Patients may also need to limit their intake of caffeine-containing beverages or foods (e.g., coffee, green tea, other teas, colas, or chocolate) to avoid caffeine-like side effects. (Moderate) Concurrent administration of theophylline or aminophylline with sympathomimetics can produce excessive stimulation manifested by skeletal muscle activity, agitation, and hyperactivity. Additive adverse effects on the cardiovascular and nervous system are possible, some which may be undesirable. Calculate initial total daily dose using the following equation: Total daily dose (mg) = [(0.2 x age in weeks) + 5] x (kg body weight). This medication belongs to a class of drugs known as xanthines. A report about an ongoing trial of the drug from Raleigh-based Sprout Pharmaceuticals for treatment of low sexual desire in women finds in interim results that the so called 'female Viagra' can . Of the macrolides, azithromycin may be an alternative since it does not inhibit cytochrome P450 enzymes; no dosage adjustment of theophylline (or aminophylline) is required when azithromycin is coadministered. (Moderate) Beta-agonists are commonly used in conjunction with aminophylline or theophylline therapy. Reductions in CYP1A2 activity have been noted with various alpha interferons, and likely provide a mechanism for the interaction. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Usual dose: 450 +/- 100 mg/day.[63867]. In neonates, theophylline is metabolized to caffeine; initiating caffeine after theophylline therapy is halted may result in caffeine toxicity in neonates if serum caffeine levels are not monitored prior to the initiation of caffeine therapy. Theophylline may require dosage adjustment when therapy with lansoprazole is initiated or discontinued. Tobacco smoking has been shown to increase the clearance of theophylline by about 50% in young adult tobacco smokers and about 80% in elderly tobacco smokers. Adjust subsequent dosage based on serum theophylline concentrations. Increased theophylline exposure is possible. Acetaminophen; Aspirin, ASA; Caffeine: (Major) Caffeine is a CNS stimulant. Initially, 300 to 400 mg/day PO every 24 hours; evening dosing is not recommended. Concomitant use can cause additive CNS stimulation; some patients may experience tremor or nervousness with combined use. Further dose adjustments may be needed due to concurrent medical conditions that reduce clearance or concomitant drug therapy; review drug interactions. Blinatumomab: (Moderate) No drug interaction studies have been performed with blinatumomab. In addition, some preparations of theophylline elixir contain significant amounts of ethanol, which can cause reactions with disulfiram; read labels carefully. In vitro,sarilumab has the potential to affect expression of multiple CYP enzymes, including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, and CYP3A4. If clarithromycin is used with aminophylline therapy, patients should be monitored for elevated theophylline levels and/or theophylline toxicity. Obeticholic Acid: (Moderate) Obeticholic acid may increase the exposure to concomitant drugs that are CYP1A2 substrates, such as theophylline, aminophylline. Consider checking potassium levels if clinically indicated. One small study documented a significant decrease in theophylline clearance after therapy with famotidine. Theophylline belongs to a group of medicines known as bronchodilators. After a 3-day oral aprepitant regimen, the AUC of midazolam (given on days 1, 4, 8, and 15) increased by 25% on day 4, and then decreased by 19% and 4% on days 8 and 15, respectively. Initially, 300 mg/day PO in divided doses every 6 to 8 hours. In this study, theophylline was administered as Theo-Dur tablets (NOTE: no longer commercially available) 3.3 mg/kg PO twice daily for 5 days. Since 100 mg of aminophylline is equivalent to 80 mg of theophylline, errors in dosing are possible, and clinicians should carefully assess dose adjustments and calculations when switching between aminophylline dose forms and theophylline dose forms. Consider checking potassium levels if clinically indicated. This interaction does not occur with IV aminophylline. Larger doses of isoniazid and longer duration of isoniazid administration are more likely to affect theophylline pharmacokinetics. If clarithromycin is used with aminophylline or theophylline therapy, patients should be monitored for elevated theophylline levels and/or theophylline toxicity. Ticlopidine: (Major) Aminophylline clearance may be significantly reduced when ticlopidine is administered concomitantly. Adverse effects such as tremors, insomnia, seizures, or cardiac arrhythmias are also possible when excessive dosages of caffeine are taken concurrently with theophylline. Patients who regularly consume ethanol but do not exhibit overt hepatic dysfunction may actually require larger doses than normal. Make sure you tell your doctor if you have any other medical problems, especially: Portions of this document last updated: May 01, 2023. The clinical significance of this interaction is not certain. Clinical monitoring for adverse effects is recommended during coadministration. Downward dosage adjustments of such drugs and more frequent monitoring may be required during smoking cessation. Patients taking theophylline should avoid medications containing caffeine when possible. Consider twice daily dosing in patients with rapid metabolism and who repeatedly have symptoms at the end of a 24-hour dosing interval. Do not start, stop, or change the dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider, or pharmacist first. Zileuton: (Major) Concurrent use of zileuton and theophylline results in an approximate doubling of theophylline serum concentrations and increased frequency of theophylline-related adverse effects. Generic:- Store at controlled room temperature (between 68 and 77 degrees F)Elixophyllin:- Store at controlled room temperature (between 68 and 77 degrees F)Quibron T:- Store between 59 to 77 degrees FQuibron T/SR:- Store at controlled room temperature (between 68 and 77 degrees F)Theo X:- Store at controlled room temperature (between 68 and 77 degrees F)Theo-24:- Store below 77 degrees FTheochron:- Storage information not availableTheo-Dur:- Store at controlled room temperature (between 68 and 77 degrees F)Theolair SR:- Store at controlled room temperature (between 68 and 77 degrees F)T-Phyl:- Store at controlled room temperature (between 68 and 77 degrees F)Uni-Dur:- Store at controlled room temperature (between 68 and 77 degrees F)Uniphyl:- Store at controlled room temperature (between 68 and 77 degrees F). Etomidate: (Moderate) Aminophylline used concurrently with inhaled general anesthetics may increase the risk of cardiac arrhythmias. Theophylline. Lower doses may be necessary for patients with congestive heart failure, including cor pulmonale, due to decreased theophylline clearance (>= 50% decrease). The concurrent administration of caffeine to patients taking theophylline may produce excessive caffeine-like side effects, such as nausea, irritability or nervousness. The formation of CYP450 enzymes may be altered by increased concentrations of cytokines during chronic inflammation. This interaction occurs from the inhibition of methylxanthine oxidation in the liver. Consider checking potassium levels if clinically indicated. Patients taking theophylline should avoid medications containing caffeine when possible. A aminophylline or theophylline dose adjustment may be needed in some patients. Animal studies show risk and human studies are not available or neither animal nor human studies were done. (Moderate) Aminophylline can increase renal clearance of lithium, reducing its therapeutic effectiveness. (Moderate) Concurrent administration of theophylline or aminophylline with sympathomimetics can produce excessive stimulation manifested by skeletal muscle activity, agitation, and hyperactivity. The clinical significance of this interaction is not certain. Theophylline is a CYP1A2 substrate with a narrow therapeutic index and rucaparib is a moderate CYP1A2 inhibitor. Theophylline has moderate interactions with at least 145 different drugs. (Major) Alpha interferons, when administered systemically, may decrease the clearance of theophylline resulting in increased plasma concentrations. Caution and close monitoring are advised if these drugs are used together. Oritavancin: (Moderate) Avoid oritavancin with drugs that have a narrow therapeutic window, such as aminophylline. One of the mainstays of ED treatment is the oral phosphodiesterase type 5 (PDE5) inhibitor class. Its use in cats and dogs to treat cough and bronchoconstriction is 'off label' or 'extra label. Careful consideration must be given to the benefits and risks of theophylline or aminophylline use and the need for more intensive monitoring of serum theophylline concentrations in older adult and geriatric patients more than 60 years of age. Continue taking theophylline as long as your healthcare provider recommends. A aminophylline or theophylline dose adjustment may be needed in some patients. Patients may also need to limit their intake of caffeine-containing beverages or foods (e.g., coffee, green tea, other teas, colas, or chocolate) to avoid caffeine-like side effects. (Moderate) Addition of theophylline to tacrolimus therapy may result in increased concentrations of tacrolimus. These reactions have included cardiac arrest, seizure, status epilepticus, and respiratory failure. In addition, isoproterenol infusions have been shown to increase the clearance of theophylline by 20 to 40%. Monitor the patient for worsening symptoms and manage according to clinical practice. Adverse effects such as tremors, insomnia, seizures, or cardiac arrhythmias are also possible when excessive dosages of caffeine are taken concurrently with theophylline. Caffeine: (Major) Caffeine is a CNS stimulant. Neuromuscular blockers: (Moderate) A higher neuromuscular blocker dose may be required to achieve neuromuscular block with concomitant aminophylline use. Seizures or cardiac arrhythmias are also possible. Adjust subsequent dosage based on serum theophylline concentrations. It may also be administered by your veterinarian in hospital in the form of an injection. If a patient is taking prescribed medications containing theophylline, aminophylline, then they should seek health care professional advice prior to the use of racepinephrine. In vitro, tocilizumab has the potential to affect expression of multiple CYP enzymes, including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, and CYP3A4. Patients should avoid medications containing caffeine when possible. Hydrocodone; Pseudoephedrine: (Moderate) Concurrent administration of theophylline or aminophylline with some sympathomimetics can produce excessive stimulation and effects such as nervousness, irritability, or insomnia. After administration, fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions. Reduced doses may be needed for infants with risk factors for reduced theophylline clearance (e.g., cardiac or liver dysfunction, renal dysfunction). However, as a single 150 mg intravenous dose, fosaprepitant only weakly inhibits CYP3A4 for a duration of 2 days; there is no evidence of CYP3A4 induction. Side effects such as nausea, tremor, nervousness, difficulty with sleep, and increased heart rate may be additive. (Moderate) Concurrent administration of theophylline or aminophylline with sympathomimetics can produce excessive stimulation manifested by skeletal muscle activity, agitation, and hyperactivity. Seizures or cardiac arrhythmias are also possible. Quazepam: (Minor) Aminophylline or Theophylline have been reported to counteract the pharmacodynamic effects of diazepam and possibly other benzodiazepines. (Moderate) Aminophylline is a substrate for CYP3A4 and, theoretically, plasma concentrations could be increased via CYP3A4 inhibition by aprepitant/fosaprepitant, although this interaction has not been studied. Give 0.2 mg/kg/hour IV (up to 400 mg/day) to patients with CHF, cor pulmonale, liver dysfunction, sepsis with multiorgan failure, shock, or other factors for reduced theophylline clearance. The concurrent administration of caffeine to patients taking aminophylline may produce excessive caffeine-like side effects, such as nausea, irritability or nervousness. (Moderate) Concurrent administration of theophylline or aminophylline with sympathomimetics can produce excessive stimulation manifested by skeletal muscle activity, agitation, and hyperactivity. 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