Aminophylline (aminophylline)

Dosage of theophylline in children younger than 1 year of age, particularly in premature and term neonates, must be carefully individualized. Elimination of the drug in children younger than 1 year of age, especially in neonates, generally appears to be reduced. Because of potential toxicity, use of the drug in children younger than 1 year of age should be carefully considered and, if used, the initial and maintenance dosages (particularly the latter) should be conservative. Maintenance dosage should not be exceeded and therapy with the drug should not be continued unless the drug is well tolerated and clinically beneficial. Recommended initial maintenance dosages for neonates and infants for the treatment of bronchospasm are shown in the following table:

Table 8. Recommended Dosage Titration for Children <1 Year of Age using Immediate-Release Preparations

Age Dosage Titration Premature neonates <24 days Initially, 1 mg/kg every 12 hours. postnatal age Adjust dosage to maintain a peak steady-state serum concentration of 5-10 mcg/mL Premature neonates >=24 days Initially, 1.5 mg/kg every 12 hours. postnatal age Adjust dosage to maintain a peak steady-state serum concentration of 5-10 mcg/mL Full-term infants <26 weeks of age ((0.2 x age in weeks) + 5) x body weight (kg) = total daily dosage (mg); administer in 3 equally divided doses every 8 hours. Adjust dose to maintain a peak steady-state serum concentration of 5-10 mcg/mL in neonates or 10-15 mcg/mL in older infants Infants 26-52 weeks of age ((0.2 x age in weeks) + 5) x body weight (kg) = total daily dosage (mg); administer in 4 equally divided doses every 6 hours. Adjust dosage to maintain a peak steady-state serum concentration of 10-15 mcg/mL

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Theophylline increases excretion of lithium and may decrease its therapeutic effectiveness. Higher doses of lithium may be required during concurrent administration of theophylline. The direct stimulatory effect of theophylline on the myocardium may enhance the sensitivity and toxic potential of the cardiac glycosides. Theophylline may exhibit synergistic toxicity with ephedrine and other sympathomimetics and, when administered concomitantly, these agents may further predispose the patient to the development of cardiac arrhythmias.

Theophylline may enhance the effects of the oral anticoagulants by increasing plasma prothrombin and factor V, but therapeutic theophylline dosages will probably have little or no effect on anticoagulant response.

Cimetidine, high-dose allopurinol (e.g., 600 mg daily), oral contraceptives, propranolol, ciprofloxacin, erythromycin, and troleandomycin may increase serum theophylline concentrations by decreasing theophylline's hepatic clearance. Rifampin may decrease serum theophylline concentrations by increasing theophylline's hepatic clearance. Concomitant theophylline and phenytoin administration can result in decreased serum concentrations of either or both agents by increasing hepatic metabolism.

Methotrexate may decrease clearance of theophylline; plasma theophylline concentrations should be monitored in patients receiving theophylline concomitantly with methotrexate.

There is some evidence from animal studies that concomitant administration of a beta-adrenergic agonist (e.g., isoproterenol) and a theophylline derivative (e.g., aminophylline) may produce increased cardiotoxic effects. Although such an interaction has not been established in humans, a few reports have suggested that such a combination may have the potential for producing cardiac arrhythmias. Further accumulation of clinical data is needed to determine whether this potential interaction exists in humans.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Animal reproduction studies have not been performed with theophyllines. It is not known whether theophyllines can cause fetal harm when administered to pregnant women. Although safe use of theophyllines during pregnancy has not been established relative to the potential risk to the fetus, the drugs have been used during pregnancy without teratogenicity or other adverse fetal effect; because of the risk of uncontrolled asthma, their safety during pregnancy when clearly needed is generally not seriously questioned.

Theophylline is distributed into milk and may occasionally induce irritability or other signs of toxicity in nursing infants. The risk to the breast-fed infant must be weighed against the benefit of nursing in lactating women who are receiving theophylline.

No enhanced messaging available.