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Theophylline Disease Interactions

There are 7 disease interactions with theophylline:

Methylxanthines (Includes Theophylline) ↔ Pud

Severe Potential Hazard, High plausibility

Applies to: Peptic Ulcer

Methylxanthines are known to stimulate peptic acid secretion. Therapy with products containing methylxanthines should be administered with extreme caution in patients with active peptic ulcer disease. Some manufacturers consider their use to be contraindicated under such circumstance.

References

  1. "Product Information. Theo-Dur (theophylline)." Schering Laboratories, Kenilworth, NJ.
  2. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity." Am Fam Physician 54 (1996): 1473
  3. Stoller JL "Oesophageal ulceration and theophylline." Lancet 2 (1985): 328-9
View all 4 references

Methylxanthines (Includes Theophylline) ↔ Renal Dysfunction

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The metabolites of theophylline, which are generally undetectable in patients with normal renal function, may accumulate in patients with renal impairment and contribute to the toxicity of theophylline. In addition, the plasma protein binding of theophylline may be significantly decreased in renal impairment, resulting in elevated free drug concentrations and further increasing the risk of toxicity. Therapy with theophyllines should be administered cautiously in patients with impaired renal function. Dosage adjustments and more intensive monitoring of serum theophylline concentrations may be required.

References

  1. Vanholder R, Van Landschoot N, De Smet R, Schoots A, Ringoir S "Drug protein binding in chronic renal failure: evaluation of nine drugs." Kidney Int 33 (1988): 996-1004
  2. Leakey TE, Elias-Jones AC, Coates PE, Smith KJ "Pharmacokinetics of theophylline and its metabolites during acute renal failure: a case report." Clin Pharmacokinet 21 (1991): 400-8
  3. Kraan J, Jonkman JH, Koeter GH, et al "The pharmacokinetics of theophylline and enprofylline in patients with liver cirrhosis and in patients with chronic renal disease." Eur J Clin Pharmacol 35 (1988): 357-62
View all 8 references

Methylxanthines (Includes Theophylline) ↔ Seizure Disorders

Severe Potential Hazard, High plausibility

Applies to: Seizures, Head Injury, Cerebral Vascular Disorder

The use of theophyllines is considered by some manufacturers to be contraindicated in patients with underlying seizure disorders unless they are receiving adequate anticonvulsant therapy. Theophyllines may cause seizures, which have generally been associated with toxic drug levels but have also been reported at therapeutic concentrations in patients with head trauma or cerebral infarct. If theophylline therapy is administered in patients with these or other risk factors for seizures, serum drug levels should be monitored closely and maintained in the low therapeutic range. Intractable seizures and death have been reported during acute theophylline toxicity.

References

  1. Bahls FH, Ma KK, Bird TD "Theophylline-associated seizures with "therapeutic" or low toxic serum concentrations: risk factors for serious outcome in adults." Neurology 41 (1991): 1309-12
  2. Hendeles L, Weinberger M, Johnson G "Monitoring serum theophylline levels." Clin Pharmacokinet 3 (1978): 294-312
  3. Nakada T, Kwee IL, Lerner AM, Remler MP "Theophylline-induced seizures: clinical and pathophysiologic aspects." West J Med 138 (1983): 371-4
View all 11 references

Methylxanthines (Includes Theophylline) ↔ Gerd

Moderate Potential Hazard, High plausibility

Applies to: Gastroesophageal Reflux Disease

Methylxanthines increase gastric acidity and may also relax lower esophageal sphincter, which can lead to gastric reflux into the esophagus. Therapy with products containing methylxanthines should be administered cautiously in patients with significant gastroesophageal reflux.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  2. Stoller JL "Oesophageal ulceration and theophylline." Lancet 2 (1985): 328-9
  3. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity." Am Fam Physician 54 (1996): 1473
View all 4 references

Methylxanthines (Includes Theophylline) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Theophylline is removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. Blouin RA, Bauer LA, Bustrack JA, Record KE, Bivins BA "Theophylline hemodialysis clearance." Ther Drug Monit 2 (1980): 221-3
  2. Lee CS, Marbury TC, Perrin JH, Fuller TJ "Hemodialysis of theophylline in uremic patients." J Clin Pharmacol April (1979): 219-26
  3. Levy G, Gibson TP, Whitman W, Procknai J "Hemodialysis clearance of theophylline." JAMA 237 (1977): 1466-7
View all 8 references

Methylxanthines (Includes Theophylline) ↔ Reduced Clearance

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Pulmonary Edema, Cor Pulmonale, Liver Disease, Sepsis, Shock, Influenza, Fever, Hypothyroidism, Panhypopituitarism

Certain conditions have been identified as causes of reduced theophylline clearance. They include age (neonates and infants < 1 year as well as elderly patients > 60 years) and the following concurrent diseases: acute pulmonary edema; decompensated heart failure; cor pulmonale; fever (>= 102 degrees for 24 hours or more, or lesser temperature elevations for longer periods); influenza; untreated or uncontrolled hypothyroidism; liver disease, cirrhosis or acute hepatitis; reduced renal function in infants < 3 months of age; sepsis with multi-organ failure; and shock. Therapy with theophyllines should be administered cautiously in patients presenting with one or more of these risk factors, and the dosage should be appropriately reduced to prevent toxicity. More intensive monitoring of serum theophylline concentrations may be required. Toxicity is most likely to occur when levels exceed 20 mcg/mL. Severe cases, sometimes without previous warning, have led to cardiac arrhythmias, intractable seizures, and death.

References

  1. Kraan J, Jonkman JH, Koeter GH, et al "The pharmacokinetics of theophylline and enprofylline in patients with liver cirrhosis and in patients with chronic renal disease." Eur J Clin Pharmacol 35 (1988): 357-62
  2. Clark BG, Vestal RE "Adverse drug reactions in the elderly: case studies." Geriatrics 39 (1984): 53-4,60-3,66
  3. O'Connor P, Feely J "Clinical pharmacokinetics and endocrine disorders. Therapeutic implications." Clin Pharmacokinet 13 (1987): 345-64
View all 27 references

Methylxanthines (Includes Theophylline) ↔ Tachyarrhythmias

Moderate Potential Hazard, Moderate plausibility

Applies to: Tachyarrhythmia, Angina Pectoris, Myocardial Infarction, Post MI Syndrome, Hypertension, Hyperthyroidism

The use of theophyllines is associated with an increase in heart rate which may progress to supraventricular tachycardia or ventricular arrhythmia at high serum drug concentrations. Appearance of cardiac adverse effects is generally an indication of theophylline toxicity, although patients with a history of tachyarrhythmias may be more susceptible to the chronotropic effect of these drugs. Therapy with theophyllines should be administered cautiously in such patients. Caution is also advised in patients with hypertension, hyperthyroidism, angina pectoris, or recent myocardial infarction, since high dosages of the drugs are associated with positive inotropic as well as chronotropic effects. Clinical monitoring of serum drug concentrations is recommended to prevent toxicity.

References

  1. Levine JH, Michael JR, Guarnieri T "Multifocal atrial tachycardia: a toxic effect of theophylline." Lancet 1 (1985): 12-4
  2. Sessler CN "Theophylline toxicity: clinical features of 116 consecutive cases." Am J Med 88 (1990): 567-76
  3. Bittar G, Friedman HS "The arrhythmogenicity of theophylline: a multivariate analysis of clinical determinants." Chest 99 (1991): 1415-20
View all 12 references

You should also know about...

theophylline drug Interactions

There are 352 drug interactions with theophylline

theophylline alcohol/food Interactions

There are 3 alcohol/food interactions with theophylline

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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