Skip to Content

Hydroxy Compound (ephedrine / hydroxyzine / theophylline) and Alcohol/Food Interactions

There are 3 alcohol/food/lifestyle interactions with Hydroxy Compound (ephedrine / hydroxyzine / theophylline) which include:

Moderate

theophylline food

Moderate Food Interaction

Consumer information for this interaction is not currently available.

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. 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
  2. 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
  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
Moderate

hydrOXYzine food

Moderate Food Interaction

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. "Product Information. Fycompa (perampanel)." Eisai Inc, Teaneck, NJ.
  3. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc, Rockville, MD.
  4. Gilman AG, Rall TW, Nies AS, Taylor P, eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 8th ed." New York, NY: Pergamon Press Inc. (1990):
View all 4 references
Moderate

High Blood Pressure (Hypertension)

Moderate Potential Hazard, Moderate plausibility

methylxanthines - tachyarrhythmias

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. Bittar G, Friedman HS "The arrhythmogenicity of theophylline: a multivariate analysis of clinical determinants." Chest 99 (1991): 1415-20
  3. Sessler CN "Theophylline toxicity: clinical features of 116 consecutive cases." Am J Med 88 (1990): 567-76
  4. Albert S "Aminophylline toxicity." Pediatr Clin North Am 34 (1987): 61-73
  5. Schiff GD, Hegde HK, LaCloche L, Hryhorczuk DO "Inpatient theophylline toxicity: preventable factors." Ann Intern Med 114 (1991): 748-53
  6. Patel AK, Skatrud JB, Thomsen JH "Cardiac arrhythmias due to oral aminophylline in patients with chronic obstructive pulmonary disease." Chest 80 (1981): 661-5
  7. Chazan R, Karwat K, Tyminska K, Tadeusiak W, Droszcz W "Cardiac arrhythmias as a result of intravenous infusions of theophylline in patients with airway obstruction." Int J Clin Pharmacol Ther 33 (1995): 170-5
  8. Taniguchi A, Ohe T, Shimorura K "Theophylline-induced ventricular tachycardia in a patient with chronic lung disease: sensitivity to verapamil." Chest 96 (1989): 958-9
  9. Hendeles L, Weinberger M, Johnson G "Monitoring serum theophylline levels." Clin Pharmacokinet 3 (1978): 294-312
  10. Marchlinski FE, Miller JM "Atrial arrhythmias exacerbated by theophylline: response to verapamil and evidence for triggered activity in man." Chest 88 (1985): 931-4
  11. Mccarthy M "Theophylline, beta-agonists, and cardiovascular death." Lancet 349 (1997): 33
  12. Milgrom H, Bender B "Current issues in the use of theophylline." Am Rev Respir Dis 147 (1993): s33-9
View all 12 references

Hydroxy Compound (ephedrine / hydroxyzine / theophylline) drug interactions

There are 799 drug interactions with Hydroxy Compound (ephedrine / hydroxyzine / theophylline)

Hydroxy Compound (ephedrine / hydroxyzine / theophylline) disease interactions

There are 21 disease interactions with Hydroxy Compound (ephedrine / hydroxyzine / theophylline) which include:

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.