If symptoms are controlled and current dosage is tolerated, maintain dose and recheck serum concentration at 6-12 month intervals. If symptoms are not controlled and current dosage is tolerated consider adding additional medications to treatment regimen. Estrogen Derivatives: May increase the serum concentration of Theophylline Derivatives. Before making a dose increase to determine whether the serum concentration is sub-therapeutic in a patient who continues to be symptomatic.
Overdose symptoms may include severe forms of some of the side effects listed in this medication guide. Febuxostat: May increase serum concentrations of the active metabolites of Theophylline Derivatives. Specifically, concentrations of 1-methylxanthine, a metabolite of unknown clinical importance, may become elevated. The Effect of Other Drugs on Theophylline Serum Concentration Measurements: 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. Erythromycin steady-state serum concentrations decrease by a similar amount.
Isoproterenol: May decrease the serum concentration of Theophylline Derivatives. Your dose of medication may need to be adjusted. Do not stop taking any medications without consulting your healthcare provider.
Do not crush or chew the capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Side effects may go away after you take the medicine for a while. Table VI. Dosage adjustment guided by serum Theophylline concentration. The treatment of asthma exacerbations with aminophylline is not supported or recommended by current clinical practice guidelines GINA 2016; NAEPP 2007. The treatment of acute COPD exacerbations with aminophylline is not recommended by current clinical practice guidelines Global Initiative for COPD Guidelines 2017.
Caffeine may increase some of the side effects of 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. Theophylline has two distinct actions; smooth muscle relaxation ie, bronchodilation and suppression of the response of the airways to stimuli ie, non-bronchodilator prophylactic effects. Bronchodilation is mediated by inhibition of two isoenzymes, phosphodiesterase PDE III and, to a lesser extent, PDE IV while non-bronchodilation effects are mediated through other molecular mechanisms. Theophylline increases the force of contraction of diaphragmatic muscles through enhancement of calcium uptake through adenosine-mediated channels. There are several readily identifiable causes of reduced Theophylline clearance. If the total daily dose is not appropriately reduced in the presence of these risk factors, severe and potentially fatal Theophylline toxicity can occur. When your caregiver claps, you should hear a hollow sound. If you hear a slapping, the hand is not cupped enough. Uniphyl theophylline anhydrous tablet Tablets whether dosed in the morning or evening. 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. Hepatic impairment: Use with caution in patients with hepatic impairment eg, cirrhosis, acute hepatitis, cholestasis; risk of severe and potentially fatal theophylline toxicity is increased. DexPak are often used during asthma flares to provide prompt relief for patients. Although very effective, these medications have many side effects and are only used when absolutely necessary. Some patients with severe asthma, however, may require oral steroids frequently or even on a daily basis. Sessler CN "Theophylline toxicity: clinical features of 116 consecutive cases. The molecular formula of anhydrous theophylline is C 7H 8N 4O 2 with a molecular weight of 180. If symptoms are not controlled and current dosage is tolerated, increase dose about 25%. Recheck serum concentration after three days for further dosage adjustment.
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. Leukotriene modifiers can also serve as anti-inflammatory agents. These medications include montelukast Singulair zafirlukast Accolate and zileuton Zyflo. Do not use theophylline to treat an asthma or bronchospasm attack. Use only a fast acting inhalation medication. 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. Serum theophylline and phenytoin concentrations decrease about 40%. Sintek C, Hendeles L, Weinberger M. Inhibition of theophylline absorption by activated charcoal. Serum Theophylline Concentration Monitoring. FDA pregnancy category C. This medication may be harmful to an unborn baby. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Where should I keep my supply of ZYLFO? ZYFLO can be continued during acute exacerbations of asthma. bonviva
All patients with gonorrhea should have a serologic test for syphilis at the time of diagnosis. Patients treated with enoxacin should have a follow-up serologic test for syphilis after 3 months. Theophylline concentration than the value listed. All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine. 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. Cross-resistance with other quinolones has been demonstrated. Teriflunomide: May decrease the serum concentration of CYP1A2 Substrates. online dimenhydrinate testimonials dimenhydrinate
Should be taken with water 1 hour before or 2 hours after meals. Premixed injection may contain corn-derived dextrose and its use is contraindicated in patients with allergy to corn-related products. Serum theophylline concentrations may continue to increase after presentation of the patient for medical care as a result of continued absorption of theophylline from the gastrointestinal tract. Serial monitoring of serum theophylline concentrations should be continued until it is clear that the concentration is no longer rising and has returned to non-toxic levels. Efficacy for this organism in this system at the recommended dose was studied in fewer than ten infections. The dosage regimens for complicated and uncomplicated urinary tract infections are different. The drugs listed in Table II have the potential to produce clinically significant pharmacodynamic or pharmacokinetic interactions with theophylline. The information in the "Effect " column of Table II assumes that the interacting drug is being added to a steady-state theophylline regimen. Absorption: Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. Cardiovascular disease: Use with caution in patients with tachyarrhythmias eg, sinus tachycardia, atrial fibrillation since use may exacerbate these arrhythmias. Gender Gender differences in theophylline clearance are relatively small and unlikely to be of clinical significance. Significant reduction in theophylline clearance, however, has been reported in women on the 20th day of the menstrual cycle and during the third trimester of pregnancy. Minton NA, Glucksman E, Henry JA. Prevention of drug absorption in simulated theophylline overdose. 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. Keep ZYFLO and all medicines out of the reach of children. When these two medicines are taken together, your body may not process theophylline properly. Journal of Cosmetic and Laser Therapy: “Effects of cellulite treatment with RF, IR light, mechanical massage and suction treating one buttock with the contralateral as a control. What should I discuss with my healthcare provider before taking TheoCap theophylline? Theophylline blocks adenosine receptors.
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 of adverse effects. Genitourinary side effects have included urinary retention. Serum theophylline concentration measurements are readily available and should be used to determine whether the dosage is appropriate. No dosage adjustment is required for adults or children older than 3 mo of age with renal function impairment. In neonates with reduced renal function, dose reduction and frequent monitoring of serum concentrations is required. Digoxin: Enoxacin may raise serum digoxin levels in some individuals. If signs and symptoms suggestive of digoxin occur when enoxacin and digoxin are given concomitantly, physicians are advised to obtain serum digoxin levels and adjust digoxin doses appropriately. When theophylline is given with enteral tube feedings, blood levels may be decreased due to interference with its absorption. This may reduce the effectiveness of the medication. To minimize potential for interaction, you may interrupt the feeding for one hour before and one hour after the theophylline dose. You may need more frequent blood tests to monitor theophylline levels. Administer multiple-dose oral activated charcoal and measures to control emesis. Take this by with or without food as directed by your doctor, usually 3 to 4 times daily. U400 on the other side. 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 can pass into breast milk and may harm a nursing baby. Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. The drugs listed in Table II have the potential to produce clinically significant pharmacodynamic or pharmacokinetic interactions with Theophylline. The information in the “Effect” column of Table II assumes that the interacting drug is being added to a steady-state Theophylline regimen. Decrease dose by 25% even if no adverse effects are present. Recheck serum concentration after 3 days to guide further dosage adjustment. serevent get quit program serevent
Drug Interactions for information regarding table. Clinical Interventions in Aging: “Can cellulite be treated with low-energy extracorporeal shock wave therapy? Treatment with broad-spectrum antibacterial agents alters the normal of the and may permit overgrowth of clostridia. 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. 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. This is not a complete list of side effects and others may occur. Similar to cimetidine, also increases renal clearance of theophylline. epoetin-alfa vendita online italia
Pancuronium. Theophylline Derivatives may diminish the neuromuscular-blocking effect of Pancuronium. Management: Pancuronium dosage adjustment may be necessary to induce paralysis in patients receiving concomitant theophylline derivatives. Bernstein JE, Lorincz AL "Ethylenediamine-induced exfoliative erythroderma. Decrease your cellulite using the latest science. Hurst 2004; elevate extremity. Caffeine concentrations are usually undetectable in adults regardless of renal function. In neonates, caffeine may accumulate to concentrations that approximate the unmetabolized theophylline concentration and thus, exert a pharmacologic effect. Theophylline concentrations at above average doses have the greatest likelihood of experiencing large changes in serum Theophylline concentration in response to dosage changes. 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. Recently, two medications have been approved that bind to a chemical messenger in the body, called interleukin 5 IL-5. Mepolizumab Nucala is administered subcutaneously, and reslizumab Cinqair is administered intravenously. IL-5 promotes activation and development of eosinophils, a type of white blood cell that is known to contribute to asthma in certain patients. These medications are indicated in patients with asthma not controlled by first line medications who also have an elevated eosinophil count in their blood. SD where actual range not reported. Increases in the dose of theophylline should not be made in response to an acute exacerbation of symptoms of chronic lung disease since theophylline provides little added benefit to inhaled beta 2-selective agonists and systemically administered corticosteroids in this circumstance and increases the risk of adverse effects. A peak steady-state serum theophylline concentration should be measured before increasing the dose in response to persistent chronic symptoms to ascertain whether an increase in dose is safe.
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. Ophthalmologic abnormalities, including cataracts and multiple punctate lenticular opacities, have been noted in patients undergoing treatment with enoxacin, as well as with some other quinolones, but have also been observed in patients receiving in comparative trials. In using multiple-dose therapy, levels of enoxacin and other quinolones were significantly higher than respective concentrations. The causal relationship, if any, of quinolones to lenticular abnormalities has not been established. 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. 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. ZYFLO. This includes all prescription and nonprescription medicines. Vemurafenib: May increase the serum concentration of CYP1A2 Substrates. Management: Consider alternatives to such combinations whenever possible, particularly if the CYP1A2 substrate has a relatively narrow therapeutic index. Theophylline Oral Solution USP is a clear red solution with a berry flavor. Each tablespoonful 15 mL contains 80 mg theophylline anhydrous. Uniphyl theophylline anhydrous tablet Tablets. Excretion: In neonates, approximately 50% of the Theophylline dose is excreted unchanged in the urine. Beyond the first three months of life, approximately 10% of the Theophylline dose is excreted unchanged in the urine. price of wellbutrin
Decreases theophylline clearance and pharmacologic interaction. 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. Acebrophylline: May enhance the stimulatory effect of Theophylline Derivatives. If symptoms are not controlled and current dosage is tolerated consider adding additional medications to treatment regimen. This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden breathing problems. If sudden shortness of breath occurs, use your quick-relief inhaler as prescribed. Careful monitoring of side effects and drug blood levels is recommended. Serum Theophylline concentrations may continue to increase after presentation of the patient for medical care as a result of continued absorption of Theophylline from the gastrointestinal tract. Serial monitoring of serum Theophylline serum concentrations should be continued until it is clear that the concentration is no longer rising and has returned to non-toxic levels. About 6% of a Theophylline dose is N-methylated to caffeine. Other quinolones also produce erosions of cartilage of weight-bearing joints and other signs of arthropathy in immature animals of various species. ZYFLO in the treatment of asthma. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Riociguat: Theophylline Derivatives may enhance the hypotensive effect of Riociguat. Consider prophylactic anticonvulsant therapy. 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. Use ideal body weight for obese patients. Table I. Mean and range of total body clearance and half-life of Theophylline related to age and altered physiological states. evik.info cabergoline
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For various North American patient populations from literature reports. Different rates of elimination and consequent dosage requirements have been observed among other peoples. Table III. Drugs that have been documented not to interact with Theophylline or drugs that produce no clinically significant interaction with Theophylline. The Effect of Other Drugs on Theophylline Serum Concentration Measurements: 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. mectizan in canada with prescription
Aderka D, Shavit G, Garfinkel D, et al "Life-threatening theophylline intoxication in a hypothyroid patient. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Changes in your body during the last 3 months of pregnancy 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. Endermologie or lipomassage or endermology is a specific type of mechanical massage. A machine with low-pressure suction kneads your skin between two spinning rollers. The theory is that the deep massage will break up the connective tissue that causes dimples. Most studies show that massage techniques, including endermologie, make your skin look better for a short time but offer no long-term benefit. Some experts worry that the suction can cause your skin to slacken prematurely, making it look worse.
Higher doses of adenosine may be required to achieve desired effect. What is theophylline Uniphyl? 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. Stop infusion and treat overdose; if resumed, decrease subsequent infusion rate at least 50%. Several studies have described the clinical manifestations of theophylline overdose and attempted to determine the factors that predict life-threatening toxicity. feldene
Take the missed dose as soon as you remember. 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. Table V. Dosing initiation and titration as anhydrous theophylline.