Saturday, June 23, 2012

Theophylline



Generic Name: theophylline (thee OFF i lin)

Brand names: Elixophyllin, Theo-24, Theo-Time, TheoCap, Theochron, Uniphyl, ...show all 34 brand names.


What is theophylline?

Theophylline is a bronchodilator. It works by relaxing muscles in the lungs and chest, and makes the lungs less sensitive to allergens and other causes of bronchospasm.


Theophylline is used to treat the symptoms of asthma, bronchitis and emphysema.


Theophylline may also be used for other purposes not listed in this medication guide.


What is the most important information I should know about theophylline?


If there are any changes in the brand, strength, or type of theophylline you use, your dosage needs may change. Always check your medicine when it is refilled to make sure you have received the correct brand and type as prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.


Do not start or stop smoking without first talking to your doctor. Smoking changes the way your body uses theophylline, and you may need to use a different dose. Avoid drinks or foods that contain caffeine, such as coffee, tea, cola, and chocolate. Caffeine may increase some of the side effects of theophylline.

There are many other medicines that can interact with theophylline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.


What should I discuss with my healthcare provider before taking theophylline?


Do not use this medication if you are allergic to theophylline.

Before taking theophylline, tell your doctor if you are allergic to any drugs, or if you have:



  • a stomach ulcer;




  • epilepsy or other seizure disorder;




  • a heart rhythm problem;




  • congestive heart failure;




  • fluid in your lungs;




  • underactive thyroid;




  • a high fever;




  • liver disease (such as cirrhosis or hepatitis);




  • kidney disease; or




  • if you have recently quit smoking cigarettes or marijuana.



If you have any of these conditions, you may need a dose adjustment or special tests to safely take theophylline.


FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. 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.

Older adults may be more likely to have side effects from theophylline.


How should I take theophylline?


Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.


Your doctor may occasionally change your dose to make sure you get the best results from this medication.


Take this medicine with a full glass of water.

You may take theophylline with or without food, but take it the same way every time.


Do not crush, chew, break, or open an extended-release tablet or capsule unless your doctor tells you to. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

Your doctor may tell you to break a regular theophylline tablet before you take it. Some tablets have special scored marks on them to make breaking the tablet easier. Follow your doctor's instructions.


Measure the liquid form of theophylline with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.


If there are any changes in the brand, strength, or type of theophylline you use, your dosage needs may change. Always check your medicine when it is refilled to make sure you have received the correct brand and type as prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.


Do not start or stop smoking without first talking to your doctor. Smoking changes the way your body uses theophylline, and you may need to use a different dose. Store theophylline at room temperature, away from moisture, heat, and light.

See also: Theophylline dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, insomnia, tremors, restlessness, uneven heartbeats, and seizure (convulsions). Seizures caused by a theophylline overdose can cause death or permanent brain damage.

What should I avoid while taking theophylline?


Theophylline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinks or foods that contain caffeine, such as coffee, tea, cola, and chocolate. Caffeine may increase some of the side effects of theophylline.

Theophylline side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using theophylline and call your doctor at once if you have any of these serious side effects:

  • seizure (convulsions);




  • worsening of your condition, or symptoms of new illness;




  • severe or ongoing nausea and vomiting, headache, fast or uneven heart rate, and trouble sleeping (insomnia);




  • coughing up blood or vomit that looks like coffee grounds;




  • ongoing fever;




  • feeling restless, irritable, nervous, or jittery.




  • tremors; or




  • urinating more than usual.



Less serious side effects may include:



  • mild nausea, loss of appetite, weight loss;




  • restlessness, tremor, or insomnia; or




  • headache, lightheadedness, or dizziness.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Theophylline Dosing Information


Usual Adult Dose for Asthma -- Acute:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Maintenance dose:

Otherwise Healthy Nonsmoking Adult: 10 mg/kg/day. Do not exceed 900 mg/day.

Otherwise Healthy Adult Smoker: 16 mg/kg/day.

Patient with congestive heart failure or cor pulmonale: 5 mg/kg/day. Do not exceed 400 mg/day.

Usual Adult Dose for Asthma -- Maintenance:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Maintenance dose:

Otherwise Healthy Nonsmoking Adult: 10 mg/kg/day. Do not exceed 900 mg/day.

Otherwise Healthy Adult Smoker: 16 mg/kg/day.

Patient with congestive heart failure or cor pulmonale: 5 mg/kg/day. Do not exceed 400 mg/day.

Usual Geriatric Dose for Asthma -- Acute:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Otherwise healthy, nonsmokers: 10 mg/kg/day. Do not exceed 900 mg/day

Patient with congestive heart failure, cor pulmonale, and/or liver dysfunction: 5 mg/kg/day. Do not exceed 400 mg/day

Usual Geriatric Dose for Asthma -- Maintenance:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Otherwise healthy, nonsmokers: 10 mg/kg/day. Do not exceed 900 mg/day

Patient with congestive heart failure, cor pulmonale, and/or liver dysfunction: 5 mg/kg/day. Do not exceed 400 mg/day

Usual Pediatric Dose for Asthma -- Acute:

Loading dose:
If no theophylline has been administered in the previous 24 hours: 5 mg/kg loading dose to achieve a serum concentration of about 10 mcg/mL; loading doses should be given using a rapidly absorbed oral product not a sustained release product).

If theophylline has been administered in the previous 24 hours: 2.5 mg/kg theophylline may be given in emergencies when serum concentrations are not available. A modified loading dose (mg/kg) may be calculated (when the serum level is known) by: [Blood concentration desired - blood concentration measured] divided by 2 (for every 1 mg/kg theophylline given, the blood level will rise by approximately 2 mcg/mL).

Maintenance dose:

less than 42 days: 4 mg/kg/day orally.

42 days to 181 days: 10 mg/kg/day orally. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

6 months less than 12 months: 12 to 18 mg/kg/day. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

1 year to 8 years: 20 to 24 mg/kg/day.

9 years to 11 years: 16 mg/kg/day.

12 years to 15 years: 13 mg/kg/day.

16 years or older: 10 mg/kg/day. Do not exceed 900 mg/day.

Usual Pediatric Dose for Asthma -- Maintenance:

Loading dose:
If no theophylline has been administered in the previous 24 hours: 5 mg/kg loading dose to achieve a serum concentration of about 10 mcg/mL; loading doses should be given using a rapidly absorbed oral product not a sustained release product).

If theophylline has been administered in the previous 24 hours: 2.5 mg/kg theophylline may be given in emergencies when serum concentrations are not available. A modified loading dose (mg/kg) may be calculated (when the serum level is known) by: [Blood concentration desired - blood concentration measured] divided by 2 (for every 1 mg/kg theophylline given, the blood level will rise by approximately 2 mcg/mL).

Maintenance dose:

less than 42 days: 4 mg/kg/day orally.

42 days to 181 days: 10 mg/kg/day orally. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

6 months less than 12 months: 12 to 18 mg/kg/day. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

1 year to 8 years: 20 to 24 mg/kg/day.

9 years to 11 years: 16 mg/kg/day.

12 years to 15 years: 13 mg/kg/day.

16 years or older: 10 mg/kg/day. Do not exceed 900 mg/day.

Usual Pediatric Dose for Apnea of Prematurity:

Manufacturer recommendations:
Loading dose: 4.6 mg/kg/dose
Maintenance:
Premature neonates: Post natal age less than 24 days: 1 mg/kg/dose every 12 hours
Premature neonates: Post natal age 24 or more days: 1.5 mg/kg/dose every 12 hours
Full term infants: Total daily dose (mg) = [(0.2 x age in weeks) +5] x (weight in kg); divide dose into 3 equal amounts and administer at 8 hour intervals

Alternative dosing:
Loading dose: 5 to 6 mg/kg/dose
Maintenance: 2 to 6 mg/kg/day divided every 8 to 12 hours


What other drugs will affect theophylline?


Before taking theophylline, tell your doctor if you are using any of the following drugs:



  • carbamazepine (Carbatrol, Tegretol);




  • cimetidine (Tagamet);




  • enoxacin (Penetrex);




  • ephedrine or similar medications found in cold medicine or diet pills;




  • erythromycin (E.E.S., E-Mycin, Ery-Tab);




  • fluvoxamine (Luvox);




  • propranolol (Inderal, InnoPran);




  • rifampin (Rifadin, Rifater, Rifamate, Rimactane);




  • St. John's wort; or




  • thiabendazole (Mintezol).



This list is not complete and there are many other medicines that can interact with theophylline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.



More theophylline resources


  • Theophylline Side Effects (in more detail)
  • Theophylline Dosage
  • Theophylline Use in Pregnancy & Breastfeeding
  • Drug Images
  • Theophylline Drug Interactions
  • Theophylline Support Group
  • 5 Reviews for Theophylline - Add your own review/rating


  • theophylline Advanced Consumer (Micromedex) - Includes Dosage Information

  • Theophylline Prescribing Information (FDA)

  • Theophylline MedFacts Consumer Leaflet (Wolters Kluwer)

  • Theophylline Professional Patient Advice (Wolters Kluwer)

  • Elixophyllin Prescribing Information (FDA)

  • Elixophyllin Elixir MedFacts Consumer Leaflet (Wolters Kluwer)

  • Quibron-T Prescribing Information (FDA)

  • Theo-24 Prescribing Information (FDA)

  • TheoCap Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

  • Theochron Sustained-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

  • Theolair tablets Prescribing Information (FDA)

  • Theophyllines Monograph (AHFS DI)

  • Uniphyl Prescribing Information (FDA)



Compare theophylline with other medications


  • Apnea of Prematurity
  • Asthma, acute
  • Asthma, Maintenance


Where can I get more information?


  • Your pharmacist can provide more information about theophylline.

See also: theophylline side effects (in more detail)



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