The effect of drug interactions on costs and other outcomes for hospitalized patients receiving warfarin or theophylline was studied. It took an additional 20 years until it was first reported as an asthma treatment. It is important to recognize the factors that both increase and decrease plasma theophylline concentrations, as these may affect efficacy and safety. Both smoking and excessive caffeine consumption can alter the blood levels of theophylline, which may affect the dosing. T here is a strong relationship between the number of medications taken and the likelihood of a potentially serious drug drug interaction. Plasma theophylline concentrations should be checked if there are any adverse effects or if there are concerns about compliance. Its used to treat airflow obstruction symptoms such as wheezing, shortness of breath, and chest. Interaction between phenytoin and theophylline in healthy. Although hundreds of drug interactions have been documented, relatively few are of enough clinical significance to constitute a contraindication to simultaneous. As a member of the xanthine family, it bears structural and pharmacological similarity to theobromine and caffeine, and is readily found in nature, being present in tea camellia.
It is noteworthy that when the drugs were used in combination the effects of theophylline and salbutamol were additive in inhibiting tnfalpha. Theophylline toxicity due to drug interaction sciencedirect. To reduce the risk of developing potentially dangerous drug interactions with theophylline, you should talk with your healthcare provider or pharmacist about any theophylline interactions that may apply to you. Tobacco and marijuana smoke including secondhand exposure generally reduces, while caffeine increases, blood levels. This may reduce the effectiveness of the medication. Th attained during therapy for asthma and improved pulmonary function or unwanted side effects, serves to link the. Currently, theophylline is being used predominantly as sustainedrelease capsules or tablets. Plasmatheophylline concentration is measured 5 days after starting oral treatment and at least 3 days after any dose adjustment. Theophylline interactions learning article pharmaceutical. Aminophylline was administered intravenously, followed by a 30h blood sampling period. In addition, its low cost makes lowdose theophylline in combination with a generic inhaled corticosteroid the most cost effective way to manage persistent asthma in developing. Theo 24, theocron theophylline dosing, indications. Effect of drug interactions on outcomes of patients.
Effect of drug interactions on outcomes of patients receiving. The major mechanism for distribution interaction is alteration in proteindrug binding. Pharmacokinetic drug interaction profiles of proton pump. Therapeutic consequences of drug interactions with theophylline. This document does not contain all possible drug interactions. Many drugs interact with theophylline by inhibiting or potentiating its metabolism by cyp1a2 see. Theophylline and alcohol drug interactions a study of fda. Identifying drugdrug interaction ddi is an important topic for the development of safe pharmaceutical drugs and for the optimization of multidrug regimens for complex diseases such as cancer and hiv. The drug was prescribed in a syrup up to the 1970s as theostat 20 and theostat 80, and by the early 1980s in a tablet form called quibron. Pharmacokinetic drug interactions with theophylline. Theophylline, also known as 1,3dimethylxanthine, is a methylxanthine drug used in therapy for respiratory diseases such as chronic obstructive pulmonary disease copd and asthma under a variety of brand names.
Many drugs interact with theophylline by inhibiting or potentiating its metabolism by cyp1a2 see commonlyused drugs that interact with theophylline. Clinical studies indicate that the drug does not interact with theophylline malmstrom, am j ther. Pharmacist intervention and knowledge in the drug disease interaction, considering the pharmacokinetics data, would be. Coadmininstration with drugs that decrease theophylline clearance eg, cimetidine, ciprofloxacin, and erythromycin and other macrolides. Johns wort can decrease the level of theophylline in your blood, perhaps making it less effective. Macrolide antibiotics, including troleandomycin and erythromycin, cimetidine, and allopurinol, have the capability of decreasing theophylline clearance with resulting increased serum levels, while phenytoin increases theophylline clearance. Theophylline is indicated for the treatment of the symptoms and reversible airflow obstruction associated with chronic asthma and other chronic lung diseases, e. T here is a strong relationship between the number of medications taken and the likelihood of a potentially serious drugdrug interaction. However, the possible interaction between theophylline and. Adverse reactions and interactions with theophylline springerlink.
Theophylline s first clinical use came in 1902 as a diuretic. Drug interactions are reported among people who take theophylline and alcohol together. In the midseventies the first preparations for use with a dosage interval of 12 hours twicedaily preparations were introduced. Differences in the halflife of theophylline are important because. When repaglinide was coadministered with theophylline, the only pharmacokinetic change was that the peak plasma theophylline concentration was slightly reduced. See what the interactions are and for which people. Although hundreds of drug interactions have been documented, relatively few are of enough clinical significance to constitute a contraindication to simultaneous use or to require a change in dosage. The drug is metabolised in the liver by cytochrome p450 isoenzymes, principally cyp1a2, to demethylated and hydroxylated products. In vitro studies indicate that montelukast does not inhibit cyp450 enzymes.
Theophylline is the generic name for the prescription drugs uniphyl in canada and theo24. Drug interactions are particularly important and are listed in table 2. Theophylline is now usually used as an addon therapy in asthma patients not well controlled on inhaled. The cyp2c19mediated interaction that seems to exist between clopidogrel and. Levofloxacin and theophylline drug interactions a study of. Dailymed theophylline theophylline anhydrous solution. Whatever the mechanism, the interaction may be sufficient to necessitate adjustment of the theophylline dosage, preferably. Drugdisease interactions of theophylline with cirrhosis, congestive heart failure, chronic obstructive. This study is created by ehealthme based on reports of 186 people who take levofloxacin and theophylline from food and drug administration fda, and is updated regularly. Drug interactions fall into three broad categories. If you are taking these drugs together, your healthcare provider may need to adjust your theophylline dosage. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Its also available in an intravenous iv form, which is. Concerning drug interactions with theophylline journal of.
Theophylline and aminophylline are used systemically carried in the blood stream through the body and have side effects throughout the body. Its available as an oral solution, an extendedrelease tablet, and an extendedrelease capsule. Theophylline appears to have an effect that is different from those of corticosteroids, and it may therefore be a useful drug to combine with lowdose inhaled steroids. Dec, 2012 since up to 90% of a theophylline dose is biotransformed, drugs influencing microsomal enzyme systems in the liver may affect the elimination of theophylline. During treatment with theophylline, do not start or stop taking st. Selected herbdrug interactions herb common use may interact with potential effect alfalfa medicago sativa multiple, including treatment of arthritis, asthma, dyspepsia, hyperlipidemia, and diabetes anticoagulants 1,2 alfalfa contains coumarin constituents and vitamin k.
Competitive displacement interactions displaced drug displacer anti coagulants phenylbutazone, chloral hydrate increased clotting tme. To evaluate an interaction between these two drugs, we studied theophylline pharmacokinetics before, after 10 days of ticlopidine administration, and 1 month later in. Danger of interaction between ciprofloxacin and theophylline br med j clin res ed 1988. Many reports of herbinduced interactions lack crucial documentation on temporal relations and concomitant drug use. Whatever the mechanism, the interaction may be sufficient to necessitate adjustment of the theophylline dosage. Perhaps the most serious problem encountered in analysing such reports is the consistent absence of any effort beyond that of reading the label to establish a positive identification of the herb involved, and to exclude the effect of contaminants or adulterants. Interaction between phenytoin and theophylline in healthy volunteers.
Since up to 90% of a theophylline dose is biotransformed, drugs influencing microsomal enzyme systems in the liver may affect the elimination of theophylline. Johns wort without first talking with your healthcare provider. Montelukast has fewer drug interactions than either zafirlukast or zileuton. Interactions between theophylline and salbutamol on cytokine. Levofloxacin and theophylline drug interactions a study. Food interactions with sustainedrelease theophylline. However, it may also be brought about by interference of its metabolism secondary to the concurrent administration of other drugs. In patients taking many drugs, however, the likelihood of significant drug interactions is increased. Since 1983, theophylline preparations that can be given with an interval of 24 hours oncedaily preparations have become available. When theophylline is given with enteral tube feedings, blood levels may be decreased due to interference with its absorption. Theophylline new perspectives for an old drug american.
Adverse drug interaction involving pancuronium and aminophylline. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be. A drug interaction between zafirlukast and theophylline. See what others have said about theophylline, including the effectiveness, ease of use and side effects. Drug interactions are reported among people who take levofloxacin and theophylline together. Induction of cyp1a2 results in a more rapid clearance of theophylline, which leads to reduced, and most likely subtherapeutic, serum theophylline concentrations. Theophylline oral interactions with other medication. We would like to show you a description here but the site wont allow us. The plasmatheophylline concentration is increased in heart failure, hepatic impairment, and in viral infections. Interactions between drugs in vitro eg, precipitation when mixed in solutions for intravenous administration are usually classified as drug incompatibilities, not drug interactions. In this paper, we introduced an automatic computational method for the systematic. Taking theophylline with propranolol can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. Elimination of theophylline from the body occurs mainly approximately 90% by biotransformation, followed by excretion of the metabolites.
Uniphyl theophylline anhydrous tablet 400 or 600 mg tablets can be taken once a day in the morning or evening. Theophylline interactions bnf content published by nice. Calculate initial dosage using the following equation. The clinician should not assume that a drug does not interact with theophylline if it is not listed here. This study is created by ehealthme based on reports of 186 people who take levofloxacin and theophylline from food and drug administration fda, and is.
The effect of phenytoin, 100 mg thrice daily for 3 weeks, on theophylline disposition was studied in eight healthy volunteers. Theophylline interacts with a wide variety of drugs. Blocks adenosine receptors, often necessitating a higher dose of adenosine to achieve the desired effect. Definition drug interaction is defined as the pharmacological activity of one drug is altered by the concominant use of another drug or by the presence of some other substance. Data were collected from medical records during a oneyear period in two community teaching hospitals in maryland. The plasmatheophylline concentration is decreased in smokers, and by alcohol consumption. Theophylline drug interactions can alter the level of theophylline in your blood or make some drugs less effective, among other things. Theophylline and its interactions1 cleveland clinic. Theophylline is a drug that has been used for asthma disease, for more than 80 years.
Theophylline uniphyl and theo24 side effects, dosage. A case report and study of the influence of thiabendazole and mebendazole on theophylline pharmacokinetics in adults. There have been about 150,000 publications on ddis in pubmed, which is a great resource for ddi studies. Theophylline has also been combined successfully with inhaled steroids. Selected herbdrug interactions university of michigan. Theophylline drug information kaiser permanente washington. Pdf interactions between theophylline and salbutamol on. Adjust oxtriphylline, theophylline theophylline dose. If patient is already taking theophylline, give smaller loading dose. Dailymed theophylline anhydrous theophylline tablet. Distribution interactions are those where the distribution pattern of the object drug is altered. Interactions between theophylline and salbutamol on.861 294 1162 145 347 896 1452 773 487 263 124 1178 1560 1565 1563 529 649 1637 484 156 984 664 1230 504 1117 205 400