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Dyphylline

Pronunciation: DYE-fi-lin
Class: Xanthine derivative

Trade Names

Dylix
- Elixir 100 mg per 15 mL

Lufyllin
- Tablets 200 mg
- Tablets 400 mg

Pharmacology

Relaxes bronchial smooth muscle and stimulates central respiratory drive.

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Pharmacokinetics

Absorption

Rapidly absorbed, reaching a mean C max of 17.1 mcg/mL in about 45 min.

Metabolism

Not metabolized.

Elimination

Unchanged by the kidney. Elimination half-life is approximately 2 h. Approximately 88% excreted unchanged in the urine.

Special Populations

Renal Function Impairment

Cl would be correspondingly reduced in patients with impaired renal function. In anuric patients, the half-life may be increased 3 to 4 times normal.

Hepatic Function Impairment

Pharmacokinetics not affected by hepatic function impairment.

Indications and Usage

Relief of acute bronchial asthma and reversible bronchospasm associated with chronic bronchitis and emphysema.

Contraindications

Hypersensitivity to any component of the product or related xanthine compounds.

Dosage and Administration

Adult

PO Usual dose is up to 15 mg/kg every 6 h.

Elixir

200 to 400 mg (2 to 4 Tbsp) every 6 h. Dose should be titrated to severity of condition and response of patient. Measure and administer prescribed dose of elixir using dosing syringe, dosing spoon, or dosing cup.

Renal Function Impairment

Cl is reduced in patients with impaired renal function; make appropriate dosage adjustments.

Storage/Stability

Store elixir at 59° to 86°F. Store tablets at 68° to 77°F.

Drug Interactions

Halothane

Catecholamine-induced arrhythmias have been reported when halothane was administered after theophylline.

Probenecid

May increase the plasma half-life of dyphylline.

Sympathomimetic bronchodilators

Synergistic pharmacologic effect may occur.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Circulatory failure, extrasystoles, flushing, hypotension, palpitation, tachycardia, ventricular arrhythmias.

CNS

Agitation, generalized clonic and tonic convulsions, headache, hyperexcitability, insomnia, irritability, muscle twitching, restlessness.

GI

Diarrhea, epigastric pain, hematemesis, nausea, vomiting.

Metabolic

Hyperglycemia, SIADH.

Renal

Albuminuria, diuresis, gross and microscopic hematuria.

Respiratory

Tachypnea.

Precautions

Monitor

Note frequency and severity of asthma attacks.


Pregnancy

Category C .

Lactation

Excreted in breast milk.

Children

Safety and efficacy have not been established.

Elderly

Use with caution (usually starting at the low end of the dosage range) because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.

Renal Function

Cl is reduced in patients with impaired renal function; make appropriate dosage adjustments.

Special Risk Patients

Use with caution in patients with severe cardiac disease, hypertension, hyperthyroidism, acute myocardial injury, or peptic ulcer.

Xanthine products

Ensure other xanthine products (eg, theophylline) are not being coadministered with dyphylline.

Overdosage

Symptoms

Agitation, anorexia, cardiac arrhythmias, CV collapse, death, dehydration, diaphoresis, diarrhea, excessive thirst, extrasystoles, fasciculation, generalized clonic and tonic convulsions, headache, hyperreflexia, hyperthermia, insomnia, irritability, nausea, nervousness, restlessness, seizures, severe vomiting, tachycardia, tinnitus, vomiting.

Patient Information

  • Advise patient to take prescribed dose every 6 h without regard to meals, but to take with food if stomach upset occurs.
  • Advise patient or caregiver using elixir to measure and administer prescribed dose using dosing syringe, dosing spoon, or dosing cup.
  • Advise patient if a dose is missed, to take the dose as soon as remembered; however, if it is less than 3 h before the next scheduled dose, advise patient to skip the missed dose and take the next dose at the regularly scheduled time. Caution patient not to double the dose to catch up.
  • Instruct patient not to stop the medication once symptoms have been controlled and that continued daily use is necessary to continue to control symptoms.
  • Advise patient that medication does not replace controller medications (eg, inhaled or oral corticosteroids) and to continue daily use of controller medications as prescribed by health care provider.
  • Caution patient not to increase dose and to inform health care provider if asthma symptoms do not improve or worsen, if more short-acting bronchodilator than usual is needed, or if the short-acting bronchodilator appears to become less effective.
  • Advise patient to carry medical identification (eg, card, bracelet) if experiencing acute severe asthma attacks requiring rapid systemic treatment.
  • Advise patient or caregiver to promptly report any of the following to health care provider: anxiety, nervousness, or restlessness; persistent nausea, vomiting, or diarrhea; fainting spells or light-headedness; fast or irregular heartbeat; pounding in the chest; flushing of the face; seizures (convulsions); skin rash, itching, or hives; tremor; unusual weakness or tiredness.

Copyright © 2009 Wolters Kluwer Health.

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