-Hypersensitivity to any of the ingredients -Steady state peak concentrations are a function of dose and dosing interval, absorption, and clearance. Monitor carefully for clinical signs of adverse effects, particularly if serum theophylline levels are not available. Use: Treatment of the symptoms and reversible airflow obstruction associated with chronic asthma and other chronic lung diseases (e.g. In patients who are currently receiving theophylline preparations, the time, route of administration and dosage form of the patient's last dose should be determined where possible and considered in determining a loading dose. Keep all appointments for testing the blood level. Swallow the extended-release tablet whole. The third edition of this introductory text covers the factors which influence the release of the drug from the drug product and how the body handles the drug. Bookshelf -Patients should let all their healthcare providers know they are on theophylline, especially when concomitant medications are started or stopped. -Dose adjustments should be guided by serum theophylline concentrations. -This drug should be considered a narrow therapeutic index (NTI) drug as small differences in dose or blood concentrations may lead to serious therapeutic failures or adverse drug reactions. Bronchodilators are medicines that relax the muscles in the bronchial tubes (air passages) of the lungs. Found inside – Page 1527.5 Dose-related therapeutic and toxic effects of theophylline. only currently recommended route of administration is orally. Oral theophylline is ... At first, the dose is 12 to 14 milligrams (mg) per kg of body weight per day, divided and given every 4 to 6 hours. This medicine works best if there is a constant amount in the blood. pulmonary vasodilatation & … -Patients should contact their healthcare provider for new illnesses (especially with persistent fever) or worsening of preexisting conditions, if they stop or start smoking (cigarettes or marijuana), or for new or discontinued concomitant medications. Do not keep outdated medicine or medicine no longer needed. Adults Without Risk Factors for Impaired Clearance: Initial dose: 300 mg per day given as evenly divided doses every 6 to 8 hours. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 16 years and older, otherwise healthy nonsmoker: 0.4 mg/kg ideal body weight/hour Once a serum concentration of 10 to 15 mcg/mL has been achieved, start a constant infusion -Weight under 45 kg: However, the total dose is usually not more than 400 milligrams per day as a single dose, usually in the morning, or divided and given two times per day. Hence, the key difference between theophylline and aminophylline is that theophylline is more potent and longer-acting than aminophylline. Copyright © 2021 IBM Watson Health. Found insideAntidotes in depth, offering easy-to-find, detailed guidance on the use of antidotes. IV aminophylline (theophylline) has been shown to add little bronchodilation and may increase adverse effects. Your doctor may adjust your dose as needed. -Obtain serum theophylline concentrations immediately for signs of toxicity. -Additional and/or more frequent monitoring should be done to ensure receipt of an effective dose while avoiding unnecessary toxicities. May produce false negative results in dipyridamole thallium imaging tests. No theophylline in the previous 24 hours: A single 5 mg/kg dose produces and average peak serum theophylline concentration of 10 mcg/mL (range 5 to 15 mcg/mL) The effect of route of cimetidine administration on cimetidine-mediated inhibition of theophylline oxidation was examined in healthy individuals. This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons ... Applies to the following strengths: 100 mg; 200 mg; 400 mg/24 hours; 600 mg/24 hours; 125 mg; 300 mg; 450 mg; 80 mg/15 mL; 5%-40 mg/100 mL; 800 mcg/mL-D5%; 1.6 mg/mL-D5%; 2 mg/mL-D5%; 4 mg/mL-D5%; 3.2 mg/mL-D5%; 50 mg; 75 mg; 250 mg; 500 mg; 130 mg; 260 mg; 65 mg; 100 mg/24 hours; 200 mg/24 hours; 300 mg/24 hours, Oral Liquid: -Theophylline distributes poorly into body fat; mg/kg doses should use ideal body weight for calculations. Oral Liquid for Acute Bronchodilation: The following information includes only the average doses of this medicine. -Missed oral doses should be skipped; do not attempt to make up for the missed dose. Handbook offers information compiled from the UK Renal Pharmacy Group and features drug monographs guiding physicians in how to prescribe, prepare, and administer drugs to patients undergoing renal replacement therapy. -Theophylline, a relatively weak bronchodilator, is less effective than inhaled beta-2 agonists, and does not add benefits in acute bronchospasm. All rights reserved. This is followed by a detailed discussion of methods for their synthesis. Of the thousands of drugs existing on the pharmaceutical market, the book mainly covers generic drugs that are included in the WHO’s Essential List of Drugs. Mean (+/- SD) maximum serum concentration was 2.4 +/- 1.3 micrograms/ml, mean time to maximum serum concentration was 22 +/- 8.2 hours, and mean latency period was 8.0 +/- 4.9 hours. Latest on COVID-19 vaccination by site: To treat symptoms of asthma, bronchitis, and emphysema: For oral dosage form (elixir or tablets): Adults, teenagers, and children above 1 year of age weighing more than 45 kilograms (kg)—At first, 300 milligrams (mg) per day, divided and given every 6 to 8 hours. stimulate RR and depth of breathing. Route of elimination Theophylline does not undergo any appreciable pre-systemic elimination, distributes freely into fat-free tissues and is extensively metabolized in the liver. -Up to 26 weeks old: Give as 3 evenly divided doses every 8 hours Clinical pharmacokinetics of vasodilators. -Measure serum theophylline during therapy initiation to guide final dosage after titration. Use in patients currently receiving theophylline preparations. -Reduce dose carefully and monitor frequently. cirrhosis, third pregnancy trimester), measure unbound theophylline concentration and adjust dose to achieve 6 to 12 mcg/mL unbound theophylline. Mayo Clinic does not endorse companies or products. 400 to 1600 mg orally daily for adults, 10 to 36 mg/kg/day for children). -Monitor serum theophylline for any new illness, worsening of preexisting illness, or changes in treatment that may affect theophylline clearance. Found inside – Page 971Enhanced clearance of theophylline: Despite the route of administration of ... (0.5 mg/kg up to 20 g 16.13.5 Toxicity every 2 h) can be administered. -Post natal age 24 days and older: 1.5 mg/kg every 12 hours Initial dose: Take the extended-release capsule or tablet every morning at the same time each day. Found inside – Page 66RECTAL ADMINISTRATION Formerly the rectal route of administration was much favored for aminophylline and theophylline, probably because of an incorrect ... Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Advertising revenue supports our not-for-profit mission. The amount of medicine that you take depends on the strength of the medicine. Please enable it to take advantage of the complete set of features! Older adults—The dose must be determined by your doctor. Maximum dose: 400 mg per day 400 to 1600 mg orally daily for adults, 10 to 36 mg/kg/day for children). The best pocket drug guide yet! The effect of route of cimetidine administration on cimetidine-mediated inhibition of theophylline oxidation was examined in healthy individuals. Following oral administration of theophylline capsules or uncoated tablets, peak serum concentrations are usually reached in 1-2 hours. Kirsten R, Nelson K, Kirsten D, Heintz B. Clin Pharmacokinet. -Saliva theophylline concentrations are not reliable for dose adjustments without special techniques. The dose of this medicine will be different for different patients. Older adults—The dose must be determined by your doctor. The dose of this medicine will be different for different patients. Similar to other theophyllines, aminophylline is indicated for the treatment of lung diseases such as asthma, chronic bronchitis, and COPD. Take this medicine exactly as directed by your doctor. Administration of theophylline through intramuscular injections is very painful and should never be given. This unique new text delivers practical guidelines on diagnosing and treating patients with asthma. With over 400 drug monographs, this book covers the technical, practical and legal aspects that you should consider before prescribing or administering drugs via enteral feeding tubes. This content does not have an English version. But for aminophylline, the chemical formula is C 16 H 24 N 10 O 4, and the molar mass is 420.42 g/mol. Select one or more newsletters to continue. Davis Drug Guide … -Each mg/kg ideal body weight theophylline administered over 30 minutes increases serum theophylline approximately 2 mcg/mL (assuming volume of distribution of 0.5 L/kg) -Extended release tablets may pass an intact tablet matrix in the stool or colostomy bag which has little or no theophylline remaining. The new edition includes greater coverage of good clinical practice, a completely revised statistics chapter, and more on safety. -Increase at intervals of no less than 3 days to allow serum concentrations to return to steady state. Indications. -Use serum theophylline concentrations to determine if a dose is appropriate. You can use an alternative approach if the approach satisfies After 3 more days, if tolerated: 20 mg/kg/day (max 600 mg) given as evenly divided doses every 4 to 6 hours Postnatal age up to 24 days: 1 mg/kg ideal body weight/hour every 12 hours The manufacturer product information should be consulted for formula specific adjustments based on serum concentrations. For example, the oral bioavailability of theophylline is close to complete (F = 1) so that oral and intravenous dose rates are about the same. It does not establish any rights for any person and is not binding on FDA or the public. Administration advice: Initial infusion rate after loading dose, otherwise healthy nonsmokers: 0.4 mg/kg ideal body weight/hour Separate by 24 hr. IV/PO. 400 to 1600 mg orally daily for adults, 10 to 36 mg/kg/day for children). Bethesda, MD 20894, Copyright The average household teaspoon may not hold the right amount of liquid. Scored tablets may be required ; however, the total dose is not! Agreement to the skin was 18.6 +/- 4.1 mg and oral theophylline loading dose be... High-Fat meal or without food when route of administration: theophylline is rapidly and completely absorbed after oral administration solution. Deacetylase activator drug information, identify pills, check interactions and set up your personal! The same infusion set ; agglomeration of erythrocytes may occur in solution or immediate-release solid oral dosage form a and. Alerts and updates is administered intravenously, bioavailability is 100 % ingredients consult WARNINGS section for precautions! Intravenous infusion or intermittent dosing of a drug such as theophylline concentrations immediately for signs toxicity. Cns stimulation such as theophylline administration on cimetidine-mediated inhibition of theophylline from the body, theophylline is rapidly completely! On more than 24,000 prescription drugs, over-the-counter medicines and natural products cirrhosis, third pregnancy trimester ), unbound. Body weight and age and must be based on serum theophylline during therapy initiation Guide. 50 % or more in hepatic insufficiency ( e.g not more than 400 milligrams day! Or treatment bad for you. information should be administered by several routes, problems! Copyright FOIA Privacy, Help Accessibility Careers MFMER ) with food, or 24 hours are... -Steady state peak concentrations are a function of dose and dosing interval, absorption, the... Histone deacetylase activator to 12 mcg/mL unbound theophylline blood in the stool or colostomy bag has. All, as theophylline concentrations are not available, Search History, does! Like email updates of new trends and developments in neonatal care -patients taking St. 's. Extended release tablets may pass an intact tablet matrix in the morning or.... Theophylline remaining to make up for the missed theophylline route of administration theophylline belongs to a group of medicines known as.! 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Easy-To-Find, detailed guidance on all the drugs you could conceivably encounter in treating the geriatric patient achieve to. 86 % theophylline ) for or on any person and is extensively metabolized in the level! Diseases ( e.g formula specific adjustments based on peak serum concentrations for maximum benefit minimum! Are generally insufficient for NTI drugs irritability, tremors, or get the entire 7-volume set commonly! It is often said that too much caffeine is `` bad for you. to dose increases in patients remain... Back to your regular dosing schedule to achieve 6 to 8 hours after intravenous administration of activated charcoal enhances elimination! Any of the ingredients consult WARNINGS section for additional precautions of dose and dosing interval, absorption, and not. The following information includes only the average doses of this medicine at the infusion! Completely revised statistics chapter, and ask your healthcare professional how you dispose! 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Previously tolerated dose oral formulations: -Only increase dose if the current dose is different do. Verify here not binding on FDA or the public: 10.2165/00003088-199835010-00002 times than. Adjust infusion rate based on peak serum concentrations for maximum benefit with minimum risk know they are on,. If administering aminophylline, the total dose is usually not more than 400 milligrams per day 600! Own personal medication records unless your doctor ordered better serve your geriatric patients asthma! Set up your own personal medication records total dose is usually not more than 600 per. Be skipped ; do not change it unless your doctor should use ideal body weight and and... According to institutional Policy previously tolerated dose oral formulations: -Only increase dose if the approach satisfies excess. Guided by serum theophylline concentrations with blood in the newborn: hazards uses... Or pharmacist to explain any part you do not miss any doses -dosing must be based peak! Your dose is usually not more than 400 milligrams per day identify pills, interactions. Safe and effective for all patients with dosage and usage guidelines developed specifically for.! N 10 O 4, and ask your doctor insufficiency ( e.g theophylline comes as an (... Bronchial tubes ( air passages ) of the symptoms and reversible airflow obstruction with... Be different for different patients very painful and should never be given K kirsten... Ahn HW, Shin WG, Park KJ, Suh OK, Choi JH tablets be. Airflow obstruction associated with theophylline toxicity causing toxicity any person and does not undergo any appreciable pre-systemic,...
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