Interactions between Slo-Phyllin and Ticlopidine
1 drug interaction and 34 additional warnings found for the following 2 drugs:
- Slo-Phyllin (theophylline)
- ticlopidine
Drug interactions
Moderate drug interactions
Moderate:
theophylline ticlopidine
Applies to: Slo-Phyllin (theophylline) and ticlopidine
Monitor
In one study, theophylline clearance was reduced by 37% and theophylline half-life increased by 42% during concomitant ticlopidine therapy. The exact mechanism of this interaction is not known, but ticlopidine probably interferes with theophylline metabolism.
Management
Theophylline levels and clinical response should be monitored when ticlopidine therapy is initiated or discontinued. Patients should be advised to report any signs of theophylline toxicity during concurrent therapy, including nausea, vomiting, diarrhea, headache, restlessness, insomnia, or irregular heartbeat to their physician.
References (1)
- Colli A, Buccino G, Cocciolo M, Parravicini R, Elli GM, Scaltrini G (1987) "Ticlopidine-theophylline interaction." Clin Pharmacol Ther, 41, p. 358-62
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
theophylline Food/Lifestyle
Applies to: Slo-Phyllin (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 (3)
- Jonkman JH, Sollie FA, Sauter R, Steinijans VW (1991) "The influence of caffeine on the steady-state pharmacokinetics of theophylline." Clin Pharmacol Ther, 49, p. 248-55
- Sato J, Nakata H, Owada E, Kikuta T, Umetsu M, Ito K (1993) "Influence of usual intake of dietary caffeine on single-dose kinetics of theophylline in healthy human subjects." Eur J Clin Pharmacol, 44, p. 295-8
- Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67
Moderate:
ticlopidine Food/Lifestyle
Applies to: ticlopidine
Adjust dosing interval
The bioavailability and gastrointestinal tolerance of ticlopidine is enhanced by food.
Management
Patients may be advised to take ticlopidine with meals.
References (1)
- (2001) "Product Information. Ticlid (ticlopidine)." Syntex Laboratories Inc
Moderate:
theophylline Caffeine
Applies to: Slo-Phyllin (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 (2)
- Jonkman JH, Sollie FA, Sauter R, Steinijans VW (1991) "The influence of caffeine on the steady-state pharmacokinetics of theophylline." Clin Pharmacol Ther, 49, p. 248-55
- Sato J, Nakata H, Owada E, Kikuta T, Umetsu M, Ito K (1993) "Influence of usual intake of dietary caffeine on single-dose kinetics of theophylline in healthy human subjects." Eur J Clin Pharmacol, 44, p. 295-8
Moderate:
theophylline Nicotine
Applies to: Slo-Phyllin (theophylline)
Monitor
Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.
Management
Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.
References (4)
- (2024) "Product Information. Cytisine (cytisinicline)." Consilient Health Ltd
- jeong sh, Newcombe D, sheridan j, Tingle M (2015) "Pharmacokinetics of cytisine, an a4 b2 nicotinic receptor partial agonist, in healthy smokers following a single dose." Drug Test Anal, 7, p. 475-82
- Vaughan DP, Beckett AH, Robbie DS (1976) "The influence of smoking on the intersubject variation in pentazocine elimination." Br J Clin Pharmacol, 3, p. 279-83
- Zevin S, Benowitz NL (1999) "Drug interactions with tobacco smoking: an update" Clin Pharmacokinet, 36, p. 425-38
Disease interactions
30 potential interactions Applies to: 28 conditions, including High Blood Pressure, High Cholesterol, GERD, Underactive Thyroid, and Heart Failure.
Angina
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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.
Bleeding Disorder
Major:
ticlopidine
Ticlopidine has a major potential interaction with Bleeding Disorder.
The use of ticlopidine is contraindicated in patients with hemostatic disorders such as vascular defect or coagulation dysfunction or active pathological bleeding such as peptic ulcer disease or intracranial hemorrhage. Ticlopidine induces an irreversible inhibition of platelet aggregation resulting in a prolongation of bleeding time.
Cerebral Vascular Disorder
Major:
Slo-Phyllin
The theophylline in Slo-Phyllin 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.
Coagulation Defects and Disorders
Major:
ticlopidine
Ticlopidine has a major potential interaction with Coagulation Defects and Disorders.
The use of ticlopidine is contraindicated in patients with hemostatic disorders such as vascular defect or coagulation dysfunction or active pathological bleeding such as peptic ulcer disease or intracranial hemorrhage. Ticlopidine induces an irreversible inhibition of platelet aggregation resulting in a prolongation of bleeding time.
Cor Pulmonale
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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.
High Cholesterol
Moderate:
ticlopidine
Ticlopidine has a moderate potential interaction with High Cholesterol.
Ticlopidine can induce increases in serum cholesterol and triglycerides. Serum total cholesterol levels have increased 8% to 10% in some patients within 1 month of initiation of ticlopidine therapy and have persisted at those levels. Clinical monitoring of lipid profiles is recommended during ticlopidine therapy in patients at risk for hyperlipidemia-associated adverse events.
Hyperthyroidism
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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.
Influenza
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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
Major:
ticlopidine
Ticlopidine has a major potential interaction with Liver Disease.
The use of ticlopidine is contraindicated in patients with severe hepatic impairment. Ticlopidine is extensively metabolized to inactive forms by the liver. Therapy with ticlopidine should be administered cautiously in patients with mild to moderate hepatic impairment and dosage modifications should be considered. Clinical monitoring of hepatic function and bleeding activity is recommended.
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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
Major:
ticlopidine
Ticlopidine has a major potential interaction with Neutropenia.
The use of ticlopidine is contraindicated in patients with hematopoietic disorders such as neutropenia and/or thrombocytopenia or a past history of thrombotic thrombocytopenic purpura (TTP) or aplastic anemia. Ticlopidine can cause life-threatening hematological adverse reactions, including neutropenia/agranulocytosis, TTP and aplastic anemia. Clinical monitoring of hematopoietic function is required for all patients receiving ticlopidine, since severe hematopoietic disorders may develop suddenly, usually within the first 3 weeks to 3 months of therapy. CBCs (including differential and platelet count) should be performed prior to initiation of ticlopidine and every 2 weeks through the first 3 months or as often as necessary.
Panhypopituitarism
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
ticlopidine
Ticlopidine has a moderate potential interaction with Renal Dysfunction.
Ticlopidine is primarily eliminated by the kidney, and there is limited experience in patients with renal impairment. Elevated serum concentration of ticlopidine and prolonged half-live have been noted in patients with mild and moderate renal impairment. Prolonged bleeding times have been reported in patients with moderate renal impairment. Therapy with ticlopidine should be administered cautiously in patients with compromised renal function and dosage modifications may be necessary.
Seizures
Major:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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:
Slo-Phyllin
The theophylline in Slo-Phyllin 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.
Thrombocytopathy
Major:
ticlopidine
Ticlopidine has a major potential interaction with Thrombocytopathy.
The use of ticlopidine is contraindicated in patients with hemostatic disorders such as vascular defect or coagulation dysfunction or active pathological bleeding such as peptic ulcer disease or intracranial hemorrhage. Ticlopidine induces an irreversible inhibition of platelet aggregation resulting in a prolongation of bleeding time.
Thrombocytopenia
Major:
ticlopidine
Ticlopidine has a major potential interaction with Thrombocytopenia.
The use of ticlopidine is contraindicated in patients with hematopoietic disorders such as neutropenia and/or thrombocytopenia or a past history of thrombotic thrombocytopenic purpura (TTP) or aplastic anemia. Ticlopidine can cause life-threatening hematological adverse reactions, including neutropenia/agranulocytosis, TTP and aplastic anemia. Clinical monitoring of hematopoietic function is required for all patients receiving ticlopidine, since severe hematopoietic disorders may develop suddenly, usually within the first 3 weeks to 3 months of therapy. CBCs (including differential and platelet count) should be performed prior to initiation of ticlopidine and every 2 weeks through the first 3 months or as often as necessary.
Underactive Thyroid
Moderate:
Slo-Phyllin
The theophylline in Slo-Phyllin 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
Slo-Phyllin
A total of 335 drugs are known to interact with Slo-Phyllin.
- Slo-phyllin is in the drug class methylxanthines.
- Slo-phyllin is used to treat the following conditions:
ticlopidine
A total of 235 drugs are known to interact with ticlopidine.
- Ticlopidine is in the drug class platelet aggregation inhibitors.
- Ticlopidine is used to treat Cerebral Thrombosis/Embolism.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.