THEO-DUR (THEOPHYLLINE)

DRUG INTERACTION

DRUG-DRUG INTERACTION
CONTRAINDICATION
Dipyridamole

Febuxostat

Riociguat

OTHER DRUGS
Carbamazepine

Erythromycin

Enoxacin

Fluroxamine

Ephedrine

Propanolol

Rifampin

Thiabendazole

DRUG-DRUG INTERACTION cont.

DECREASE THEOPHYLLINE METABOLISM
Macrolide antibiotics

Quinolone

Cimetidine

INCREASE THEOPHYLLINE METABOLISM

Phenytoin

Phenobarbital

Rifampin

HYPOKALEMIA IF IN CONCURRENT USE WITH:2 agonist

Steroids

Diuretics

*** also in hypoxia, severe asthmatic patient

DRUG-FOOD INTERACTION
THEOPHYLLINE CAFFEINE
Increase serum concentration of theophylline
increase side effects: nausea and vomiting, insomnia, tremors, restlessness, uneven
heartbeat, seizure
MOA
competitive inhibition of theophylline metabolism via CYP450 1A2
metabolic conversion of caffeine to theophylline in vivo
saturation of theophylline metabolism at higher serum concentration
caffeine also increase apparent elimination t1/2 of theophylline by 32%
decrease total body clearance by 23%
Advice: limit or avoid significant fluctuation in intake of pharmacologic & dietary
caffeine

DRUG-FOOD INTERACTION cont.

THEOPHYLLINE TOBACCO
Smoking changes the way body uses Theophylline dose adjustment needed
Smokers & children = higher metabolizer dose individualized
T1/2 shorter in smoker require large / more frequent dose
HIGH CARBOHYDRATES, LOW PROTEIN / LOW CARBOHYDRATES, HIGH
PROTEIN INTAKE
Increase Theophylline clearance

DRUG INTERACTION IMPACT ON

MEASUREMENT
COFFEE, REA, COLA BAVERAGES, CHOCOLATE, ACETAMINOPHEN
Cause falsely high level of Theophylline during Spectrophotometric measure
CAFFEINE, CEPHALOSPORIN, SULFA MEDICATION
Cause falsely high level of Theophylline during HPLC measure