Theophylline blocks adenosine receptors. Do not use theophylline to treat an asthma or bronchospasm attack. Use only a fast acting inhalation medication. Tablets are not to be chewed or crushed because it may lead to a rapid release of theophylline with the potential for toxicity. The scored tablet may be split. Infrequently, patients receiving Uniphyl 400 or 600 mg Tablets may pass an intact matrix tablet in the stool or via colostomy. These matrix tablets usually contain little or no residual theophylline. Coffee and other caffeinated beverages seem to increase alertness when consumed throughout the day. Caffeine can improve mental performance and alertness in -deprived people, and guarana would logically have the same effect. aseb.info danazol
Phenytoin increases theophylline clearance by increasing microsomal enzyme activity. Theophylline decreases phenytoin absorption. What happens if I miss a dose Uniphyl? There are several readily identifiable causes of reduced theophylline clearance. Inform your doctor if your condition persists or worsens.
American Journal of Clinical Dermatology: “A randomized, placebo-controlled trial of topical retinol in the treatment of cellulite. Increased risk of ventricular arrhythmias. Helliwell M, Berry D. Theophylline absorption by effervescent activated charcoal Medicoal. Smokers: 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.
Crush one 300 mg extended release tablet in a mortar and reduce to a fine powder. The most common causes of chronic theophylline overdosage include patient or care giver error in dosing, clinician 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. Maintain dosage if tolerated. Recheck serum theophylline concentration at 24-hour intervals for acute IV dosing or at 6- to 12-month intervals for oral dosing. Finer adjustments in dosage may be needed for some patients.
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. LDL ratio, and urinary free cortisol excretion may be increased by theophylline. Theophylline may decrease triiodothyronine. Consider extracorporeal removal, even if the patient has not experienced a seizure see OVERDOSAGE, Extracorporeal Removal. Theophylline throughout the gastrointestinal tract, even when administered several hours after ingestion. 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. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Keep taking this medication even if you feel well. Do not increase your dose, take this drug more often, or stop taking it without first consulting your doctor. Combination controller medications exist for patients whose asthma symptoms are not well controlled on inhaled corticosteroids alone. Levine JH, Michael JR, Guarnieri T "Multifocal atrial tachycardia: a toxic effect of theophylline. There are no adequate and well-controlled studies in pregnant women. In patients with chronic obstructive pulmonary disease COPD clinical studies have shown that theophylline decreases dyspnea, air trapping, the work of breathing, and improves contractility of diaphragmatic muscles with little or no improvement in pulmonary function measurements. For a given population there is no single Theophylline dose that will provide both safe and effective serum concentrations for all patients. Administration of the median Theophylline dose required to achieve a therapeutic serum Theophylline concentration in a given population may result in either sub-therapeutic or potentially toxic serum Theophylline concentrations in individual patients. 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. Talk to your doctor if you have any questions about ZYFLO. Sucralfate and antacids: Quinolones form chelates with metal cations. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Always consult your doctor or healthcare specialist for medical advice. P450 isoenzymes 1A2, 2C9 and 3A4 CYP1A2, CYP2C9 and CYP3A4.
Diffusion Techniques: methods that require measurement of zone diameters give the most precise estimate of susceptibility of to agents. One such standardized procedure 1 that has been recommended for use with disks to test susceptibility of organisms to enoxacin uses the 10-µg enoxacin disk. What are the possible side effects of ZYFLO? Recheck level in 3 days. However, the incidence of drug-related adverse reactions was comparable between age groups. Mexiletine: May decrease the metabolism of Theophylline Derivatives. Enoxacin is a potent inhibitor of the cytochrome P-450 isozymes responsible for the of methylxanthines. In a multiple-dose study, enoxacin caused a dose-related increase in the mean elimination half-life of caffeine, thereby decreasing the clearance of caffeine by up to 80% and leading to a five-fold increase in the AUC and the half-life of caffeine. Trough enoxacin levels were also 20% higher when caffeine and enoxacin were administered concomitantly. Caffeine-related adverse effects have occurred in patients consuming caffeine while on therapy with enoxacin. 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. 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. 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. Drug-Drug Interactions: Theophylline interacts with a wide variety of drugs. Besides the guarana seed itself, there are no natural food sources of guarana. It has become a common additive to some foods and drinks. spiriva
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. 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. Children may be more sensitive to the side effects of this drug. Careful monitoring of side effects and drug blood levels is recommended. If symptoms recur, or signs of toxicity appear during the once-daily dosing interval, dosing on the q12h basis should be reinstituted. Children, Adolescents, and Adults: No dosage adjustment necessary. Zileuton: May increase the serum concentration of Aminophylline. Management: Reduce aminophylline dose by 50% upon initiation of zileuton therapy. If aminophylline is added to existing zileuton therapy, use a lower starting dose. Monitor for increased theophylline serum concentrations and effects. While simultaneously instituting treatment, contact a regional poison center to obtain updated information and advice on individualizing the recommendations that follow. Decrease your cellulite using the latest science.
Store at room temperature away from moisture, heat, and light. 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. Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while Theophylline blocks adenosine receptors. Uniphyl theophylline anhydrous tablet be taken with meals. Elderly: Use extreme caution in the elderly; these patients are at greater risk of serious theophylline toxicity. ZYFLO, call your doctor immediately. What are the possible side effects of theophylline Elixophyllin, Theo-24? Peptic ulcer disease: Use with caution in patient with peptic ulcer disease; use may exacerbate this condition. Cardiovascular disease: Use with caution in patients with tachyarrhythmias eg, sinus tachycardia, atrial fibrillation since use may exacerbate these arrhythmias. Serum theophylline concentration measurements are readily available and should be used to determine whether the dosage is appropriate. If the asthma has been under control for several months at a certain dose of medicine, the dose may be reduced. This can help find the least amount of medicine that will control the asthma. 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. generic metronidazole order otc
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. Chromones stabilize mast cells allergic cells but are rarely used in clinical practice. Cromolyn and nedocromil are in this drug class. Generally, these products offer little benefit alone, but they may add some value when combined with other treatments. Clearance represents the volume of blood completely cleared of Theophylline by the liver in one minute. Smoking: Clearance is increased by smoking ie, marijuana or tobacco by approximately 50% in young adult smokers and 80% in elderly tobacco smokers. Cessation of smoking for 1 week improves theophylline Cl by 40%. This medication may interfere with certain lab tests such as blood sugar, cholesterol, uric acid, dipyridamole-thallium imaging tests possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug. The average percent fraction of fluctuation was 244%. Adenosine: Theophylline Derivatives may diminish the therapeutic effect of Adenosine. 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. Charcoal may decrease the amount of theophylline your body absorbs.
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment. Theophylline is safe and effective for the approved indications in pediatric patients. The dosage is based on your medical condition, response to treatment, age, weight, lab tests theophylline blood levels and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. 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. What are the possible side effects of theophylline Uniphyl? Tablets can be taken once a day in the morning or evening. It is recommended that Uniphyl be taken with meals. Patients should be advised that if they choose to take Uniphyl with food it should be taken consistently with food and if they take it in a fasted condition it should routinely be taken fasted. It is important that the product whenever dosed be dosed consistently with or without food. Antithyroid Agents: May increase the serum concentration of Theophylline Derivatives. MTX, higher dose MTX may have a greater effect. However, it can actually make the dimpled fat left behind look worse. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. If any of these effects persist or worsen, tell your doctor or promptly. Ask your doctor or pharmacist about using this product safely. Methotrexate: May increase the serum concentration of Theophylline Derivatives. amlodipine oral price
Table V. Due to the immaturity of theophylline metabolic pathways in infants under the age of one year, particular attention to dosage selection and frequent monitoring of serum theophylline concentrations are required when theophylline is prescribed to pediatric patients in this age group. Use ideal body weight for obese patients. 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. United States for delivery via a nebulizer. Cromolyn is suggested as an alternative medication to inhaled corticosteroids for asthma control, usually in mild asthma. It is not a commonly used asthma medication. Extravasation: Vesicant; ensure proper catheter or needle position prior to and during infusion. Avoid extravasation. Side effects may go away after you take the medicine for a while. 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. Once theophylline enters the systemic circulation, about 40% is bound to plasma protein, primarily albumin. Unbound theophylline distributes throughout body water, but distributes poorly into body fat. Erythromycin metabolite decreases theophylline clearance by inhibiting cytochrome P450 3A3. Anticipate Need for Anticonvulsants. Inhaled steroids are first-line anti-inflammatory therapy. Examples of these medications include budesonide Pulmicort fluticasone Flovent beclomethasone Qvar mometasone Asmanex and ciclesonide Alvesco. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. It is usually used with an inhaled corticosteroid. It can be used by itself or with an inhaled corticosteroid to control symptoms at night. Thiabendazole: May decrease the metabolism of Theophylline Derivatives. In contrast, approximately 50% of the administered theophylline dose is excreted unchanged in the urine in neonates. Careful monitoring of side effects and drug blood levels is recommended.
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. Table III. Drugs that have been documented not to interact with theophylline or drugs that produce no clinically significant interaction with theophylline. Refer to PRECAUTIONS, Drug Interactions for information regarding table. Absorption Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. Caffeine and 3-methylxanthine are the only theophylline metabolites with pharmacologic activity. Dosage: Should be individualized. Theophylline concentrations in three emergency departments. Theophylline: Enoxacin is a potent inhibitor of the cytochrome P-450 isozymes responsible for the metabolism of methylxanthines. Enoxacin interferes with the metabolism of theophylline resulting in a 42% to 74% dose-related decrease in theophylline clearance and a subsequent 260% to 350% increase in serum theophylline levels. Theophylline-related adverse effects have occurred in patients when theophylline and enoxacin were coadministered. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. 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 drugs you are taking, check with your doctor, nurse or pharmacist. Schiff GD, Hegde HK, LaCloche L, Hryhorczuk DO "Inpatient theophylline toxicity: preventable factors. Covelli HD, Knodel AR, Heppner BT "Predisposing factors to apparent theophylline-induced seizures. salbutamol
Saliva concentrations of theophylline cannot be used reliably to adjust dosage without special techniques. Keep with you. If your are severe, you should keep two injection kits with you at all times and readily available. If you experience any sign of anaphylaxis, do not hesitate to use the epinephrine auto-injector, even if those symptoms do not appear to be allergy related. Using the auto-injector as a precaution will not harm you and could save you. Dial 911 after being injected. Theo-24 is contraindicated in patients with a history of hypersensitivity to theophylline or other components in the product. 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. It could give results for 2 to 6 months, but more research about how well it works and how long results may last is needed. Alcohol Ethyl: May increase the serum concentration of Aminophylline. Decrease dose by 25%even if no adverse effects are present.
Is there any way to eliminate the “cottage cheese” on your thighs and rear end? Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care 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. Adalimumab: May decrease the serum concentration of Theophylline Derivatives. Theophylline increases the force of contraction of diaphragmatic muscles. This action appears to be due to enhancement of calcium uptake through an adenosine-mediated channel. Acebrophylline: May enhance the stimulatory effect of Theophylline Derivatives. 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. 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. The mechanism of theophylline-induced seizures has not been determined. Seizures are generally focal with secondary generalization. Permanent neurologic deficits have been reported and morbidity may be high, especially in the elderly, patients with severe underlying disease, and patients with prolonged, uncontrolled seizure activity. The onset of seizures is not always preceded by less severe symptoms of theophylline toxicity. Patients with an abnormal neurologic history, including a history of seizures, cerebral infarct, or head trauma, may be predisposed to seizure activity. If theophylline is used in these types of patients, serum concentrations should be monitored closely and maintained in the low, therapeutic range. Dose reduction and frequent monitoring of serum theophylline concentrations are required. indocin online kaufen forum
Older adults may be more likely to have side effects from theophylline. Refer to adult dosing. The patient should be instructed to contact their clinician if they develop a new illness, especially if accompanied by a persistent fever, if they experience worsening of a chronic illness, if they start or stop smoking cigarettes or marijuana, or if another clinician adds a new medication or discontinues a previously prescribed medication. Patients should be instructed to inform all clinicians involved in their care that they are taking theophylline, especially when a medication is being added or deleted from their treatment. Patients should be instructed to not alter the dose, timing of the dose, or frequency of administration without first consulting their clinician. If a dose is missed, the patient should be instructed to take the next dose at the usually scheduled time and to not attempt to make up for the missed dose. Distribution: Once Theophylline enters the systemic circulation, about 40% is bound to plasma protein, primarily albumin. Unbound Theophylline distributes throughout body water, but distributes poorly into body fat. Patients and prescribers should be alert for neuropsychiatric events. Stop infusion for 24 hours and decrease subsequent infusion rate at least 25%. If symptomatic, stop infusion and consider whether overdose treatment is indicated. There are many triggers that may initiate the release of inflammatory substances. Theophylline concentrations should be monitored at 6 month intervals for rapidly growing children and at yearly intervals for all others. Your dosage needs may change if you are ill, or if your doctor changes your brand, strength, or type of theophylline. You will need regular medical tests to be sure you are using the right dose. Do not change your medication dose or schedule without your doctor's advice. This is not a complete list of side effects and others may occur. 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. Dosing Guidelines, Table VI.
Note: Serum theophylline concentrations may continue to increase after presentation of the patient for medical care. Guarana has among the highest concentrations of in any plant. Decreased and subsequent decreased were noted in rats and dogs treated with doses of enoxacin that produced plasma levels in the animals three times higher than those produced in humans at the recommended therapeutic dosage. The potential for enoxacin to affect spermatogenesis in male patients is unknown. Enoxacin is an ivory-to-slightly yellow powder. In dilute aqueous solution, it is unstable in strong sunlight. Store theophylline at room temperature, away from moisture, heat, and light. F for at least 24 hours is probably required to produce a clinically significant increase in serum Theophylline concentrations. Uniphyl theophylline anhydrous tablet Tablet. Increases theophylline clearance by induction of microsomal enzyme activity. 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. Loading dose: Oral, IV: Refer to adult dosing. The use of theophyllines is associated with an increase in heart rate which may progress to supraventricular tachycardia or ventricular arrhythmia at high serum drug concentrations. Appearance of cardiac adverse effects is generally an indication of theophylline toxicity, although patients with a history of tachyarrhythmias may be more susceptible to the chronotropic effect of these drugs. Therapy with theophyllines should be administered cautiously in such patients. Caution is also advised in patients with hypertension, hyperthyroidism, angina pectoris, or recent myocardial infarction, since high dosages of the drugs are associated with positive inotropic as well as chronotropic effects. Clinical monitoring of serum drug concentrations is recommended to prevent toxicity. If you suspect that certain foods are for you, discuss this with your doctor. can be done to determine if you are allergic to these foods. What Do I Do If I Have Food Allergies and Asthma? For various North American patient populations from literature reports. cozaar shopping
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Institute supportive care, including establishment of intravenous access, maintenance of the airway, and electrocardiographic monitoring. This medication does not work right away and should not be used for sudden attacks of breathing trouble. What is theophylline, and how does it work mechanism of action? Theophylline is available as pills, capsules, liquid, and injection.
Theophylline clearance are continued. Phenobarbital may cause respiratory depression, particularly in elderly patients and patients with COPD. Some theophylline side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding. Teriflunomide: May decrease the serum concentration of CYP1A2 Substrates. COPD treatment: Theophylline is currently considered second-line intravenous therapy in the emergency department or hospital setting when there is inadequate or insufficient response to short acting bronchodilators Global Initiative for COPD Guidelines 2013.
Barbiturates: May decrease the serum concentration of Theophylline Derivatives. Higher doses of Theophylline may be required to achieve desired effect. The clinical importance of these changes should be weighed against the potential therapeutic benefit of theophylline in individual patients. In contrast, approximately 50% of the administered Theophylline dose is excreted unchanged in the urine in neonates. Increases theophylline clearance by increasing cytochrome P450 1A2 and 3A3 activity.
Patients with more rapid metabolism, clinically identified by higher than average dose requirements, should receive a smaller dose more frequently every 8 hours to prevent breakthrough symptoms resulting from low trough concentrations before the next dose. Table V contains Theophylline dosing titration schema recommended for patients in various age groups and clinical circumstances. Table VI contains recommendations for Theophylline dosage adjustment based upon serum Theophylline concentrations. Application of these general dosing recommendations to individual patients must take into account the unique clinical characteristics of each patient. In general, these recommendations should serve as the upper limit for dosage adjustments in order to decrease the risk of potentially serious adverse events associated with unexpected large increases in serum Theophylline concentration.