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. Patients who have received aminophylline or theophylline in the previous 24 hours: A loading dose should not be given before obtaining a serum theophylline concentration. Patients and prescribers should be alert for neuropsychiatric events. Some of the side effects that can occur with aminophylline may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. bafi.info cetirizine
Goldberg MJ, Spector R, Park GD, Johnson GF, Roberts P. The effect of sorbitol and activated charcoal on serum theophylline concentrations after slow-release theophylline. Uniphyl theophylline anhydrous tablet be taken with meals. Monitor the patient and obtain a serum theophylline concentration in 2 - 4 hours to insure that the concentration is not increasing.
If theophylline has been administered in the previous 24 hours: A loading dose is not recommended without obtaining a serum theophylline concentration. Theophylline serum concentrations are a significant predictor of arrhythmias. Larger diazepam doses may be required to produce desired level of sedation. Discontinuation of Theophylline without reduction of diazepam dose may result in respiratory depression.
No food or liquid other than water was allowed for 4 hours after which a standard lunch was served. Overview: Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. Theophylline does not undergo any appreciable pre-systemic elimination, distributes freely into fat-free tissues and is extensively metabolized in the liver. What are the possible side effects of theophylline Elixophyllin, Theo-24? Cmax of terfenadine of approximately 35%. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.
Decreases Theophylline clearance and pharmacologic interaction. Levine JH, Michael JR, Guarnieri T "Multifocal atrial tachycardia: a toxic effect of theophylline. 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. Theophylline clearance is altered by another drug resulting in increased or decreased serum Theophylline concentrations. Theophylline only rarely alters the pharmacokinetics of other drugs. This medication does not work right away and should not be used for sudden attacks of breathing trouble. 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. What should I avoid while talking ZYFLO? Adalimumab: May decrease the serum concentration of Theophylline Derivatives. FluvoxaMINE: May decrease the metabolism of Theophylline Derivatives.
Reported range or estimated range mean 2 SD where actual range not reported. Dose reduction and frequent monitoring of serum theophylline concentrations are required. 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. Caffeine and 3-methylxanthine are the only theophylline metabolites with pharmacologic activity. Dosing Guidelines, Table VI. Increased risk of ventricular arrhythmias. Theophylline toxicity: Severe and potentially fatal theophylline toxicity may occur if reduced theophylline clearance occurs. dimenhydrinate
At the high dose, systemic toxicity was observed in both species including decreases in testicular weight. General: The chronicity and pattern of Theophylline overdosage significantly influences clinical manifestations of toxicity, management and outcome. Take the missed dose as soon as you remember. Larger diazepam doses may be required to produce desired level of sedation. 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. The pharmacokinetics of theophylline vary widely among similar patients and cannot be predicted by age, sex, body weight or other demographic characteristics. In addition, certain concurrent illnesses and alterations in normal physiology see and co-administration of other drugs see can significantly alter the pharmacokinetic characteristics of theophylline. Within-subject variability in metabolism has also been reported in some studies, especially in acutely ill patients. Theophylline also strengthens right heart function and movement. Theophylline was approved by the FDA in April 1979.
Peptic ulcer disease: Use with caution in patient with peptic ulcer disease; use may exacerbate this condition. In studies in which pregnant mice, rats and rabbits were dosed during the period of organogenesis, theophylline produced teratogenic effects. Uniphyl theophylline anhydrous tablet Tablet regimens. Whenever signs or symptoms of theophylline toxicity are present. 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. Enoxacin is an ivory-to-slightly yellow powder. In dilute aqueous solution, it is unstable in strong sunlight. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity. Deferasirox: May increase the serum concentration of CYP1A2 Substrates. Table III. Drugs that have been documented not to interact with Theophylline or drugs that produce no clinically significant interaction with Theophylline. CYP1A2 Inhibitors Moderate: May decrease the metabolism of CYP1A2 Substrates. Jain R, Tholl DA. Activated charcoal for theophylline toxicity in a premature infant on the second day of life. What are the uses for theophylline? Theophylline per day is likely to receive 10- 20 mg of Theophylline per day. Serious adverse effects in the infant are unlikely unless the mother has toxic serum Theophylline concentrations. ZYFLO or stop taking the medicine without talking to your doctor first. order clozapine zamiennik
Cellfina was approved in 2015 to make this procedure more precise. It provides vacuum-assisted control of the depth and area treated. About 20 to 30 individual cellulite dimples are treated during an average 1-hour session. Results can last up to 2 years. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. What is theophylline, and how does it work mechanism of action? At least one death has been reported in a young woman with who consumed a guarana containing drink. People with MVP should speak to their doctor before using guarana. Discuss the risks and benefits with your doctor. Changes in your body during the last may affect the amount of this drug in your blood. Your doctor should carefully monitor the amount of drug in your blood, as well as any side effects, so that your dose may be changed if needed. Absorption: Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form.
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. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients. Do not start or stop smoking without first talking to your doctor. changes the way your body uses theophylline, and you may need to use a different dose. 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. Morning is the best time to do postural drainage, because it helps clear mucus that has built up during the night. Avoid eating foods that are high in fat within 1 hour before or after taking theophylline. The symptoms of asthmatic bronchitis are a combination of the symptoms of bronchitis and asthma. Radomski L, Park GD, Goldberg MJ, Spector R, Johnson GF, Quee CK. Model for theophylline overdose treatment with oral activated charcoal. Amitai Y, Yeung AC, Moye J, Lovejoy FH Jr. Repetitive oral activated charcoal and control of emesis in severe theophylline toxicity. 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. What are the side effects of theophylline? However, the incidence of drug-related adverse reactions was comparable between age groups. Anticipate Need for Anticonvulsants. Barr RG, et al. 2003. Methylxanthines for exacerbations of chronic obstructive pulmonary disease: Meta-analysis of randomised trials. BMJ, 327: 643-648. sulfasalazine buy shop uk
Cannabis: May decrease the serum concentration of CYP1A2 Substrates. Calculate doses based on lean body weight. Base dose adjustments on improved clinical response and improvement in pulmonary function with careful monitoring of serum levels. Increase Theophylline clearance by increasing demethylation and hydroxylation. Decreases renal clearance of Theophylline. AUC achieved at the maximum recommended human daily oral dose. Teratogenic effects were observed in animal reproduction studies. Theophylline crosses the placenta; adverse effects may be seen in the newborn. The most common causes of chronic theophylline overdosage include patient or care giver error in dosing, healthcare professional prescribing of an excessive dose or a normal dose in the presence of factors known to decrease the rate of theophylline clearance, and increasing the dose in response to an exacerbation of symptoms without first measuring the serum theophylline concentration to determine whether a dose increase is safe. Theophylline is excreted into breast milk and may cause irritability or other signs of mild toxicity in nursing human infants. The concentration of theophylline in breast milk is about equivalent to the maternal serum concentration. 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. 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. 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. Side effects may go away after you take the medicine for a while. This is not a complete list of side effects and others may occur. Similar to cimetidine, also increases renal clearance of theophylline. 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. Theophylline may also be used for purposes not listed in this medication guide.
THEOLAIR theophylline tablets Tablets are contraindicated in patients with a history of hypersensitivity to theophylline or any other components in these products. Many drugs can interact with theophylline and not all possible interactions are listed in this medication guide. Cardiovascular disease: Use with caution in patients with tachyarrhythmias eg, sinus tachycardia, atrial fibrillation since use may exacerbate these arrhythmias. Have persistent nighttime symptoms. 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. Taking Theophylline extended-release tablets immediately after a high-fat content meal may result in a somewhat higher C max and delayed T max and somewhat greater extent of absorption. Sulfinpyrazone: May decrease the serum concentration of Theophylline Derivatives. Stop infusion for 24 hours and decrease subsequent infusion rate at least 25%. If symptomatic, stop infusion and consider whether overdose treatment is indicated. Educate patient about signs of a significant reaction eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Theophylline: Hepatic via demethylation CYP 1A2 and hydroxylation CYP 2E1 and 3A4; forms active metabolites caffeine and 3-methylxanthine. The steady-state peak serum theophylline concentration is a function of the dose, the dosing interval, and the rate of theophylline absorption and clearance in the individual patient. 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. CYP1A2 Inhibitors Strong: May decrease the metabolism of CYP1A2 Substrates. Administer a single dose of oral activated charcoal. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. Moderate-to-severe phototoxicity reactions have been observed in patients exposed to direct sunlight while receiving enoxacin or some other drugs in this class. Excessive sunlight should be avoided. Therapy should be discontinued if phototoxicity occurs. kamagra
If any of these effects persist or worsen, tell your doctor or promptly. Bahls FH, Ma KK, Bird TD "Theophylline-associated seizures with "therapeutic" or low toxic serum concentrations: risk factors for serious outcome in adults. Theo-24 theophylline anhydrous is supplied in extended-release capsules containing 100, 200, 300 or 400 mg of anhydrous theophylline. Careful monitoring of side effects and drug blood levels is recommended. United States and its territories. Indications, uses and warnings on Drugs. Table III. Drugs that have been documented not to interact with theophylline or drugs that produce no clinically significant interaction with theophylline. What are the possible side effects of ZYFLO? If the serum sample is drawn more or less than twelve 12 hours after the dose, the results must be interpreted with caution since the concentration may not be reflective of the peak concentration. In contrast, when signs or symptoms of theophylline toxicity are present, the serum sample should be obtained as soon as possible, analyzed immediately, and the result reported to the healthcare professional without delay. 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. 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. Co-administration of Theophylline with food or antacids does not cause clinically significant changes in the absorption of Theophylline from immediate-release dosage forms.
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. Stewart JT "Prolongation of ECT-induced seizures with theophylline. 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. FDA pregnancy category C. This medication may be harmful to an unborn baby. Loading dose: Oral, IV: Refer to adult dosing. You may take theophylline with or without food, but take it the same way every time. 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. Theophylline at least twofold by absorption of Theophylline secreted into gastrointestinal fluids. Charcoal must be retained in, and pass through, the gastrointestinal tract to be effective; emesis should therefore be controlled by administration of appropriate antiemetics. Alternatively, the charcoal can be administered continuously through a nasogastric tube in conjunction with appropriate antiemetics. A single dose of sorbitol may be administered with the activated charcoal to promote stooling to facilitate clearance of the adsorbed Theophylline from the gastrointestinal tract. Sorbitol alone does not enhance clearance of Theophylline and should be dosed with caution to prevent excessive stooling which can result in severe fluid and electrolyte imbalances. 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. In patients with intractable vomiting, extracorporeal methods of Theophylline removal should be instituted see OVERDOSAGE, Extracorporeal Removal. Refer to for information regarding table. Shannon M, Amitai Y, Lovejoy FH Jr. Multiple dose activated charcoal for theophylline poisoning in young infants. Tobacco and marijuana smoking appears to increase the clearance of theophylline by induction of metabolic pathways. Theophylline clearance has been shown to increase by approximately 50% in young adult tobacco smokers and by approximately 80% in elderly tobacco smokers compared to non-smoking subjects. Passive smoke exposure has also been shown to increase theophylline clearance by up to 50%. Abstinence from tobacco smoking for one week causes a reduction of approximately 40% in theophylline clearance. Careful attention to dose reduction and frequent monitoring of serum theophylline concentrations are required in patients who stop smoking see . Use of nicotine gum has been shown to have no effect on theophylline clearance. To guide a dose increase, the blood sample should be obtained at the time of the expected peak serum Theophylline concentration; 12 hours after an evening dose or 9 hours after a morning dose at 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. buy zithromax from india
When initiating therapy to guide final dosage adjustment after titration. Monitor the patient and obtain a serum theophylline concentration in 2-4 hours to insure that the concentration is not increasing. Dispense in tight, light-resistant container. It is possible that some side effects of theophylline may not have been reported. Where can I get more information? Clearance represents the volume of blood completely cleared of Theophylline by the liver in one minute. 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. Follow your doctor's instructions about whether to take your medication with food or on an empty stomach. Take the medication the same way every time.
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. Talk to your doctor if you have any questions about ZYFLO. Race Pharmacokinetic differences in theophylline clearance due to race have not been studied. Mexiletine: May decrease the metabolism of Theophylline Derivatives. Deferasirox: May increase the serum concentration of Theophylline. Chromones stabilize mast cells allergic cells but are rarely used in clinical practice. Cromolyn and nedocromil are in this drug class. Doses should be individualized based on steady-state serum concentrations and ideal body weight. 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. pyridostigmine generico shop
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Anti-IgE can be used in moderate to severe allergic asthma. Omalizumab Xolair is an anti-IgE medication. 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. Tell your doctor if you are following a dietary plan or eat beef every day. The dose of your medicine may need to be adjusted. Get medical help right away if your worsen or if you are using your quick-relief more than usual or more often than prescribed. clotrimazole
Hagley MT, Traeger SM, Schuckman H "Pronounced metabolic response to modest theophylline overdose. Lower initial doses may be required in patients with reduced theophylline clearance. Dosage should be adjusted according to serum level measurements. Stoller JL "Oesophageal ulceration and theophylline.
Guarana has among the highest concentrations of in any plant. Theophylline concentration when afebrile may be at greater risk of toxic effects from decreased clearance during sustained fever. Vesicant; ensure proper needle or catheter placement prior to and during IV infusion. Avoid extravasation.
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. Make sure lab personnel and all your doctors know you use this drug. 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 . 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.