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Information needed on theophylline / Phyllocontin.

12 years ago•6 Replies

Information needed on theophylline / Phyllocontin. Does it interact with other drugs.? It is often mentioned as "tell your Dr if you are taking ...." on drug information leaflets. Is it compatible with clarithromycin?

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BelleBea

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elian12 years ago

If you can make sense of the following, which I cut and pasted from "Nursing link", you are a better man/woman than I am

"Theophylline

Theophylline is metabolized by the CYP1A2, CYP2E1, and CYP3A4 isoenzymes.8 Due to its metabolism by CYP1A2, inducing agents such as omeprazole and cigarette smoke increase the clearance of the drug. Thus, larger doses of theophylline may be necessary when patients are taking omeprazole concomitantly or if they currently smoke cigarettes, and the dose decreased when either is discontinued.

Erythromycin and clarithromycin (but not azithromycin) inhibit the metabolism of theophylline, increasing the risk for theophylline toxicity.5 Other CYP3A4 inhibitors that decrease the metabolism of theophylline include ciprofloxacin, enoxacin, clarithromycin, itraconazole, ketoconazole, fluconazole, cimetidine, omeprazole, quinidine, nefazodone, fluoxetine, fluvoxamine, and sertraline.8 Theophylline plasma concentrations can increase to the toxic range if the dose of theophylline is not reduced when given with one of these agents. Indeed, several fatal cases of theophylline toxicity have been reported with the concomitant use of erythromycin and theophylline. Although this interaction is more likely to occur in patients receiving high doses of erythromycin for a long duration of time, fatal interactions have occurred at low doses of erythromycin taken for 5 to 7 days. The risk of theophylline toxicity can be minimized by using concurrent drug(s) that are not metabolized by CYP3A4, or by reducing the theophylline dose while frequently monitoring the patient’s theophylline plasma concentration. "

I think a chat with your GP would prove useful in this case.

BelleBea in reply to elian12 years ago

Thanks so much for the information. Will mention it to my GP. Took a course of clarithromycin recently which was effective, I think, for the infection but after a few days made me feel REALLY bad. Maybe it was because of using at same time as Theophyline .

Daxiemad12 years ago

I have used Theophylline in the past, so in laymans speak as follows:

First you must stick to the brand you have first been prescribed, as they all slightly differ. In order for Theophylline to work successfully you need to have certain levels (between 10 and 20mg/1 is the normal therapeutic range) within your blood constantly, often most prescribed Theophyllines are slow release. In order to make sure you are on the right dose, regular blood tests should be carried out over the first few months of taking this drug, too high a dose and you can become toxic, a dangerous place to be.

Aminophylline is often prescribed in an emergency situation to open up the airways (usually for Asthmatics), so it is very important you inform the emergency attending medics that you are taking Theophyllines so that this can be taken into consideration. Otherwise it is possible you will overdose and become toxic. Often in an emergency situation your Theophylline levels will be measured before Aminophylline is administered.

Theophylline has various side effects when you first start it, and these generally pass over time, like insomnia, restlessness, nausea. Do not under any circumstances drink high energy drinks like Red Bull (Lucozade ok) that contain large amounts of caffeine, Theophylline can give you the jitters if you are on large doses of it, add a high energy drink into the mix and even though I haven't done it myself, I am told the side effects are pretty awful. You can drink coffee that contains caffeine, but if you are a heavy coffee drinker then seriously cut back, because you also experience the jitters. Also it is very important to be careful with using alternative medicines with this drug, in particular St Johns Wort that is used for depression. Do not use St Johns Wort as it reduces the effectiveness of the drug.

Clarithromycin will increase the levels of Theophylline in the blood, so careful consideration should be given when prescribing, and Theophylline levels in the blood closely monitored.

Slow release preparations are usually given in two separate doses, morning and night!

Finally some chesty cough medicines that you buy over the counter at the chemist contain theophyllines in small doses, so if you are taking Theophyllines these will no longer be an option as it is possible to overdose.

Just about everything I can think of, hope my layman terms help. I understand a lot of the stuff they put on line about medications, but it can be quite daunting and so I hope my personal experiences are of some use.

Cheers Daxiemad xxxxx

BelleBea in reply to Daxiemad12 years ago

Thank you for the info. Very useful. My doc never mentioned high energy drinks or caffeine and certainly never suggested measuring my levels. I am new to this site and determined to try 'self managing' my condition so. I am very grateful for help from such well informed people.

Bellebea ( name also inspired by pet dog!)

Daxiemad12 years ago

Hi again Bellebea, it is a must to measure your levels when you first start Theophylline, in respect to the high energy caffeine drinks, it isn't general medical advice but I know fellow users of the drug and a close friend made the mistake.

Cheers Daxiemad

2malinka9 years ago

I have just been prescribed this drug aminophylline 225 mg and I am feeling a little nauseous. The consultant did warn me about this. Hopefully it will be worth it if it makes my breathing easier.

Cheers

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