Recent studies suggest that dosing of extended-release theophylline products at night after the evening meal results in serum concentrations of theophylline which are not identical to those recorded during waking hours and may be characterized by early trough and delayed peak levels. This appears to occur whether the drug is given as an immediate-release, extended-release, or intravenous product. To avoid this phenomenon when two doses per day are prescribed, it is recommended that the second dose be given 10 to 12 hours after the morning dose and before the evening meal. Minton NA, Henry JA. Prevention of drug absorption in simulated theophylline overdose. buy paroxetine rome
What are the possible side effects of theophylline Elixophyllin, Theo-24? The nature of acute toxicity of theophylline differs from chronic toxicity. Acute overdose is associated with higher theophylline concentrations and younger patients. In acute overdose the severity of toxicity is correlated with peak serum concentrations. Chronic overdosage is seen more commonly in older patients, and severe toxicity may occur with serum concentrations which are much lower than those seen in severe acute toxicity. In these patients, age is a predictor of severe toxicity. 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.
Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. The molecular formula of anhydrous theophylline is C 7H 8N 4O 2 with a molecular weight of 180. 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. Table III. Drugs that have been documented not to interact with Theophylline or drugs that produce no clinically significant interaction with Theophylline.
Canadian labeling: Additional contraindications not in US labeling: Coronary artery disease where cardiac stimulation might prove harmful; peptic ulcer disease. The listing of drugs in Table II and III are current as of February 9, 1995. New interactions are continuously being reported for theophylline, especially with new chemical entities. What should I avoid while taking Theo-Dur theophylline? Caution is advised when using this drug in the elderly because they may be more sensitive to its effects. Careful monitoring of side effects and drug levels is recommended. HPLC techniques. Caffeine and xanthine metabolites in neonates or patients with renal dysfunction may cause the reading from some dry reagent office methods to be higher than the actual serum Theophylline concentration.
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Children may be more sensitive to the side effects of this drug. Careful monitoring of side effects and drug blood levels is recommended. Theophylline passes freely across the placenta, into breast milk and into the cerebrospinal fluid CSF. Saliva theophylline concentrations approximate unbound serum concentrations, but are not reliable for routine or therapeutic monitoring unless special techniques are used. An increase in the volume of distribution of theophylline, primarily due to reduction in plasma protein binding, occurs in premature neonates, patients with hepatic cirrhosis, uncorrected acidemia, the elderly and in women during the third trimester of pregnancy. Theophylline from the tissue compartment. Peritoneal dialysis is ineffective for Theophylline removal; exchange transfusions in neonates have been minimally effective. Antithyroid Agents: May increase the serum concentration of Theophylline Derivatives. Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first. In contrast, approximately 50% of the administered theophylline dose is excreted unchanged in the urine in neonates. Dosage reduction may alleviate the caffeine-like adverse effects in these patients, however, persistent adverse effects should result in a reevaluation of the need for continued theophylline therapy and the potential therapeutic benefit of alternative treatment. This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden breathing problems. If sudden shortness of breath occurs, use your quick-relief inhaler as prescribed. Serum theophylline concentrations may continue to increase after presentation of the patient for medical care as a result of continued absorption of theophylline from the gastrointestinal tract. Serial monitoring of serum theophylline concentrations should be continued until it is clear that the concentration is no longer rising and has returned to non-toxic levels. Your blood levels of theophylline may increase and cause harmful effects. Theophylline blocks adenosine receptors. QuiNINE: May increase the serum concentration of Theophylline Derivatives. Theophylline only rarely alters the pharmacokinetics of other drugs. The drugs listed in Table II have the potential to produce clinically significant pharmacodynamic or pharmacokinetic interactions with theophylline. The information in the "Effect" column of Table II assumes that the interacting drug is being added to a steady-state theophylline regimen. Non-steroidal anti-inflammatory agents: Seizures have been reported in patients taking enoxacin concomitantly with the fenbufen. Animal studies also suggest an increased potential for seizures when these two drugs are given concomitantly. Fenbufen is not approved in the United States at this time.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Decrease infusion rate by 25% even if no adverse effects present. Albert S "Aminophylline toxicity. Theophylline Respbid, Slo-Bid, Theo-24 also helps with bronchodilation opening the airways but again is rarely used in clinical practice due to an unfavorable side effect profile. Fever: 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. Consult your doctor before -feeding. Enoxacin is known to be excreted by the and the risk of adverse reactions may be greater in patients with impaired renal function. The dosage should be reduced in patients with renal impairment. Swallow the pill whole. Cigarette smoking may decrease the effectiveness of theophylline. Shannon M "Life-threatening events after theophylline overdose - A 10-year prospective analysis. augmentin
To guide a dose increase, the blood sample should be obtained at the time of the expected peak serum theophylline concentration: 1-2 hours after a dose at steady-state. 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 has been taken at unequal intervals. Decrease dose by 25% even if no adverse effects are present. Thiabendazole: May decrease the metabolism of Theophylline Derivatives. Lithium: Theophylline Derivatives may decrease the serum concentration of Lithium. Theophylline is a bronchodilator. It works by relaxing muscles in the lungs and chest, making the lungs less sensitive to allergens and other causes of bronchospasm. Erythromycin metabolite decreases Theophylline clearance by inhibiting cytochrome P450 3A3. Radomski L, Park GD, Goldberg MJ, Spector R, Johnson GF, Quee CK. Model for theophylline overdose treatment with oral activated charcoal. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. order quinine cheap quinine
If any of these effects last or get worse, tell your doctor or pharmacist promptly. Hold each position for 5 minutes to help the mucus drain from your lungs. Similar to cimetidine, also increases renal clearance of Theophylline. What happens if I overdose Uniphyl? Hyponatremia and hypophosphatemia were seen less frequently. Wort Hypericum perforatum should not be taken at the same time as Theophylline, since it may result in decreased Theophylline levels. Hypersensitivity to aminophylline, theophylline, ethylenediamine, or any component of the formulation. Smoking: Clearance is increased by smoking ie, marijuana or tobacco by approximately 50% in young adult smokers and 80% in elderly tobacco smokers. Cessation of smoking for 1 week improves theophylline Cl by 40%. This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using theophylline. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Keep taking this medication even if you feel well. Do not increase your dose, take this drug more often, or stop taking it without first consulting your doctor. How often did hospital staff describe possible side effects in a way you could understand? National Institutes of Health 2007. National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma NIH Publication No. 08-5846. Your doctor or may already be aware of any possible and may be monitoring you for them. not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. This noninvasive procedure freezes and kills fat cells. Increases theophylline clearance by increasing cytochrome P450 1A2 and 3A3 activity. price levothyroxine quit
Dosage adjustment based on serum theophylline concentrations: Note: Recheck serum theophylline concentration 12 hours after dosage adjustment. There are no adequate and well-controlled studies in pregnant women. Theophylline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. The listing of drugs in Tables II and III are current as of February 9, 1995. New interactions are continuously being reported for Theophylline, especially with new chemical entities. Theophylline tablets can be taken once a day in the morning or evening. It is recommended that Theophylline tablets be taken with meals. Patients should be advised that if they choose to take Theophylline tablets with food it should be taken consistently with food and if they take it in a fasted condition it should routinely be taken fasted. It is important that the product whenever dosed be dosed consistently with or without food. If you suspect that certain foods are for you, discuss this with your doctor. can be done to determine if you are allergic to these foods. What Do I Do If I Have Food Allergies and Asthma? Treatment of Cardiac Arrhythmias. Theophylline dose is excreted unchanged in the urine of children greater than three months of age and adults. Older adults may be more likely to have side effects from theophylline. apub.info condyline
Increase Theophylline clearance by increasing demethylation and hydroxylation. Decreases renal clearance of Theophylline. GINA 2015. Both guidelines recommend against theophylline for the treatment of asthma exacerbations due to poor efficacy and safety concerns GINA 2016; NAEPP 2007. Yellow No. 6, fruit flavor, purified water and saccharin sodium. May contain sodium citrate for pH adjustment. The majority of side effects have been dependent on the serum concentration. To avoid excessive caffeine intake, be careful when taking guarana along with other foods and supplements that contain caffeine, such as coffee and sodas. Seizure disorder: Use with caution in patients with seizure disorders; use may exacerbate seizure disorder. Genitourinary side effects have included urinary retention. Complete the What is a document? There is a different type of inhaled medication called tiotropium Spiriva that may be used for asthma patients, usually together with inhaled corticosteroids. This medication may be indicated for patients who need a combination therapy but who are unable to tolerate the long-acting beta-agonists. Elevated serum CK-MB levels have been associated with theophylline toxicity in the absence of cardiac disease. CK-MB levels have returned to normal following discontinuation of theophylline therapy. Treatment of seizures: Because of the high morbidity and mortality associated with Theophylline-induced seizures, treatment should be rapid and aggressive. It looks lumpy because it pushes against connective tissue, causing the skin above it to pucker. That's why you can have it whether you're heavy or thin. Women are more likely to get it than men.
Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. However, the incidence of drug-related adverse reactions was comparable between age groups. Other quinolones also produce erosions of cartilage of weight-bearing joints and other signs of arthropathy in immature animals of various species. True RJ, Berman JM, Mahutte CK. Treatment of theophylline toxicity with oral activated charcoal. COPD: The Global Initiative for Chronic Obstructive Lung Disease Guidelines 2013 suggest that while higher doses of slow release formulations of theophylline have been proven to be effective for use in COPD, it is not a preferred agent due to its potential for toxicity. Theophylline clearance is altered by another drug resulting in increased or decreased serum Theophylline concentrations. Theophylline only rarely alters the pharmacokinetics of other drugs. Isoproterenol: May decrease the serum concentration of Theophylline Derivatives. While the mechanisms of action of Theophylline are not known with certainty, studies in animals suggest that bronchodilation is mediated by the inhibition of two isozymes of phosphodiesterase PDE III and, to a lesser extent, PDE IV while non-bronchodilator prophylactic actions are probably mediated through one or more different molecular mechanisms, that do not involve inhibition of PDE III or antagonism of adenosine receptors. detrol
Medicines and illnesses can affect how quickly theophylline is cleared from the body. So the amount of theophylline in the must be measured regularly to be sure it stays at a safe level. Theophylline from extended-release dosage forms administered at night. The exact relationship of these and other factors to nighttime serum concentrations and the clinical significance of such findings require additional study. Therefore, it is not recommended that Theophylline extended-release once-daily dosing be administered at night. Adenosine: Theophylline Derivatives may diminish the therapeutic effect of Adenosine. Skip next dose and decrease subsequent doses at least 25% even if no adverse effects are present. Recheck serum concentration after 3 days to guide further dosage adjustment. If symptomatic, consider whether overdose treatment is indicated see recommendations for chronic overdosage. The of adverse events reported by patients in multiple-dose clinical trials, without regard to drug relationship, was 23%. The incidence of drug-related adverse reactions in multiple-dose clinical trials was 16%. Uniphyl theophylline anhydrous tablet Tablets on a mg-for-mg basis. torsemide generic cost walgreens
Beta-Blockers Beta1 Selective: May diminish the bronchodilatory effect of Theophylline Derivatives. Management: Monitor for reduced theophylline efficacy during concomitant use with any beta-blocker. Beta-1 selective agents are less likely to antagonize theophylline than nonselective agents, but selectivity may be lost at higher doses. Phenytoin increases Theophylline clearance by increasing microsomal enzyme activity. Theophylline decreases phenytoin absorption. Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. The addition of theophylline to an inhaled corticosteroid can improve function in adults with uncontrolled mild-to-moderate persistent asthma. Cardiovascular side effects have included increases in heart rate which have progressed to supraventricular tachycardia or ventricular tachycardia. Patients with a history of arrhythmias may be predisposed to this effect. Hypotension has occurred with rapid intravenous administration. What should I discuss with my healthcare provider before taking theophylline? In studies in which pregnant mice, rats and rabbits were dosed during the period of organogenesis, Theophylline produced teratogenic effects. Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution AAP, 1997; Zar 2007. What other drugs will affect theophylline Uniphyl? Skip next dose and decrease subsequent doses at least 25% even if no adverse effects are present. Your dosage needs may change if you are ill, or if your doctor changes your brand, strength, or type of theophylline. You will need regular medical tests to be sure you are using the right dose. Do not change your medication dose or schedule without your doctor's advice. Dosage adjustment based on serum theophylline concentrations: Note: Recheck serum theophylline concentration 24 hours after dosage adjustment. Increases theophylline clearance by induction of microsomal enzyme activity. Monitor the patient and obtain serial theophylline concentrations every 2 - 4 hours to gauge the effectiveness of therapy and to guide further treatment decisions. Do not stop taking any medications without consulting your healthcare provider. Ask your doctor or pharmacist about using this product safely. purchase now motrin mastercard
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. The most frequently reported events in single-dose trials, without regard to drug relationship, were and vomiting 2%. Events that occurred in less than 1% of patients are listed below. What is theophylline, and how does it work mechanism of action? 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. Serious and occasionally fatal hypersensitivity anaphylactoid or anaphylactic reactions, some following the first dose, have been reported in patients receiving quinolone therapy. Theophylline concentration than the value listed. Anticholinergic agents can help decrease sputum production. Examples of these medications include ipratropium Atrovent and tiotropium Spiriva. Levels of theophylline in the blood may be decreased, making the theophylline less effective. Note: Recheck serum theophylline levels after 3 days when using oral dosing, or after 12 hours children or 24 hours adults when dosing intravenously. Patients maintained with oral therapy may be reassessed at 6- to 12-month intervals. 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. Beta-2 blocking effect may decrease efficacy of Theophylline. Shannon M, Amitai Y, Lovejoy FH Jr. Multiple dose activated charcoal for theophylline poisoning in young infants. If the asthma has been under control for several months at a certain dose of medicine, the dose may be reduced. This can help find the least amount of medicine that will control the asthma. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. Hagley MT, Traeger SM, Schuckman H "Pronounced metabolic response to modest theophylline overdose. vantin
Absorption Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. Theo-24 is contraindicated in patients with a history of hypersensitivity to theophylline or other components in the product. Peak expiratory flow. A test that measures the force of air you breathe out exhale into the mouthpiece of a device called a peak expiratory flow meter. Bronchitis itself can be caused by a virus or bacteria, which are contagious. However, chronic asthmatic bronchitis typically is not contagious. 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. TiZANidine: CYP1A2 Inhibitors Weak may increase the serum concentration of TiZANidine. Management: Avoid these combinations when possible. If combined use cannot be avoided, initiate tizanidine at an adult dose of 2 mg and increase in 2-4 mg increments based on patient response. Monitor for increased effects of tizanidine, including adverse reactions. Cyproterone: May decrease the serum concentration of CYP1A2 Substrates. Isoniazid: May increase the serum concentration of Theophylline Derivatives. Increases theophylline clearance by increasing demethylation and hydroxylation. Lower initial doses may be required in patients with reduced theophylline clearance. Dosage should be adjusted according to serum level measurements. The dose of your medicine may need to be adjusted. SD hours. The amount of the dose absorbed was approximately 13% at 3 hours, 31% at 6 hours, 55% at 12 hours, 70% at 16 hours, and 88% at 24 hours. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose?
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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. F in original carton. Protect from light. Do not use if discolored or if crystals are present. Hall RC, Beresford TP, Stickney SK, et al "Psychiatric reactions produced by respiratory drugs. Halothane sensitizes the myocardium to catecholamines, Theophylline increases release of endogenous catecholamines. zetia
Macrolide Antibiotics: May decrease the metabolism of Theophylline Derivatives. Exceptions: Azithromycin Systemic; Fidaxomicin; Roxithromycin; Spiramycin; Telithromycin. General: The chronicity and pattern of Theophylline overdosage significantly influences clinical manifestations of toxicity, management and outcome. 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. Serious side effects may be more likely in older adults taking theophylline. cost procyclidine pharmaceuticals
Gender: Gender differences in Theophylline clearance are relatively small and unlikely to be of clinical significance. Significant reduction in Theophylline clearance, however, has been reported in women on the 20th day of the menstrual cycle and during the third trimester of pregnancy. Similar to cimetidine and pharmacologic interaction. Serious adverse effects in the infant are unlikely unless the mother has toxic serum theophylline concentrations. FDA pregnancy category C. It is not known whether theophylline will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
Table V contains Theophylline dosing titration schema recommended for patients in various age groups and clinical circumstances. Table VI contains recommendations for Theophylline dosage adjustment based upon serum Theophylline concentrations. Application of these general dosing recommendations to individual patients must take into account the unique clinical characteristics of each patient. In general, these recommendations should serve as the upper limit for dosage adjustments in order to decrease the risk of potentially serious adverse events associated with unexpected large increases in serum Theophylline concentration.