Dosage is based on your medical condition, response to treatment, age, weight, drug blood levels, and other drugs you may be taking. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using theophylline. Quibron is a combination xanthine derivative and expectorant. The xanthine derivative works by relaxing the smooth muscle surrounding the bronchial tubes air passages of the lungs, allowing the tubes to widen, and making breathing easier. Quibron improves contraction of the diaphragm the major breathing muscle. The expectorant works by increasing respiratory secretions and loosening mucus in the airways.
Association américaine des endocrinologues cliniques grâce Knoll Pharmaceutical Company pour une subvention à l'éducation pour soutenir le développement des lignes directrices de pratique, 1996. Serum Concentrations at Steady State After multiple doses of immediate-release theophylline, steady state is reached in 30-65 hours average 40 hours in adults. 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.
Other factors associated with decreased theophylline clearance include the third trimester of pregnancy, sepsis with multiple organ failure, and hypothyroidism. Careful attention to dose reduction and frequent monitoring of serum theophylline concentrations are required in patients with any of these conditions see . Other factors associated with increased theophylline clearance include hyperthyroidism and cystic fibrosis. Store Quibron at room temperature, between 59 and 77 degrees F 15 and 25 degrees C in tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Do not refrigerate. Keep Quibron out of the reach of children and away from pets.
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 have been taken at unequal intervals. 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. These observations were not associated with increased mortality.
Other medications can affect the removal of theophylline from your body, which may affect how theophylline works. Examples include cimetidine, disulfiram, fluvoxamine, interferon, mexiletine, propranolol, rifampin, drugs used to treat seizures such as carbamazepine, phenytoin St. John's wort, ticlopidine, among others. Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Yeh TF, Pildes RS "Transplacental aminophylline toxicity in a neonate. 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. Weeks of age; divide dose into 4 equal amounts administered at 6 hour intervals. Serum theophylline and phenytoin concentrations decrease about 40%. Table IV. Manifestations of theophylline toxicity. To guide a dose increase, the blood sample should be obtained at the time of the expected peak serum theophylline concentration; 5-6 hours after a dose at steady-state, drawn more than 6 hours after the dose. 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 have been taken at unequal intervals. Have had a fever of 102 degrees F or higher for at least 24 hours or more.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. If you do not have a dose-measuring device, ask your pharmacist for one. Use of alcohol may increase the risk of side effects of Quibron. Talk to your doctor before drinking alcohol while you are taking Quibron. Following oral dosing, theophylline does not undergo any measurable firstpass elimination. In adults and children beyond one year of age, approximately 90% of the dose is metabolized in the liver. Dose is based on body weight and must be determined by your doctor. At first, the dose is 12 to 14 milligrams mg per kg of body weight per day as a single dose, usually in the morning, or divided and given two times per day. Your doctor may adjust your dose as needed. However, the total dose is usually not more than 20 mg per kg of body weight per day or 600 mg per day. Not reported in a comparable manner. Theophylline can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Administer multiple dose oral activated charcoal and measures to control emesis. Some medical conditions may interact with Quibron. For these reasons, FAERS case reports cannot be used to calculate incidence or estimates of risk for a particular product or compare risks between products. Your dose and the number of times you take theophylline daily will depend on the reason you are taking this medication. In selected patients at high risk for theophylline-induced seizures, consideration should be given to the administration of prophylactic anticonvulsant therapy. Certain conditions have been identified as causes of reduced theophylline clearance. Similar to cimetidine and pharmacologic interaction.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of theophylline in the elderly. However, elderly patients may be more sensitive to the effects of theophylline than younger adults, and are more likely to have kidney, liver, heart, or lung problems, which may require caution and an adjustment in the dose for patients receiving theophylline. Warning: The facts and figures contained in these reports are accurate to the best of our capability; however, our metrics are only meant to augment your medical knowledge, and should never be used as the sole basis for selecting a new medication. As with any medical decision, be sure to work with your doctor to ensure the best choices are made for your condition. Caffeine and 3-methylxanthine are the only theophylline metabolites with pharmacologic activity. It is very important that your doctor check the progress of you or your child at regular visits, especially for the first few weeks after you begin using this medicine. Blood tests may be needed to check for unwanted effects. Children may be more sensitive to the side effects of this drug. Careful monitoring of side effects and drug levels is recommended. Avoid drinks or foods that contain caffeine, such as coffee, tea, cola, and chocolate. What are the possible side effects of theophylline Theo-24? The peak milk concentration occurred between one and three hours after ingestion of the dose. Irritability was reported in one infant whose mother took aminophylline. Adverse effects were not reported in the infants of the other women participating in this study. Exposure to the infant can be minimized by administering nursing prior to administration of theophylline to avoid peak milk concentrations. The clinical importance of these changes should be weighed against the potential therapeutic benefit of theophylline in individual patients. Since the time required to reach steady-state is a function of theophylline half-life, up to 5 days may be required to achieve steady-state in a premature neonate while only 2-3 days may be required in a 6 month old infant without other risk factors for impaired clearance in the absence of a loading dose. The brand name Uniphyl is discontinued, but versions may be available.
How should I take theophylline Theo-24? Take the missed dose as soon as you remember. Be careful if you drive or do anything that requires you to be awake and alert. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Stenius-Aarniala B, Riikonen S, Teramo K "Slow-release theophylline in pregnant asthmatics.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Careful monitoring of side effects and drug blood levels is recommended. Quibron is to be used only by the patient for whom it is prescribed. Do not share it with other people. One study has shown an increase in fetal breathing movements when theophylline was ingested by pregnant women at 33 to 38 weeks gestation. Since fetal breathing movements are routinely used to assess fetal status in late gestation, maternal theophylline intake should be taken into account. 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. Use Quibron as directed by your doctor. Check the label on the medicine for exact dosing instructions. Theophylline passes freely across the placenta, into and into the cerebrospinal fluid CSF. Saliva theophylline concentrations approximate unbound serum concentrations, but are not reliable for routine or therapeutic monitoring unless special techniques are used. An increase in the volume of distribution of theophylline, primarily due to reduction in plasma protein binding, occurs in premature neonates, patients with hepatic cirrhosis, uncorrected acidemia, the elderly and in women during the third trimester of pregnancy. Do not share this medication with others. Dose tapering on treatment cessation is unnecessary due to the slow drug elimination in this patient population. Consider 10% decrease in dose to provide greater margin of safety even if current dosage is tolerated. Check with your pharmacist about how to dispose of unused medicine. Guaifenesin and theophylline can be taken with food to lessen stomach upset.
Saliva concentrations of theophylline cannot be used reliably to adjust dosage without special techniques. Some foods may change the effectiveness or increase the side effects of Quibron. Talk to your doctor about how you should take Quibron with regard to food. Do not suddenly change your diet or eating habits without first checking with your doctor. 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. Shomon M. endocrinologues défendre Synthroid Wall Street Journal. St. John's wort or vitamin supplements. Administration of Infasurf for prophylaxis should be given as soon as possible after birth. Safety and efficacy have not been established in patients younger than 12 years. At first, 300 milligrams mg per day, divided and given every 12 hours. Your doctor may adjust your dose as needed. However, the total dose is usually not more than 600 mg per day. Table II are added or discontinued. An inhaled beta-2 selective agonist, alone or in combination with a systemically administered corticosteroid, is the most effective treatment for acute exacerbations of reversible airways obstruction. Theophylline is a relatively weak bronchodilator, is less effective than an inhaled beta-2 selective agonist and provides no added benefit in the treatment of acute bronchospasm. If an inhaled or parenteral beta agonist is not available, a loading dose of an oral immediate release theophylline can be used as a temporary measure.
Use with caution. The effects may be increased because of slower removal of the medicine from the body. Keep out of the reach of children. What should I avoid while taking theophylline Theo-24? Table I. Mean and range of total body clearance and half-life of theophylline related to age and altered physiological states. 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. 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. 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. Theophylline is used to treat lung diseases such as asthma and COPD bronchitis, emphysema. It must be used regularly to prevent wheezing and shortness of breath. This medication belongs to a class of drugs known as xanthines. It works in the airways by relaxing muscles, opening breathing passages, and decreasing the lungs' response to irritants. Controlling symptoms of breathing problems can decrease time lost from work or school. Gardner MJ, Schatz M, Cousins L, Zeiger R, Middleton E, Jusko WJ "Longitudinal effects of pregnancy on the pharmacokinetics of theophylline. Our Theo-24 theophylline, anhydrous Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. Elderly patients are at significantly greater risk of experiencing serious toxicity from theophylline than younger patients due to pharmacokinetic and pharmacodynamic changes associated with aging. Theophylline clearance is reduced in patients greater than 60 years of age, resulting in increased serum theophylline concentrations in response to a given theophylline dose. Protein binding may be decreased in the elderly resulting in a larger proportion of the total serum theophylline concentration in the pharmacologically active unbound form. Elderly patients also appear to be more sensitive to the toxic effects of theophylline after chronic overdosage than younger patients. What is theophylline Theo-24? If any of these effects last or get worse, tell your doctor or promptly. Before making a dose increase to determine whether the serum concentration is sub-therapeutic in a patient who continues to be symptomatic.
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General Monitoring Procedures Electrocardiographic monitoring should be initiated on presentation and continued until the serum theophylline level has returned to a non-toxic level. Serum electrolytes and glucose should be measured on presentation and at appropriate intervals indicated by clinical circumstances. Fluid and electrolyte abnormalities should be promptly corrected. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. 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.
Prior to treatment initiation of caffeine citrate, measure baseline serum levels of caffeine in infants previously treated with theophylline and those born to mothers who consumed caffeine prior to delivery. Fever Fever, regardless of its underlying cause, can decrease the clearance of theophylline. The magnitude and duration of the fever appear to be directly correlated to the degree of decrease of theophylline clearance. Safety and efficacy of this drug has not been established; its limited use in pediatric patients has been inadequate to fully define the proper dosage and limitations of use.
Theophylline is structurally classified as a methylxanthine. Treatment of cardiac arrhythmias Sinus tachycardia and simple ventricular premature beats are not harbingers of life-threatening arrhythmias, they do not require treatment in the absence of hemodynamic compromise, and they resolve with declining serum theophylline concentrations. Other arrhythmias, especially those associated with hemodynamic compromise, should be treated with antiarrhythmic therapy appropriate for the type of arrhythmia. Decreases theophylline clearance by inhibiting hydroxylation and demethylation.
Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Theophylline is a bronchodilator. It works by relaxing muscles in the lungs and chest, making the lungs less sensitive to allergens and other causes of bronchospasm. Enhance clearance of theophylline.