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Can you take Anakinra with T-Phyl?

1 drug interaction and 31 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

theophylline anakinra

Applies to: T-Phyl (theophylline) and anakinra

Anakinra may alter the blood levels and effects of theophylline. Your doctor may need to monitor you more closely and/or adjust the dosing of your medication(s). For example, a dose adjustment may be needed if you have been receiving theophylline and are starting treatment with anakinra. Likewise, if you have been receiving both medications, the dose of theophylline may need to be adjusted when anakinra is discontinued. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

theophylline Food/Lifestyle

Applies to: T-Phyl (theophylline)

Both smoking and excessive caffeine consumption can alter the blood levels of theophylline, which may affect the dosing. Tobacco and marijuana smoke (including secondhand exposure) generally reduces, while caffeine increases, blood levels. In addition, caffeine is a stimulant and may add to the side effects of theophylline such as headache, insomnia, and increases in blood pressure and heart rate. It is best to avoid smoking and to limit caffeine consumption during theophylline therapy. Talk to a healthcare professional if you have any questions or concerns. If you start smoking or undergo smoking cessation, your doctor may need to monitor your blood levels more closely to determine if you need a dose adjustment of theophylline. You should stop taking theophylline and seek medical attention if you experience potential signs and symptoms of excessive drug levels such as nausea, vomiting, persistent headache, insomnia, and rapid heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When theophylline is given with enteral (tube) feedings, blood levels may be decreased due to interference with its absorption. This may reduce the effectiveness of the medication. To minimize potential for interaction, you may interrupt the feeding for one hour before and one hour after the theophylline dose. You may need more frequent blood tests to monitor theophylline levels.

Moderate:

theophylline Caffeine

Applies to: T-Phyl (theophylline)

Ask your doctor before using theophylline together with caffeine. Using these medications together may increase some of the side effects of theophylline. This can cause nausea, vomiting, insomnia, tremors, restlessness, uneven heartbeats, and seizure (convulsions). Avoid drinks or foods that contain caffeine, such as coffee, tea, cola, and chocolate. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate:

theophylline Nicotine

Applies to: T-Phyl (theophylline)

As you stop smoking during treatment with nicotine, your dosage requirement of theophylline may need to be changed. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

28 potential interactions Applies to: 26 conditions, including High Blood Pressure, GERD, Underactive Thyroid, Heart Failure, and Heart Attack.

Angina

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Angina.

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.

Cerebral Vascular Disorder

Major:

T-Phyl

The theophylline in T-Phyl has a major potential interaction with 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.

Cor Pulmonale

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Cor Pulmonale.

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.

Fever

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Fever.

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.

GERD

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with GERD.

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.

Head Injury

Major:

T-Phyl

The theophylline in T-Phyl has a major potential interaction with Head Injury.

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.

Heart Attack

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Heart Attack.

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.

Heart Failure

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Heart Failure.

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.

Hemodialysis

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Hemodialysis.

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

High Blood Pressure

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with High Blood Pressure.

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.

Hyperthyroidism

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with 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.

Immunodeficiency

Moderate:

anakinra

Anakinra has a moderate potential interaction with Immunodeficiency.

Anakinra has been associated with an increased incidence of serious infections in clinical trials in rheumatoid arthritis (RA). RA therapy should be discontinued if a patient develops a serious infection. In neonatal-onset multisystem inflammatory disease (NOMID) and deficiency of interleukin-1 receptor antagonist (DIRA) patients treated with anakinra, the risk of a disease flare when discontinuing this drug should be weighed against the potential risk of continued therapy. Anakinra should not be started in patients with active infections. Safety and efficacy have not been evaluated in immunosuppressed patients or in patients with chronic infections; caution is recommended when using anakinra in these patients.

Drugs that affect the immune system by blocking tumor necrosis factor have been associated with an increased risk of reactivation of latent tuberculosis; it is possible that taking drugs that block interleukin-1 (such as anakinra) increases the risk of tuberculosis or other atypical or opportunistic infections. The current US CDC guidelines should be followed both to evaluate for and to treat possible latent tuberculosis before starting therapy with anakinra.

Infection

Moderate:

anakinra

Anakinra has a moderate potential interaction with Infection.

Anakinra has been associated with an increased incidence of serious infections in clinical trials in rheumatoid arthritis (RA). RA therapy should be discontinued if a patient develops a serious infection. In neonatal-onset multisystem inflammatory disease (NOMID) and deficiency of interleukin-1 receptor antagonist (DIRA) patients treated with anakinra, the risk of a disease flare when discontinuing this drug should be weighed against the potential risk of continued therapy. Anakinra should not be started in patients with active infections. Safety and efficacy have not been evaluated in immunosuppressed patients or in patients with chronic infections; caution is recommended when using anakinra in these patients.

Drugs that affect the immune system by blocking tumor necrosis factor have been associated with an increased risk of reactivation of latent tuberculosis; it is possible that taking drugs that block interleukin-1 (such as anakinra) increases the risk of tuberculosis or other atypical or opportunistic infections. The current US CDC guidelines should be followed both to evaluate for and to treat possible latent tuberculosis before starting therapy with anakinra.

Influenza

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Influenza.

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.

Liver Disease

Moderate:

anakinra

Anakinra has a moderate potential interaction with Liver Disease.

No formal studies have been conducted examining the pharmacokinetics of anakinra administered subcutaneously in patients with hepatic dysfunction. Caution is recommended when using anakinra in these patients.

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Liver Disease.

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.

Neutropenia

Moderate:

anakinra

Anakinra has a moderate potential interaction with Neutropenia.

The use of anakinra has been associated with a decrease in neutrophil counts. Neutrophil counts should be assessed prior to initiating therapy and while receiving therapy, monthly for 3 months and thereafter quarterly for up to 1 year.

Panhypopituitarism

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with 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.

Peptic Ulcer

Major:

T-Phyl

The theophylline in T-Phyl has a major potential interaction with 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.

Post MI Syndrome

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Post MI Syndrome.

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.

Pulmonary Edema

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Pulmonary Edema.

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.

Renal Dysfunction

Major:

T-Phyl

The theophylline in T-Phyl has a major potential interaction with 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.

Moderate:

anakinra

Anakinra has a moderate potential interaction with Renal Dysfunction.

Anakinra is substantially excreted by the kidney. The risk of toxic reactions to this drug may be greater in patients with impaired renal function. Administration of the prescribed dose every other day should be considered for patients who have severe renal dysfunction or end-stage renal disease (defined as CrCl less than 30 mL/min [as estimated from serum creatinine levels]). Caution should be exercised when using anakinra in these patients.

Seizures

Major:

T-Phyl

The theophylline in T-Phyl has a major potential interaction with Seizures.

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.

Shock

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Shock.

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.

Tachyarrhythmia

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Tachyarrhythmia.

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.

Tuberculosis, Latent

Moderate:

anakinra

Anakinra has a moderate potential interaction with Tuberculosis, Latent.

Anakinra has been associated with an increased incidence of serious infections in clinical trials in rheumatoid arthritis (RA). RA therapy should be discontinued if a patient develops a serious infection. In neonatal-onset multisystem inflammatory disease (NOMID) and deficiency of interleukin-1 receptor antagonist (DIRA) patients treated with anakinra, the risk of a disease flare when discontinuing this drug should be weighed against the potential risk of continued therapy. Anakinra should not be started in patients with active infections. Safety and efficacy have not been evaluated in immunosuppressed patients or in patients with chronic infections; caution is recommended when using anakinra in these patients.

Drugs that affect the immune system by blocking tumor necrosis factor have been associated with an increased risk of reactivation of latent tuberculosis; it is possible that taking drugs that block interleukin-1 (such as anakinra) increases the risk of tuberculosis or other atypical or opportunistic infections. The current US CDC guidelines should be followed both to evaluate for and to treat possible latent tuberculosis before starting therapy with anakinra.

Underactive Thyroid

Moderate:

T-Phyl

The theophylline in T-Phyl has a moderate potential interaction with Underactive Thyroid.

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.

More resources

anakinra

A total of 536 drugs are known to interact with anakinra.

T-Phyl

A total of 335 drugs are known to interact with T-Phyl.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.