Before you buy Theophylline online
What It Does?
Theophylline is used to treat bronchial asthma, chronic bronchitis and bronchial obstruction associated with emphysema. Theophylline should not be used as first-line treatment of asthma in children.
How It Works?
The active ingredient of Theophylline is anhydrous theophylline, a xanthine derivative which relaxes smooth muscle and thereby provide bronchodilation. The mechanism of action of theophylline bronchodilator effect is incompletely understood. Theophylline has a positive chronotropic and inotropic effect and a weak diuretic and stimulant effect.
The effect persists for 12 hours, which means that Theophylline only needs to be administered two times a day.
How It Is Taken?
The dosage should be individualized and adjusted according to body weight. When calculating the weight of the body, you doctor should exclude abnormal obesity. Theophylline has a relatively small therapeutic breadth. For adequate effect it is generally recommended to reach a plasma concentration of 28-67 micromol / l (5-12 mg / l). In some cases, a plasma concentration of up to 20 mg / l is required. During concomitant treatment with beta2-agonist should theophylline could be kept lower. The tablets are preferably every 12 hours.
The pills must not be crushed or chewed, but can be shared and should be swallowed whole or half. For patients with symptoms of night asthma, the entire daily dose given in the evening.
300 mg 2 times per day. The dose may be after at least 3 days of treatment increased to 450 mg 2 times per day or be reduced to 150 mg 2 times per day, if sufficient therapeutic effect is not obtained and if toxicity occurs. Smokers may need a higher dose.
Patients with severe cardiovascular disorders and hepatic impairment: 200 mg 2 times per day. The dose may be after at least 3 days of treatment increased incrementally with 100 mg (0.5 tablet of 200 mg) 2 times a day.
Theophylline release tablets should not be used by children under 6 years. There are other formulations of theophylline that are better suited to children under 6 years.
Daily dose / kg should be adapted to the child's body weight.
Is It For Me?
Do not take Theophylline in case of hypersensitivity to the ingredients.
Any Drug Interactions or Incompatibilities?
Concurrent administration of influenza vaccine, oral contraceptives and thiabendazole may result in an increase of theophylline in plasma. Simultaneous treatment with carbamazepine may result in a reduction of theophylline in plasma.
Theophylline may potentiate hypokalemia with concomitant treatment with beta-2 agonists, steroids or diuretics, and in hypoxia (see Warnings and Precautions).
Theophylline interacts with:
Cimetidine reduces the clearance of theophylline by inhibiting its metabolism. The combination should be avoided unless theophylline levels in plasma can be followed.
Despite a number of negative interaction studies of the combination of theophylline ranitidine in healthy volunteers, has recently been a number of cases described where the theophylline content of plasma has risen significantly when patients concomitantly treated with ranitidine. It has been suggested that such interaction may occur in patients whose cytochrome P450 induced by other drugs. In combination treatment is recommended control of theophylline in plasma. The combination may require dose adjustment.
When ticlopidine inserted in patients treated with theophylline, may be theophylline in plasma increase due inhibited the metabolism of theophylline. An individual patientkasuistik have been confirmed in an experimental study in 10 healthy volunteers. In combination treatment, because the concentration of theophylline in plasma monitored and the dose adjusted accordingly.
Case reports and experimental studies show that mexiletine may reduce the clearance of theophylline, probably by inhibiting the demethylation of theophylline. The funds also have additive arrhythmogenic effects. During concomitant use Theophylline traces in plasma increase by approximately 50%, why control of theophylline in plasma is recommended. The combination may require dose adjustment.
Two well-substantiated case reports indicate that insertion of propafenone may lead to Theophylline traces in serum rise sharply, probably due inhibited metabolism. Frequent monitoring of theophylline in plasma is recommended in concomitant treatment with theophylline and propafenone. The combination may require dose adjustment.
Methylxanthines are adenosine antagonists, why treatment with such agents is expected to increase the effective dose of adenosine. The combination should be avoided.
Propranolol reduces the metabolic clearance of theophylline by about 30% at a dosage of 120 mg / day and 50% at doses of 720 mg / day. In combination treatment, the concentration of theophylline in plasma be monitored. The combination may require dose adjustment.
Verapamil reduces the clearance of theophylline in healthy subjects by approximately 20%. One case report suggests that verapamil can inhibit the metabolism of theophylline with elevated plasma levels as a result. In vitro, verapamil shown to inhibit cytochrome P450 1A2, which metabolizes theophylline. In combination treatment, the concentration of theophylline in plasma be monitored. The combination may require dose adjustment.
Erythromycin therapy can result in Theophylline traces plasma increases, probably due inhibited metabolism. In a study fell while erythromycin traces serum. In combination therapy should Theophylline traces in plasma monitored so that toxic concentrations are not developed. In addition, a negative interaction study has been published. A very pronounced metabolic interaction with 3-fold exacerbated plasma concentrations of theophylline have been described in a patient treated with erythromycin as well as ciprofloxacin. The combination may require dose adjustment.
Ciprofloxacin Theophylline clearance decreases by 30% or more with increasing plasma levels as a result. In combination therapy should Theophylline levels plasma followed. Several cases with seizure at this combination have been described and have been associated with that ciprofloxacin lower the seizure threshold via the GABA system. A very pronounced metabolic interaction with 3-fold exacerbated plasma concentrations of theophylline have been described in a patient, which further were treated with erythromycin as well as ciprofloxacin. In combination treatment, the concentration of theophylline in plasma be monitored. The combination may require dose adjustment.
Norfloxacin decreases Theophylline clearance by about 15% with increasing plasma levels as a result. In combination treatment, Theophylline levels in plasma is controlled. Norfloxacin has less effect on theophylline metabolism than ciprofloxacin and enoxacin, but three cases of convulsions have been observed with this combination. The combination may require dose adjustment.
Observations in healthy volunteers show that rifampicin may induce metabolism of theophylline. The combination may require dose adjustment.
Case report and experimental studies suggest that isoniazid can inhibit the metabolism of theophylline with increasing plasma levels as a result. In combination treatment, the concentration of theophylline in plasma be monitored. The combination may require dose adjustment.
Experimental studies of five male subjects show that concomitant treatment with acyclovir AUC of theophylline administered orally by about 50%. During concomitant therapy with acyclovir recommended concentration determination in plasma. The combination may require dose adjustment.
During concomitant treatment with theophylline and ritonavir reduces plasma concentration of theophylline by about 40%. This is because ritonavir induces CYP1A2.
Methotrexate can inhibit the metabolism of theophylline. In combination treatment, the concentration of theophylline in plasma be monitored. The combination may require dose adjustment.
- Interferon alpha
After injection of the interferon was observed a 50% (33-81%) reduction of Theophylline clearance in patients with chronic active hepatitis. The combination may require dose adjustment.
High daily doses of allopurinol (0.6 g) reduces Theophylline clearance, control of theophylline in plasma is therefore advisable. The combination may require dose adjustment.
Four case reports suggest that theophylline can trigger arrhythmias in patients with asthma during halothane anasthesia. The combination may require dose adjustment.
Clinical and experimental evidence has lowered seizure threshold in the combination of theophylline and ketamine. The combination should be avoided.
Phenobarbital, which is a metabolite of primidone, and pentobarbital increases theophylline metabolic clearance with lowered plasma levels as a result. The combination may require dose adjustment.
Phenytoin increases theophylline metabolic clearance with lowered plasma levels as a result. Conversely seem theophylline could increase phenytoin metabolic clearance. In combination treatment, thus levels of theophylline and phenytoin plasma followed. The combination may require dose adjustment.
Theophylline counteracts the sedative diazepam and psychomotor effects. Case reports suggest that theophylline may also counteract other bensodiazepiners sedative effects. The combination may require dose adjustment.
Several case reports suggest that treatment with fluvoxamine can lead to significantly increased levels of theophylline in plasma through its metabolism is inhibited. In an experimental study fell Theophylline clearance 80-24 ml / min and the elimination half-life increased from 6,6 to 22 hours during concomitant treatment with fluvoxamine. During concomitant treatment with the two agents, should the plasma concentration of theophylline checked. In vitro studies show that fluvoxamine is a potent inhibitor of cytochrome P450 1A2, which catalyzes demethylation of theophylline. The combination may require dose adjustment.
After one week of treatment with rofecoxib at therapeutic doses seen a 30% increase in AUC of theophylline compared to controls. This is probably due to an inhibition of CYP 1A2. In combination therapy should theophylline in plasma be monitored.
Disulfiram inhibits dose-dependently the metabolism of theophylline when co-administered. A dosage reduction of up to 50% may be required, depending on the amount of theophylline in the plasma increases. The combination may require dose adjustment.
Plasma concentrations of theophylline can be reduced by concomitant use of herbal preparations containing St. John's wort (Hypericum perforatum). This is because the wort induce drug enzyme. Herbal products containing St. John's wort should therefore not be combined with theophylline. The inducing effect may persist for at least 2 weeks after cessation of treatment with St. John's wort. If a patient is already taking St. John's wort, theophylline levels must be monitored before treatment with St John's Wort is terminated. Theophylline levels may increase after stopping St. John's wort. Theophylline dose may need to be adjusted.
Concomitant treatment with theophylline and felodipine leads to some decrease in plasma theophylline concentrations.
Concomitant treatment with theophylline and lithium leads to decreased lithium concentration in plasma.
Concomitant treatment with theophylline and glucagon leads to increased stimulation of glucose production in the liver.
What Side Effects Should I Brace Myself For?
10-15% of treated patients can be expected to experience adverse reactions. These are related to the plasma concentration but large interindividual variations have been observed. The most common are gastrointestinal symptoms, which usually subside or disappear after a period of treatment or after dose reduction.Loss of appetite, headache.
Sleep disorders, irritability, nervousness.
CNS induced seizures.
Any Important Tips?
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