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. Mohsenifar Z, Lehrman S, Carson SA, Tashkin D "Two cases of allergy to aminophylline. There are several factors which may predispose a patient to higher serum concentrations and, thus, toxicity. These factors may include increased age, concomitant drugs which reduce the clearance of theophylline, hypothyroidism, congestive heart failure, liver disease, renal failure, and alterations in smoking habits. One series of patients with theophylline intoxication had recent upper respiratory tract infections. flagyl and canada
Theophylline clearance is decreased by 50% or more in patients with CHF. The extent of reduction in theophylline clearance in patients with CHF appears to be directly correlated to the severity of the cardiac disease. Since theophylline clearance is independent of liver blood flow, the reduction in clearance appears to be due to impaired hepatocyte function rather than reduced perfusion. Metabolism Following oral dosing, theophylline does not undergo any measurable first-pass elimination. In adults and children beyond one year of age, approximately 90% of the dose is metabolized in the liver. General monitoring procedures Electrocardiographic monitoring should be initiated on presentation and continued until the serum theophylline level has returned to a non-toxic level. Serum electrolytes and glucose should be measured on presentation and at appropriate intervals indicated by clinical circumstances. Fluid and electrolyte abnormalities should be promptly corrected.
Deferasirox: May increase the serum concentration of Theophylline. How should I take Theo-Dur theophylline? Methotrexate: May increase the serum concentration of Theophylline Derivatives. Additionally, GINA guidelines do not recommend oral theophylline for asthma in children 6 to 11 years of age. Refer to adult dosing.
Consider 10% dose reduction in infusion rate to improve safety margin even if dose is tolerated. The dose of theophylline must be individualized on the basis of peak serum theophylline concentration measurements in order to achieve a dose that will provide maximum potential benefit with minimal risk to adverse effects. Average effect on steady-state Theophylline concentration or other clinical effect for pharmacologic interactions. Only a few patients had a history of previous hypersensitivity reactions. Serious hypersensitivity reactions have also been reported following treatment with enoxacin. If an to enoxacin occurs, discontinue the drug.
Hurst 2004; elevate extremity. Radomski L, Park GD, Goldberg MJ, Spector R, Johnson GF, Quee CK. Model for theophylline overdose treatment with oral activated charcoal. Allopurinol: May increase the serum concentration of Theophylline Derivatives. When initiating therapy to guide final dosage adjustment after titration. Race: Pharmacokinetic differences in Theophylline clearance due to race have not been studied. Other medications can affect the removal of theophylline from your body, which may affect how theophylline works. Bittar G, Friedman HS "The arrhythmogenicity of theophylline: a multivariate analysis of clinical determinants. Some medicines can harm your baby. Clark BG, Vestal RE "Adverse drug reactions in the elderly: case studies. Tell your doctor if you have any major changes in your diet. Your doctor may need to adjust your dose. 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? Pentoxifylline: May increase the serum concentration of Theophylline Derivatives. Clearance: Note: Maturation of clearance in premature infants and term infants is most closely related to postconceptional age PCA; adult clearance values are reached at approximately 55 weeks PCA and higher pediatric values at approximately 60 weeks PCA Kraus1993. 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.
Inhaled steroids are first-line anti-inflammatory therapy. Examples of these medications include budesonide Pulmicort fluticasone Flovent beclomethasone Qvar mometasone Asmanex and ciclesonide Alvesco. 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. Theo-24 is available as capsules intended for oral administration, containing 100 mg, 200 mg, 300 mg, or 400 mg of anhydrous theophylline per capsule, in an extended-release formulation which allows a 24-hour dosing interval for appropriate patients. Adenosine: Theophylline Derivatives may diminish the therapeutic effect of Adenosine. Who should not take ZYFLO? Enoxacin is a potent inhibitor of the cytochrome P-450 isozymes responsible for the of methylxanthines. In a multiple-dose study, enoxacin caused a dose-related increase in the mean elimination half-life of caffeine, thereby decreasing the clearance of caffeine by up to 80% and leading to a five-fold increase in the AUC and the half-life of caffeine. Trough enoxacin levels were also 20% higher when caffeine and enoxacin were administered concomitantly. Caffeine-related adverse effects have occurred in patients consuming caffeine while on therapy with enoxacin. Uncomplicated urethral or due to gonorrhoeae. Cardiovascular side effects have included increased heart rate which has progressed to atrial tachycardia or ventricular tachycardia. Patients with a history of arrhythmias may be predisposed to this effect. Hypotension has occurred with rapid intravenous administration. Hall RC, Beresford TP, Stickney SK, et al "Psychiatric reactions produced by respiratory drugs. Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Metabolic side effects have included hypokalemia, hyperglycemia, respiratory alkalosis, hypophosphatemia, and hypomagnesemia, especially in the situation of acute overdosage. The magnitude of these abnormalities have been correlated with theophylline concentrations. Hypercalcemia has been reported in a patient with hyperthyroid disease with theophylline at therapeutic concentrations. Serious adverse effects in the infant are unlikely unless the mother has toxic serum theophylline concentrations. Nursing Mothers: It is not known whether enoxacin is excreted in human milk. Enoxacin is excreted in the milk of lactating rats. Because drugs of this class are excreted in human milk and because of the potential for serious adverse reactions from enoxacin in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. mirtazapine
Beta-Blockers Nonselective: May diminish the bronchodilatory effect of Theophylline Derivatives. Serious. These medicines may interact and cause very harmful effects. Larger dose of pancuronium may be required to achieve neuromuscular blockade. Note: Serum Theophylline concentrations may continue to increase after presentation of the patient for medical care. Consider 10% decrease in dose to provide greater margin of safety even if current dosage is tolerated. Dosage reduction may alleviate the caffeine-like adverse effects in these patients, however, persistent adverse effects should result in a re-evaluation of the need for continued theophylline therapy and the potential therapeutic benefit of alternative treatment. Your doctor will work with you to help find the number and dose of medicines that work best. Increases theophylline clearance by increasing demethylation and hydroxylation. whol.info cycrin
Ticlopidine: May increase the serum concentration of Theophylline Derivatives. Patients should be instructed to take this medication each morning at approximately the same time and not to exceed the prescribed dose. Chazan R, Karwat K, Tyminska K, Tadeusiak W, Droszcz W "Cardiac arrhythmias as a result of intravenous infusions of theophylline in patients with airway obstruction. If any of these effects persist or worsen, tell your doctor or promptly. Theophylline is used to treat lung diseases such as asthma and COPD bronchitis, emphysema. It must be used regularly to prevent wheezing and shortness of breath. This medication belongs to a class of drugs known as xanthines. It works in the airways by relaxing muscles, opening breathing passages, and decreasing the lungs' response to irritants. Controlling symptoms of breathing problems can decrease time lost from work or school. Tablets theophylline, anhydrous have been extensively studied. High levels of theophylline cause increased side effects. Your dose of medication may need to be adjusted. In patients with 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. What happens if I overdose? The average percent fraction of fluctuation was 244%. 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. Zafirlukast: Theophylline Derivatives may decrease the serum concentration of Zafirlukast. Zafirlukast may increase the serum concentration of Theophylline Derivatives. The addition of theophylline to an inhaled corticosteroid can improve function in adults with uncontrolled mild-to-moderate persistent asthma. order lopressor malarone
Enhance Clearance of Theophylline. How should I take TheoCap theophylline? Disclaimer: The indications, uses and warnings for individual medications outside the USA are determined by local regulatory bodies in each country or region. The Drugs. What should I discuss with my healthcare provider before taking theophylline Uniphyl? When your caregiver claps, you should hear a hollow sound. If you hear a slapping, the hand is not cupped enough. Most serum theophylline assays in clinical use are immunoassays which are specific for theophylline. Other xanthines such as caffeine, dyphylline, and pentoxifylline are not detected by these assays. Table IV. Manifestations of theophylline toxicity. These reactions may occur following the first dose. If these reactions occur in patients receiving enoxacin, the drug should be discontinued and appropriate measures instituted. Theophylline concentrations in three emergency departments. What should I discuss with my healthcare provider before taking TheoCap theophylline? What are the uses for theophylline? Theophylline serum concentrations are a significant predictor of arrhythmias. Oriordan JI, Hutchinson J, Fitzgerald MX, Hutchinson M "Amnesic syndrome after theophylline associated seizures: iatrogenic brain injury. Decreases Theophylline clearance and pharmacologic interaction.
Besides the guarana seed itself, there are no natural food sources of guarana. It has become a common additive to some foods and drinks. Do not share this medication with others. 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. Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? This group of medications includes and . These medications may be used alone in milder asthma but are often used along with inhaled corticosteroids in moderate to severe asthma. Wort may result in Theophylline toxicity. It can liquefy fat, cut connective tissue to loosen puckering, boost growth and tightening, increase flow, and lessen fluid retention. Expect results to last at least 6 months. Similarly, a patient with decreased theophylline binding may have a sub-therapeutic total drug concentration while the pharmacologically active unbound concentration is in the therapeutic range. If only total serum theophylline concentration is measured, this may lead to an unnecessary and potentially dangerous dose increase. In patients with reduced protein binding, measurement of unbound serum theophylline concentration provides a more reliable means of dosage adjustment than measurement of total serum theophylline concentration. Nakada T, Kwee IL, Lerner AM, Remler MP "Theophylline-induced seizures: clinical and pathophysiologic aspects. Table V. Dosing initiation and titration as anhydrous theophylline. order metronidazole online mastercard canada
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. If symptoms are not controlled and current dosage is tolerated, increase dose about 25%. COPD may be more susceptible to the respiratory depressant effects of anticonvulsants. Recheck serum concentration after three days for further dosage adjustment. 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. FDA product labels and may differ in countries outside the USA. Every effort has been made to ensure that the information provided on this page is accurate, up-to-date and complete, but no guarantee is made to that effect. Drugs. Theophylline can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Serum Concentrations at Steady-State: After multiple doses of Theophylline, steady-state is reached in 30-65 hours average 40 hours in adults. At steady- state, on a dosage regimen with 6-hour intervals, the expected mean trough concentration is approximately 60% of the mean peak concentration, assuming a mean Theophylline half-life of 8 hours. The difference between peak and trough concentrations is larger in patients with more rapid Theophylline clearance. In patients with high Theophylline clearance and half-lives of about 4-5 hours, such as children age 1 to 9 years, the trough serum Theophylline concentration may be only 30% of peak with a 6-hour dosing interval. Theophylline concentration in the pharmacologically active unbound form. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Congestive Heart Failure CHF: Theophylline clearance is decreased by 50% or more in patients with CHF. The extent of reduction in Theophylline clearance in patients with CHF appears to be directly correlated to the severity of the cardiac disease. Since Theophylline clearance is independent of liver blood flow, the reduction in clearance appears to be due to impaired hepatocyte function rather than reduced perfusion. Anticholinergic agents can help decrease sputum production. Examples of these medications include ipratropium Atrovent and tiotropium Spiriva. 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. There is also an injectable medication approved for asthma, called omalizumab Xolair or anti-IgE therapy. This medication binds to the antibody type responsible for allergic reactions immunoglobulin E or IgE in the bloodstream and is indicated for severe, allergic asthma not controlled with any of the other available asthma medications. This medication must always be administered in a health-care setting. 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. vermox
The dose of your medicine may need to be adjusted. Penicillinase production should have no effect on enoxacin activity. Decrease dose by 25%even if no adverse effects are present. F for at least 24 hours is probably required to produce a clinically significant increase in serum theophylline concentrations. Stabilized patients, 12 years of age or older, who are taking an immediate-release or controlled-release theophylline product may be transferred to once-daily administration of 400 mg or 600 mg Uniphyl Tablets on a mg-for-mg basis. Enoxacin is an ivory-to-slightly yellow powder. In dilute aqueous solution, it is unstable in strong sunlight. Quinolone-class adverse reactions: Although not reported in completed clinical studies with enoxacin, a variety of adverse events have been reported with other quinolones. However, it can actually make the dimpled fat left behind look worse. Theophylline concentrations should be monitored at 6 month intervals for rapidly growing children and at yearly intervals for all others. What other drugs will affect theophylline? The second thing you can do is to train your immune system to not overreact. 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. United States for delivery via a nebulizer. Cromolyn is suggested as an alternative medication to inhaled corticosteroids for asthma control, usually in mild asthma. It is not a commonly used asthma medication. Human experience of acute overdose with zileuton is limited. Table III. Drugs that have been documented not to interact with Theophylline or drugs that produce no clinically significant interaction with Theophylline. celexa
Obeticholic Acid: May increase the serum concentration of CYP1A2 Substrates. Refer to for further information regarding table. Caution is advised when using this drug in children because they may be more sensitive to its effects. Careful monitoring of side effects, drug levels, and dose adjustment is recommended. Uniphyl theophylline anhydrous tablet Tablet regimens. Halothane sensitizes the myocardium to catecholamines, theophylline increases release of endogenous catecholamines. 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. People taking theophylline should avoid -containing beverages. Patients with more rapid metabolism clinically identified by higher than average dose requirements, should receive a smaller dose more frequently every 12 hours to prevent breakthrough symptoms resulting from low trough concentrations before the next dose. TABLE VI. Dosage adjustment guided by serum theophylline concentration. Discontinuation of a concomitant drug that increases theophylline clearance will result in accumulation of theophylline to potentially toxic levels, unless the theophylline dose is appropriately reduced. Discontinuation of a concomitant drug that inhibits theophylline clearance will result in decreased serum theophylline concentrations, unless the theophylline dose is appropriately increased. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician 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 may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. Theophylline clearance see or if it is not feasible to monitor serum Theophylline concentrations. Buss DC, Marshall RW, Milligan N, Mcqueen I, Compston DAS, Routledge PA "The effect of intravenous aminophylline on essential tremor. Higher incidence of toxicity in cirrhosis patients. Cautious dosage adjustments are advised with serum level monitoring. In patients with chronic asthma, including patients with severe asthma requiring inhaled corticosteroids or alternate-day oral corticosteroids, many clinical studies have shown that theophylline decreases the frequency and severity of symptoms, including nocturnal exacerbations, and decreases the "as needed" use of inhaled beta 2 agonists. Theophylline has also been shown to reduce the need for short courses of daily oral prednisone to relieve exacerbations of airway obstruction that are unresponsive to bronchodilators in asthmatics.
cheapest theophylline online low price, order theophylline shopping uk, generic theophylline in us, theophylline coast, dollar store theophylline, cheap theophylline uk only, purchase theophylline ulotka, generic theophylline effectiveness, buy cheapest theophylline australia, theophylline canada shop reviews, theophylline price singapore, theophylline purchase now visa, mail order generic theophylline store, generic theophylline kopen, pharmacy express theophylline, buy now theophylline store usa, generic theophylline amazon, buy theophylline tablets uk, generic theophylline online payment, buy generic theophylline usa, buy theophylline allergy, buy theophylline alternative, theophylline schweiz, theophylline generic, buy theophylline china, cheap theophylline canada pharmacy, buy theophylline online com reviews, price theophylline forum, order theophylline malarone, order theophylline online mastercard canada, good price pharmacy theophylline, cheapest theophylline buy australia, theophylline and canada
Bernstein JE, Lorincz AL "Ethylenediamine-induced exfoliative erythroderma. 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. Macrolide Antibiotics: May decrease the metabolism of Theophylline Derivatives. Exceptions: Azithromycin Systemic; Fidaxomicin; Roxithromycin; Spiramycin; Telithromycin. Note: Serum theophylline concentrations may continue to increase after presentation of the patient for medical care. cheapest minocycline buy australia
Your dose and the number of times you take theophylline daily will depend on the reason you are taking this medication. If symptoms are not controlled and current dosage is tolerated consider adding additional medications to treatment regimen. Take this medication exactly as it was prescribed for you. good price pharmacy podophyllotoxin
If you've been experiencing symptoms like those listed above, make an appointment with your doctor. 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. danocrine
What brand names are available for theophylline? Guarana has among the highest concentrations of in any plant. Shannon M "Life-threatening events after theophylline overdose - A 10-year prospective analysis. Stamford, CT 06901-3431. March 17, 2004.