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Drug Interactions between Fluogen and Slo-Phyllin 80

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

theophylline influenza virus vaccine, inactivated

Applies to: Slo-Phyllin 80 (theophylline) and Fluogen (influenza virus vaccine, inactivated)

Limited data suggest that administration of split, trivalent influenza vaccine may cause a transient reduction in theophylline clearance. However, further studies have not been able to reproduce this interaction. Patients should be monitored for possible theophylline toxicity following influenza vaccination. Patients should be advised to report any signs of theophylline toxicity including nausea, vomiting, diarrhea, headache, restlessness, insomnia, or irregular heartbeat to their physicians.

References

  1. Renton KW, Gray JD, Hall RI "Decreased elimination of theophylline after influenza vaccination." Can Med Assoc J 123 (1980): 288-90
  2. Bukowskyj M, Munt PW, Wigle R, Nakatsu K "Theophylline clearance: lack of effect of influenza vaccination and ascorbic acid." Am Rev Respir Dis 129 (1984): 672-5
  3. Patriarca PA, Kendal AP, Stricof RL, Weber JA, Meissner MK, Dateno B "Influenza vaccination and warfarin or theophylline toxicity in nursing home patients." N Engl J Med 308 (1983): 1601-2
  4. Meredith CG, Christian CD, Johnson RF, Troxell R, Davis GL, Schenker S "Effects of influenza virus vaccine on hepatic drug metabolism." Clin Pharmacol Ther 37 (1985): 396-401
  5. Winstanley PA, Tjia J, Back DJ, Hobson D, Breckenridge AM "Lack of effect of highly purified subunit influenza vaccination on theophylline metabolism." Br J Clin Pharmacol 20 (1985): 47-53
  6. Gomolin IH, Chapron DJ, Luhan PA "Lack of effect of influenza vaccine on theophylline levels and warfarin anticoagulation in the elderly." J Am Geriatr Soc 33 (1985): 269-72
  7. Grabowski N, May JJ, Pratt DS, Richtsmeier WJ, Bertino Jr JS "The effect of split virus influenza vaccination on theophylline pharmacokinetics." Am Rev Respir Dis 131 (1985): 934-8
  8. Jonkman JHG, Wymenga ASC, de Zeeuw RA, et al. "No effect of influenza vaccination on theophylline pharmacokinetics as studied by ultraviolet spectrophotometry, HPLC, and EMIT assay methods." Ther Drug Monit 10 (1988): 345-48
View all 8 references

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Drug and food interactions

Moderate

theophylline food

Applies to: Slo-Phyllin 80 (theophylline)

GENERALLY AVOID: Coadministration with caffeine may increase the serum concentrations of theophylline. The proposed mechanism involves competitive inhibition of theophylline metabolism via CYP450 1A2, as well as metabolic conversion of caffeine to theophylline in vivo and saturation of theophylline metabolism at higher serum concentrations. In six healthy male volunteers (all smokers), serum concentrations of theophylline (administered as aminophylline 400 mg single oral dose) were significantly higher following consumption of caffeine (2 to 7 cups of instant coffee over 24 hours, equivalent to approximately 120 to 630 mg of caffeine) than after caffeine deprivation for 48 hours. Caffeine consumption also increased the apparent elimination half-life of theophylline by an average of 32% and reduced its total body clearance by 23%. In another study, steady-state concentration and area under the concentration-time curve of theophylline (1200 mg intravenously over 24 hours) increased by 23% and 40%, respectively, in eight healthy volunteers following administration of caffeine (300 mg orally three times a day).

MANAGEMENT: Given the narrow therapeutic index of theophylline, patients should limit or avoid significant fluctuations in their intake of pharmacologic as well as dietary caffeine.

ADJUST DOSING INTERVAL: Administration of theophylline with continuous enteral nutrition may reduce the serum levels or the rate of absorption of theophylline. The mechanism has not been reported. In one case, theophylline levels decreased by 53% in a patient receiving continuous nasogastric tube feedings and occurred with both theophylline tablet and liquid formulations, but not with intravenous aminophylline.

MANAGEMENT: When administered to patients receiving continuous enteral nutrition , some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of theophylline is given; rapid-release formulations are preferable, and theophylline levels should be monitored.

References

  1. Jonkman JH, Sollie FA, Sauter R, Steinijans VW "The influence of caffeine on the steady-state pharmacokinetics of theophylline." Clin Pharmacol Ther 49 (1991): 248-55
  2. Sato J, Nakata H, Owada E, Kikuta T, Umetsu M, Ito K "Influence of usual intake of dietary caffeine on single-dose kinetics of theophylline in healthy human subjects." Eur J Clin Pharmacol 44 (1993): 295-8
  3. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67

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Moderate

theophylline food

Applies to: Slo-Phyllin 80 (theophylline)

GENERALLY AVOID: Coadministration with caffeine may increase the serum concentrations of theophylline. The proposed mechanism involves competitive inhibition of theophylline metabolism via CYP450 1A2, as well as metabolic conversion of caffeine to theophylline in vivo and saturation of theophylline metabolism at higher serum concentrations. In six healthy male volunteers (all smokers), serum concentrations of theophylline (administered as aminophylline 400 mg single oral dose) were significantly higher following consumption of caffeine (2 to 7 cups of instant coffee over 24 hours, equivalent to approximately 120 to 630 mg of caffeine) than after caffeine deprivation for 48 hours. Caffeine consumption also increased the apparent elimination half-life of theophylline by an average of 32% and reduced its total body clearance by 23%. In another study, steady-state concentration and area under the concentration-time curve of theophylline (1200 mg intravenously over 24 hours) increased by 23% and 40%, respectively, in eight healthy volunteers following administration of caffeine (300 mg orally three times a day).

MANAGEMENT: Given the narrow therapeutic index of theophylline, patients should limit or avoid significant fluctuations in their intake of pharmacologic as well as dietary caffeine.

References

  1. Jonkman JH, Sollie FA, Sauter R, Steinijans VW "The influence of caffeine on the steady-state pharmacokinetics of theophylline." Clin Pharmacol Ther 49 (1991): 248-55
  2. Sato J, Nakata H, Owada E, Kikuta T, Umetsu M, Ito K "Influence of usual intake of dietary caffeine on single-dose kinetics of theophylline in healthy human subjects." Eur J Clin Pharmacol 44 (1993): 295-8

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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