AMINOPHYLLINE

Indications & Dose:

Severe acute asthma in patients not previously treated with theophylline

• BY SLOW INTRAVENOUS INJECTION

Child: 5 mg/kg (max. per dose 500 mg), to be followed by intravenous infusion

Adult: 250–500 mg (max. per dose 5 mg/kg), to be followed by intravenous infusion

Severe acute asthma

• BY INTRAVENOUS INFUSION

Child 1 month–11 years: 1 mg/kg/hour, adjusted according to plasma-theophylline concentration

Child 12–17 years: 500–700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration 

Adult: 500–700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration

Elderly: 300 micrograms/kg/hour, adjusted according to plasma-theophylline concentration

Severe acute exacerbation of chronic obstructive pulmonary disease in patients not previously treated with theophylline

• BY SLOW INTRAVENOUS INJECTION

Adult: 250–500 mg (max. per dose 5 mg/kg), to be followed by intravenous infusion

Severe acute exacerbation of chronic obstructive pulmonary disease

• BY INTRAVENOUS INFUSION 

Adult: 500–700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration

Elderly: 300 micrograms/kg/hour, adjusted according to plasma-theophylline concentration

Chronic asthma

• BY MOUTH USING MODIFIED-RELEASE MEDICINES

Child (body-weight 40 kg and above): Initially 225 mg twice daily for 1 week, then increased if necessary to 450 mg twice daily, adjusted according to plasmatheophylline concentration

Reversible airway obstruction

• BY MOUTH USING MODIFIED-RELEASE MEDICINES 

Adult (body-weight 40 kg and above): Initially 225 mg twice daily for 1 week, then increased if necessary to 450 mg twice daily, adjusted according to plasmatheophylline concentration

Contraindications:

Side Effects:

Cautions:

Precautions:

Elderly, CHF, corpulmonale, hepatic disease, preexisting dysrhythmias, hypertension, infants <1 yr, hypoxemia, sustained high fever, history of peptic ulcer, alcoholism

PREGNANCY AND LACTATION: Pharmacokinetics of theophylline may be altered during pregnancy, monitor serum concentrations carefully; excreted into breast milk; may cause irritability in the nursing infant, otherwise compatible with breast feeding

Interaction:

Drugs

Adenosine: Decreased hemodynamic effects of adenosine

Alluprinol, Amiodarone, Cimetidine, Ciproflaxacin, Disul firam, Erythromycin, Interferon alfa, Isoniazid, Metamizole,

Metoprolol, Narfloxacin, Pefloxacin, Pentoxifylline, Prapafenane, Prapylthiouraeil,

Radioactive iodine, Tacrine, Thiabendazale,

Ticlopidine, Verapamil: Increased theophylline concentrations

Aminoglutethamide, Barbiturates, Carbamazepine,

Maricizine, Phenytoin, Rifampin, Ritanavir; Thyroid hormone: Reduced theophylline concentrations; decreased serum phenytoin levels

Beta-blackers: Reduced bronchodilating response to theophylline Enoxacin; Fluvoxamine, Mexiletine, Propranolal,

Troleandomycin: Markedly increased theophylline concentrations

Imipenem: Some patients on theophylline have developed seizures following addition of imipenem

Lithium: Reduced lithium concentrations

Smoking: Increased aminophylline dosing requirements

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Anxiety, dizziness, headache, insomnia, lightheadedness, muscle twitching, reflex hyperexcitability, restlessness, seizures

CV: Circulatory failure, flushing, hy potension, palpitations, sinus tachy cardia, ventricular dysrhythmias

GI: Anal irritation (suppositories), anorexia, bitter taste, black stools, diarrhea, dyspepsia, epigastric pain, esophageal reflux, hematemesis, nausea, vomiting

GU: Proteinuria, urinary frequency

METAB: Hyperglycemia, S1ADH

RESP: Tachypnea

SKIN: Urticaria, alopecia

Patient And Carer Advice: