long as there is no apparent risk of decreased theophylline metabolism due to concurrent drug therapies or disease states. Monitoring serum theophylline concentrations at yearly intervals should be adequate in such cases. Ophthalmologic abnormalities, including cataracts and multiple punctate lenticular opacities, have been noted in patients undergoing treatment with enoxacin, as well as with some other quinolones, but have also been observed in patients receiving in comparative trials. In using multiple-dose therapy, levels of enoxacin and other quinolones were significantly higher than respective concentrations. The causal relationship, if any, of quinolones to lenticular abnormalities has not been established. Remember that your doctor has prescribed this because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication not have serious side effects. Do not use theophylline to treat an asthma or bronchospasm attack. Use only a fast acting inhalation medication. MacCara 1983; Zenk 1981. Theophylline concentration in the pharmacologically active unbound form.
SD where actual range not reported. Theophylline Oral Solution USP is available in the following oral dosage forms: NDC 0121-4820-15 Unit dose cups of 15 mL, 10 cups per tray. 4 oz. bottle, NDC 0121-0820-04 and 16 oz. bottle, NDC 0121-0820-16. So a person with COPD who continues to smoke may need larger doses of the medicine. If any of these effects last or get worse, tell your doctor or promptly. Fever, regardless of its underlying cause, can decrease the clearance of theophylline. The magnitude and duration of the fever appear to be directly correlated to the degree of decrease of theophylline clearance. Clinical, Cosmetic and Investigational Dermatology: “Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. When these two medicines are taken together, your body may not process theophylline properly. Note: Serum Theophylline concentrations may continue to increase after presentation of the patient for medical care. After the diagnosis of pseudomembranous colitis has been established, measures should be initiated. cagd.info finasteride
Decreased and subsequent decreased were noted in rats and dogs treated with doses of enoxacin that produced plasma levels in the animals three times higher than those produced in humans at the recommended therapeutic dosage. The potential for enoxacin to affect spermatogenesis in male patients is unknown. The chronicity and pattern of theophylline overdosage significantly influences clinical manifestations of toxicity, management and outcome. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment. Frequency not defined. Adverse events observed at therapeutic serum levels. Different brands of theophylline get into the bloodstream at different rates. So always use the same generic or brand-name medicine. Long-acting bronchodilators can be added to inhaled corticosteroids. These should never be used alone for the treatment of asthma. Salmeterol and formoterol are in this class. black market atrovent pills
The listing of drugs in Table II is current as of June 2004. The listing of drugs in Table III is current as of January 2, 1996. New interactions are continuously being reported for theophylline, especially with new chemical entities. Diffusion Techniques: methods that require measurement of zone diameters give the most precise estimate of susceptibility of to agents. One such standardized procedure 1 that has been recommended for use with disks to test susceptibility of organisms to enoxacin uses the 10-µg enoxacin disk. Cyclosporine: Elevated serum levels of cyclosporine have been reported with concomitant use of cyclosporine with other members of the quinolone class. Get medical help right away if your worsen or if you are using your quick-relief more than usual or more often than prescribed. Clearance is very low in neonates and reaches max values by 1 year of age, remains relatively constant until about 9 years of age, and then slowly decreases by approximately 50% to adult values at about 16 years of age. Renal excretion of unchanged theophylline in neonates amounts to about 50% of the dose, compared to about 10% in children older than three months and in adults. Ask your doctor or pharmacist about using this product safely. Combining guarana with polyphenols may have a similar effect. The safety of using guarana for weight loss is unknown. Theophylline throughout the gastrointestinal tract, even when administered several hours after ingestion. If the patient is vomiting, the charcoal should be administered through a nasogastric tube or after administration of an antiemetic. Phenothiazine antiemetics such as prochlorperazine or perphenazine should be avoided since they can lower the seizure threshold and frequently cause dystonic reactions. A single dose of sorbitol may be used to promote stooling to facilitate removal of Theophylline bound to charcoal from the gastrointestinal tract. Sorbitol, however, should be dosed with caution since it is a potent purgative which can cause profound fluid and electrolyte abnormalities, particularly after multiple doses. Commercially available fixed combinations of liquid charcoal and sorbitol should be avoided in young children and after the first dose in adolescents and adults since they do not allow for individualization of charcoal and sorbitol dosing. Ipecac syrup should be avoided in Theophylline overdoses. Although ipecac induces emesis, it does not reduce the absorption of Theophylline unless administered within 5 minutes of ingestion and even then is less effective than oral activated charcoal. Moreover, ipecac induced emesis may persist for several hours after a single dose and significantly decrease the retention and the effectiveness of oral activated charcoal. Stop infusion for 12 hours and decrease subsequent infusion rate at least 25%. If symptomatic, stop infusion and consider whether overdose treatment is indicated. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. In patients with chronic obstructive pulmonary disease COPD clinical studies have shown that theophylline decreases dyspnea, air trapping, the work of breathing, and improves contractility of diaphragmatic muscles with little or no improvement in pulmonary function measurements. AND ADMINISTRATION, Table VI. Whenever a patient receiving Theophylline develops nausea or vomiting, particularly repetitive vomiting, or other signs or symptoms consistent with Theophylline toxicity even if another cause may be suspected additional doses of Theophylline should be withheld and a serum Theophylline concentration measured immediately. During the initiation of theophylline therapy, caffeine-like adverse effects may transiently alter patient behavior, especially in school age children, but this response rarely persists. Theophylline serum concentrations are a significant predictor of arrhythmias. Caffeine and 3-methylxanthine are the only theophylline metabolites with pharmacologic activity.
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Covelli HD, Knodel AR, Heppner BT "Predisposing factors to apparent theophylline-induced seizures. Hall KW, Dobson KE, Dalton JG, Ghignone MC, Penner SB "Metabolic abnormalites associated with intentional theophylline overdose. Decrease dose by 25%even if no adverse effects are present. renova
Drug-Food Interactions: Taking Theophylline extended-release tablets immediately after ingesting a high fat content meal 45 g fat, 55 g carbohydrates, 28 g protein, 789 calories may result in a somewhat higher C max and delayed T max and a somewhat greater extent of absorption when compared to taking it in the fasting state. The influence of the type and amount of other foods, as well as the time interval between drug and food, has not been studied. Crush one 300 mg extended release tablet in a mortar and reduce to a fine powder. Do not share this medication with others. Generally, these products offer little benefit alone, but they may add some value when combined with other treatments.
Make sure lab personnel and all your doctors know you use this drug. Table VI. Dosage adjustment guided by serum theophylline concentration. Numerous new medications are being studied, but none are currently commercially available for routine therapy of asthma. amazon canada metformin
Erythromycin steady-state serum concentrations decrease by a similar amount. Dosage adjustment based on serum theophylline concentrations: Note: Recheck serum theophylline concentration 24 hours after dosage adjustment. How should I take ZYFLO? Serum Theophylline concentration measurements are readily available and should be used to determine whether the dosage is appropriate. Increases theophylline clearance by increasing demethylation and hydroxylation. pramipexole