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Pronunciation
(am in OFF i lin)
Generic Available (U.S.)
Yes
Index Terms
Canadian Brand Names
Pharmacologic Category
Use: Labeled Indications
Treatment of symptoms and reversible airway obstruction due to asthma or other chronic lung diseases (eg, emphysema, chronic bronchitis)
Note: The National Heart, Lung, and Blood Institute Guidelines (2007) do not recommend aminophylline I.V. for the treatment of asthma exacerbations.
Use: Unlabeled/Investigational
Reversal of adenosine-, dipyridamole-, or regadenoson-induced adverse reactions (eg, angina, hypotension) during nuclear cardiac stress testing
Pregnancy Risk Factor
C
Pregnancy Considerations
Refer to Theophylline monograph.
Lactation
Enters breast milk
Breast-Feeding Considerations
Refer to Theophylline monograph.
Contraindications
Hypersensitivity to theophylline, ethylenediamine, or any component of the formulation
Canadian labeling: Additional contraindications (not in U.S. labeling): Coronary artery disease where cardiac stimulation might prove harmful; patients with peptic ulcer disease
Warnings/Precautions
Concerns related to adverse effects:
• Theophylline toxicity: If a patient develops signs and symptoms of theophylline toxicity (eg, persistent, repetitive vomiting), a serum level should be measured and subsequent doses held. Theophylline clearance may be decreased in patients with acute pulmonary edema, congestive heart failure, cor pulmonale, fever, hepatic disease, acute hepatitis, cirrhosis, hypothyroidism, sepsis with multiorgan failure, and shock; clearance may also be decreased in neonates, infants <3 months of age with decreased renal function, children <1 year of age, the elderly >60 years, and patients following cessation of smoking.
Disease-related concerns:
• Cardiovascular disease: Use with caution in patients with hypertension or cardiac arrhythmias (excluding bradyarrhythmias).
• Hyperthyroidism: Use with caution in patients with hyperthyroidism.
• Peptic ulcer disease: Use with caution in patient with peptic ulcer disease (use is contraindicated in the Canadian labeling).
• Seizure disorder: Use with caution in patients with a history of seizure disorder.
Other warnings/precautions:
• Dosage adjustments: Due to potential saturation of theophylline clearance at serum levels within (or in some patients less than) the therapeutic range, dosage adjustment should be made in small increments (maximum: 25% dose increase).
• Monitoring: Due to wide interpatient variability, theophylline serum level measurements must be used to optimize therapy and prevent serious toxicity.
Adverse Reactions
Frequency not defined. Adverse events observed at therapeutic serum levels:
Cardiovascular: Flutter, tachycardia
Central nervous system: Behavior alterations (children), headache, insomnia, irritability, restlessness, seizures
Dermatologic: Allergic skin reactions, exfoliative dermatitis
Gastrointestinal: Diarrhea, nausea, vomiting
Neuromuscular & skeletal: Tremor
Renal: Diuresis (transient)
Metabolism/Transport Effects
Substrate of CYP1A2 (major), 2E1 (minor), 3A4 (minor)
Drug Interactions
Abiraterone Acetate: May increase the serum concentration of CYP1A2 Substrates. Risk C: Monitor therapy
Adenosine: Theophylline Derivatives may diminish the therapeutic effect of Adenosine. Risk D: Consider therapy modification
Allopurinol: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Aminoglutethimide: May increase the metabolism of Theophylline Derivatives. Risk C: Monitor therapy
Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Barbiturates: May decrease the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Benzodiazepines: Theophylline Derivatives may diminish the therapeutic effect of Benzodiazepines. Risk D: Consider therapy modification
Beta-Blockers (Beta1 Selective): May diminish the bronchodilatory effect of Theophylline Derivatives. Management: Monitor for reduced theophylline efficacy during concomitant use with any beta-blocker. Beta-1 selective agents are less likely to antagonize theophylline than nonselective agents, but selectivity may be lost at higher doses. Risk C: Monitor therapy
Beta-Blockers (Nonselective): May diminish the bronchodilatory effect of Theophylline Derivatives. Risk D: Consider therapy modification
Cannabinoids: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
CarBAMazepine: Theophylline Derivatives may decrease the serum concentration of CarBAMazepine. CarBAMazepine may decrease the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Cimetidine: May decrease the metabolism of Theophylline Derivatives. Risk D: Consider therapy modification
Contraceptives (Estrogens): May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
CYP1A2 Inducers (Strong): May increase the metabolism of CYP1A2 Substrates. Risk C: Monitor therapy
CYP1A2 Inhibitors (Moderate): May decrease the metabolism of CYP1A2 Substrates. Risk C: Monitor therapy
CYP1A2 Inhibitors (Strong): May decrease the metabolism of CYP1A2 Substrates. Risk D: Consider therapy modification
Deferasirox: May increase the serum concentration of CYP1A2 Substrates. Risk C: Monitor therapy
Disulfiram: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Febuxostat: May increase serum concentrations of the active metabolite(s) of Theophylline Derivatives. Specifically, concentrations of 1-methylxanthine, a metabolite of unknown clinical importance, may become elevated. Management: The U.S. febuxostat labeling recommends using caution in patients receiving concomitant theophylline due to risks of increased theophylline metabolite exposure. The Canadian febuxostat labeling contraindicates its use with theophylline. Risk C: Monitor therapy
FluvoxaMINE: May decrease the metabolism of Theophylline Derivatives. Risk D: Consider therapy modification
Formoterol: Theophylline Derivatives may enhance the adverse/toxic effect of Formoterol. Theophylline Derivatives may enhance the hypokalemic effect of Formoterol. Risk C: Monitor therapy
Fosphenytoin: Theophylline Derivatives may decrease the serum concentration of Fosphenytoin. Fosphenytoin may decrease the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Interferons: May decrease the metabolism of Theophylline Derivatives. Risk C: Monitor therapy
Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. Risk X: Avoid combination
Isoniazid: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Isoproterenol: May decrease the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Lithium: Theophylline Derivatives may decrease the serum concentration of Lithium. Risk C: Monitor therapy
Macrolide Antibiotics: May decrease the metabolism of Theophylline Derivatives. Exceptions: Azithromycin; Azithromycin (Systemic); Spiramycin; Telithromycin. Risk D: Consider therapy modification
Methotrexate: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Mexiletine: May decrease the metabolism of Theophylline Derivatives. Risk D: Consider therapy modification
Pancuronium: Theophylline Derivatives may enhance the adverse/toxic effect of Pancuronium. Theophylline Derivatives may diminish the neuromuscular-blocking effect of Pancuronium. Management: Pancuronium dosage adjustment may be necessary to induce paralysis in patients receiving concomitant theophylline derivatives. Monitor closely for adverse effects (e.g., cardiac effects) with concomitant use of these agents. Risk D: Consider therapy modification
Pentoxifylline: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Phenytoin: Theophylline Derivatives may decrease the serum concentration of Phenytoin. Phenytoin may decrease the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Propafenone: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Protease Inhibitors: May decrease the serum concentration of Theophylline Derivatives. Exceptions: Fosamprenavir. Risk C: Monitor therapy
QuiNINE: May increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Quinolone Antibiotics: May decrease the metabolism of Theophylline Derivatives. Ciprofloxacin and enoxacin are of greatest concern. Theophylline/quinolone therapy might augment the seizure-producing potential of each of the individual agents. Exceptions: Gemifloxacin; Levofloxacin; Levofloxacin (Systemic); Lomefloxacin; Moxifloxacin; Moxifloxacin (Systemic); Nalidixic Acid; Sparfloxacin. Risk D: Consider therapy modification
Regadenoson: Aminophylline may diminish the vasodilatory effect of Regadenoson. Risk D: Consider therapy modification
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy
Thiabendazole: May decrease the metabolism of Theophylline Derivatives. Risk D: Consider therapy modification
Thyroid Products: May increase the metabolism of Theophylline Derivatives. Risk C: Monitor therapy
Ticlopidine: May decrease the metabolism of Theophylline Derivatives. Risk C: Monitor therapy
Zafirlukast: Theophylline Derivatives may decrease the serum concentration of Zafirlukast. Zafirlukast may increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Food: Food does not appreciably affect absorption. Avoid extremes of dietary protein and carbohydrate intake. Changes in diet may affect the elimination of theophylline; charcoal-broiled foods may increase elimination, reducing half-life by 50%. Ethanol may decrease theophylline clearance.
Storage
Solution: Vials should be stored at room temperature of 20°C to 25°C (68°F to 77°F). Protect from light. Do not use solutions if discolored or if crystals are present.
Tablets, immediate release: Store at room temperature of 20°C to 25°C (68°F to 77°F). Protect from light and moisture.
Tablets, sustained release (Canadian labeling, not available in the U.S.): Store at <30°C (<86°F).
Compatibility
Stable in dextran 6% in D5W, dextran 6% in NS, D5LR, D5NS, D51/2NS, D51/4NS, D5W, D10W, D20W, LR, 1/2NS, NS; variable stability (consult detailed reference) in fat emulsion 10%.
Y-site administration: Compatible: Allopurinol, amifostine, amphotericin B cholesteryl sulfate complex, aztreonam, ceftazidime, cimetidine, cladribine, docetaxel, doxorubicin liposome, enalaprilat, esmolol, etoposide, famotidine, filgrastim, fluconazole, fludarabine, foscarnet, gemcitabine, granisetron, heparin with hydrocortisone sodium succinate, inamrinone, labetalol, levofloxacin, linezolid, melphalan, meropenem, morphine, paclitaxel, pancuronium, piperacillin/tazobactam, potassium chloride, propofol, ranitidine, remifentanil, sargramostim, tacrolimus, teniposide, thiotepa, vecuronium, vitamin B complex with C. Incompatible: Amiodarone, ciprofloxacin, clarithromycin, dobutamine, hydralazine, ondansetron, vinorelbine, warfarin. Variable (consult detailed reference): Cisatracurium, diltiazem.
Compatibility in syringe: Compatible: Heparin, metoclopramide, pentobarbital, thiopental. Incompatible: Doxapram.
Compatibility when admixed: Compatible: Amobarbital, bretylium, calcium gluconate, chloramphenicol, cimetidine, dexamethasone, diphenhydramine, dopamine, erythromycin lactobionate, esmolol, floxacillin, flumazenil, furosemide, heparin, hydrocortisone sodium succinate, lidocaine, meropenem, methyldopate, metronidazole with sodium bicarbonate, nitroglycerin, pentobarbital, phenobarbital, potassium chloride, ranitidine, sodium bicarbonate, terbutaline. Incompatible: Atracurium, bleomycin, cefepime, ceftazidime, ceftriaxone, chlorpromazine, ciprofloxacin, clindamycin, dobutamine, doxorubicin, epinephrine, hydralazine, hydrocortisone sodium succinate with cephalothin sodium, hydroxyzine, insulin (regular), isoproterenol, levorphanol, meperidine, morphine, norepinephrine, papaverine with trimecaine, penicillin G potassium, pentazocine, prochlorperazine edisylate, prochlorperazine mesylate, promazine, promethazine, vitamin B complex with C. Variable (consult detailed reference): Amikacin, ascorbic acid, corticotropin, dimenhydrinate, methylprednisolone sodium succinate, nafcillin, procaine, vancomycin, verapamil, zinc.
Mechanism of Action
Causes bronchodilatation, diuresis, CNS and cardiac stimulation, and gastric acid secretion by blocking phosphodiesterase which increases tissue concentrations of cyclic adenine monophosphate (cAMP) which in turn promote catecholamine stimulation of lipolysis, glycogenolysis, and gluconeogenesis and induce release of epinephrine from adrenal medulla cells
Pharmacodynamics/Kinetics
Theophylline:
Absorption: Oral: Immediate release tablet: Rapid and complete
Distribution: 0.45 L/kg based on ideal body weight
Protein binding: 40%, primarily to albumin
Metabolism: Children >1 year and Adults: Hepatic; involves CYP1A2, 2E1, and 3A4; forms active metabolites (caffeine and 3-methylxanthine)
Half-life elimination: Highly variable and dependent upon age, liver function, cardiac function, lung disease, and smoking history
Premature infants, postnatal age 3-15 days: 30 hours (range: 17-43 hours)
Premature infants, postnatal age 25-57 days: 20 hours (range: 9.4-30.6 hours)
Children 1-4 yrs: 3.4 hours (range: 1.2-5.6 hours); 6-17 years: 3.7 hours (range: 1.5-5.9 hours)
Adults 16-60 years with asthma, nonsmoking, otherwise healthy: 8.7 hours (range: 6.1-12.8 hours)
Time to peak, serum:
Oral: Immediate release tablet: 1-2 hours; Sustained release tablet (Canadian labeling; not available in U.S.): 4-5 hours
I.V.: Within 30 minutes
Excretion: Children >3 months and Adults: Urine (10% as unchanged drug)
Dosage
Note: Doses should be individualized based on peak serum concentrations and should be based on ideal body weight. Theophylline dose is 80% of aminophylline dose.
Acute symptoms: Loading dose: Oral, I.V.:
Patients not currently receiving aminophylline or theophylline: Aminophylline 5.7 mg/kg (equivalent to theophylline 4.6 mg/kg) administered I.V. or theophylline 5 mg/kg administered orally
Patients currently receiving aminophylline or theophylline: A loading dose is not recommended without first obtaining a serum theophylline concentration in patients who have received aminophylline or theophylline within the past 24 hours. The loading dose should be calculated as follows:
Dose = (desired serum theophylline concentration - measured serum theophylline concentration) (Vd)
Acute symptoms: Maintenance dose: I.V.: Note: To achieve a target theophylline concentration of 10 mcg/mL unless otherwise noted. Lower initial doses may be required in patients with reduced theophylline clearance. Dosage should be adjusted according to serum level measurements during the first 12- to 24-hour period.
Infants 6-52 weeks: Equivalent theophylline dose: mg/kg/hour = (0.008) (age in weeks) + 0.21
Children 1-9 years: 1.01 mg/kg/hour (equivalent to theophylline 0.8 mg/kg/hour)
Children 9-12 years: 0.89 mg/kg/hour (equivalent to theophylline 0.7 mg/kg/hour)
Adolescents 12-16 years (cigarette or marijuana smokers): 0.89 mg/kg/hour (equivalent to theophylline 0.7 mg/kg/hour)
Adolescents 12-16 years (nonsmokers): 0.63 mg/kg/hour (equivalent to theophylline 0.5 mg/kg/hour); maximum: 900 mg/day unless serum levels indicate need for larger dose
Adults 16-60 years (otherwise healthy, nonsmokers): 0.51 mg/kg/hour (equivalent to theophylline 0.4 mg/kg/hour); maximum: 900 mg/day unless serum levels indicate need for larger dose
Adults >60 years: 0.38 mg/kg/hour (equivalent to theophylline 0.3 mg/kg/hour); maximum: 400 mg/day unless serum levels indicate need for larger dose
Dosage adjustment for cardiac decompensation, cor pulmonale, hepatic dysfunction, sepsis with multiorgan failure, shock: 0.25 mg/kg hour (equivalent to theophylline 0.2 mg/kg/hour); maximum: 400 mg/day unless serum levels indicate need for larger dose
Dosage adjustment after serum theophylline measurement:
Within normal limits: Asthma: 5-15 mcg/mL: Maintain dosage if tolerated. Recheck serum theophylline concentration at 24-hour intervals (for acute I.V. dosing) or at 6- to 12-month intervals (for oral dosing). Finer adjustments in dosage may be needed for some patients. If levels ≥15 mcg/mL, consider 10% dose reduction to improve safety margin.
Too high:
20-24.9 mcg/mL: Decrease dose by ~25%. Recheck serum theophylline concentrations (see "Note").
25-30 mcg/mL: Skip next dose (oral) or stop infusion for 12 hours (children) or 24 hours (adults) and decrease subsequent doses by ~25%. Recheck serum theophylline concentrations (see "Note").
>30 mcg/mL: Stop dosing and treat overdose; if resumed, decrease subsequent doses by 50%. Recheck serum theophylline concentrations (see "Note").
Too low: <9.9 mcg/mL: If tolerated, but symptoms remain, increase dose by ~25%. Recheck serum theophylline concentrations (see "Note").
Note: Recheck serum theophylline levels after 3 days when using oral dosing, or after 12 hours (children) or 24 hours (adults) when dosing intravenously. Patients maintained with oral therapy may be reassessed at 6- to 12-month intervals.
Chronic conditions: Oral:
Immediate release tablets:
Note: Increase dose only if tolerated. Consider lowering dose or using a slower titration if caffeine-like adverse events occur. Smaller doses given more frequently may be used in patients with a more rapid metabolism to prevent breakthrough symptoms which could occur due to low trough concentration prior to the next dose.
Children 1-15 years and <45 kg without risk factors for impaired theophylline clearance:
Aminophylline 15.2-17.7 mg/kg/day (equivalent to theophylline 12-14 mg/kg/day) in divided doses every 4-6 hours for 3 days (maximum daily dose: aminophylline 380 mg/day, equivalent to theophylline 300 mg/day);
Then increase to 20.3 mg/kg/day (equivalent to theophylline 16 mg/kg/day) in divided doses every 4-6 hours for 3 days (maximum dose: aminophylline 507 mg/day, equivalent to theophylline 400 mg/day)
Maintenance dose: 25.3 mg/kg/day (equivalent to theophylline 20 mg/kg/day) in divided doses every 4-6 hours (maximum dose: aminophylline 760 mg/day, equivalent to theophylline 600 mg/day)
Note: Dose adjustment in patients with risk factors for impaired theophylline clearance and patients in whom monitoring serum theophylline levels is not feasible: Do not exceed a dose of aminophylline 20.3 mg/kg/day (equivalent to theophylline 16 mg/kg/day). (Maximum dose: Aminophylline 507 mg/day, equivalent to theophylline 400 mg/day)
Children >45 kg and Adults 16-60 years without risk factors for impaired theophylline clearance:
Aminophylline 380 mg/day (equivalent to theophylline 300 mg/day) in divided doses every 6-8 hours for 3 days;
Then increase to 507 mg/day (equivalent to theophylline 400 mg/day) in divided doses every 6-8 hours for 3 days
Maintenance dose: 760 mg/day (equivalent to theophylline 600 mg/day) in divided doses every 6-8 hours
Note: Dose adjustment in patients with risk factors for impaired theophylline clearance and patients in whom monitoring serum theophylline levels is not feasible: Do not exceed a dose of aminophylline 507 mg/day (equivalent to theophylline 400 mg/day)
Adults >60 years: Refer to adult dosing. Do not exceed a dose of aminophylline 507 mg/day (equivalent to theophylline 400 mg/day)
Sustained release tablets: Canadian labeling: Children ≥12 years and Adults: Initial: 1 tablet (225-350 mg) every 12 hours (equivalent to theophylline 182.25-283.5 mg every 12 hours); may increase dose by 1/2 tablet per dose at 3- to 4-day intervals; maximum dose: 1125 mg/day (equivalent to theophylline 900 mg/day); do not exceed maximum dose without monitoring theophylline concentrations.
Reversal of adenosine-, dipyridamole-, or regadenoson-induced adverse reactions (eg, angina, hypotension) during nuclear cardiac stress testing (unlabeled use): Adults: I.V.: 50-250 mg administered over 30-60 seconds, repeat as necessary. Note: Since adenosine-induced side effects are short lived after discontinuation of the infusion, aminophylline administration is only very rarely required.
Administration: Oral
Tablet, immediate release: If dose is missed, administer the next dose at the scheduled time (do not make up missed dose).
Tablet, sustained release (Canadian labeling, not available in the U.S.): Administer every 12 hours with a full glass of water. Patient should be in the standing or sitting position. Tablets may be halved, however do not crush, chew or dissolve. Evening dose should be administered with or shortly following the evening meal. May administer a missed dose if within 4 hours of scheduled dosing time.
Administration: I.M.
Not recommended
Administration: I.V.
Loading doses should be administered I.V. over 30 minutes. Infusion rate should not exceed 21 mg/hour (equivalent to theophylline 17 mg/hour) in patients with cor pulmonale, cardiac decompensation, liver dysfunction, patients >60 years, or patients taking medications which reduce theophylline clearance.
For reversal of adenosine-, dipyridamole-, or regadenoson-induced adverse events during nuclear cardiac stress testing, administer I.V. undiluted over 30-60 seconds, repeat as necessary. Since adenosine-induced side effects are short lived after discontinuation of the infusion, aminophylline administration is only very rarely required.
Monitoring Parameters
Monitor heart rate; CNS effects (insomnia, irritability); respiratory rate (COPD patients often have resting controlled respiratory rates in low 20s); arterial or capillary blood gases (if applicable)
Theophylline levels: Serum theophylline levels should be monitored prior to making dose increases; in the presence of signs or symptoms of toxicity; or when a new illness, worsening of a present illness, or medication changes occur that may change theophylline clearance
I.V. loading dose: Measure serum concentrations 30 minutes after the end of an I.V. loading dose
I.V. infusion: Measure serum concentrations one half-life after starting a continuous infusion, then every 12-24 hours
Reference Range
Therapeutic levels: Asthma: 5-15 mcg/mL (peak level)
Toxic concentration: >20 mcg/mL
Test Interactions
Plasma glucose, uric acid, free fatty acids, total cholesterol, HDL, HDL/LDL ratio, and urinary free cortisol excretion may be increased by theophylline. Theophylline may decrease triiodothyronine.
Geriatric Considerations
Although there is a great intersubject variability for half-lives of methylxanthines (2-10 hours), elderly, as a group, have slower hepatic clearance. Therefore, use lower initial doses and monitor closely for response and adverse reactions. Additionally, elderly patients are at greater risk for toxicity due to concomitant disease (eg, congestive heart failure, arrhythmias), and drug use (eg, cimetidine, ciprofloxacin, etc).
Additional Information
Aminophylline is a 2:1 complex of theophylline and ethylenediamine.
Cardiovascular Considerations
Theophylline results in significant tachycardia and, at higher doses, may impair ventricular rate control in patients with atrial fibrillation. This is particularly a concern since patients with underlying chronic obstructive lung disease often have coexisting atrial fibrillation. Aminophylline can be used to treat patients who have adverse hemodynamic responses to adenosine, dipyridamole or regadenoson, when used during cardiovascular stress testing. Since adenosine-induced side effects are short lived after discontinuation of the infusion, aminophylline administration is only very rarely required.
Dental Health: Effects on Dental Treatment
Prescribe erythromycin products with caution to patients taking theophylline products. Erythromycin will delay the normal metabolic inactivation of theophyllines leading to increased blood levels; this has resulted in nausea, vomiting, and CNS restlessness.
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause nervousness or restlessness
Mental Health: Effects on Psychiatric Treatment
Carbamazepine and barbiturates may decrease aminophylline levels; disulfiram and propranolol may increase aminophylline levels
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Injection, solution, as dihydrate: 25 mg/mL (10 mL, 20 mL)
Injection, solution, as dihydrate [preservative free]: 25 mg/mL (10 mL, 20 mL)
Tablet, oral, as dihydrate: 100 mg, 200 mg
Pricing: U.S. (www.drugstore.com)
Tablets (Aminophylline)
100 mg (30): $12.99
200 mg (90): $18.99
References
American Society of Nuclear Cardiology, “Imaging Guidelines for Nuclear Cardiology Procedures: A Report of The American Society of Nuclear Cardiology Quality Assurance Committee,” J Nucl Cardiol, 2006, 13(6):e21-171.
Cummins LH, et al, “Erythromycin's Effect on Theophylline Blood Levels. Correspondence,” Pediatrics, 1977, 59:144-5.
Delaforge M and Sartori E, “In Vivo Effects of Erythromycin, Oleandomycin, and Erythralosamine Derivatives on Hepatic Cytochrome P450,” Biochem Pharmacol, 1990, 40(2):223-8.
Homma S, Gilliland Y, Guiney TE, et al,“Safety of Intravenous Dipyridamole for Stress Testing With Thallium Imaging,” Am J Cardiol, 1987, 59(1):152-4.
Klocke FJ, Baird MG, Lorell BH, et al, “ACC/AHA/ASNC Guidelines for the Clinical Use of Cardiac Radionuclide Imaging: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging),” J Am Coll Cardiol, 2003, 42(7):1318-33.
Ludden TM, “Pharmacokinetic Interactions of the Macrolide Antibiotics,” Clin Pharmacokinet, 1985, 10(1):63-79.
National Asthma Education and Prevention Program (NAEPP), “Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma,” Clinical Practice Guidelines, National Institutes of Health, National Heart, Lung, and Blood Institute, NIH Publication No. 08-4051, prepublication 2007. Available at http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
Ranhosky A and Kempthorne-Rawson J, “The Safety of Intravenous Dipyridamole Thallium Myocardial Perfusion Imaging. Intravenous Dipyridamole Thallium Imaging Study Group,” Circulation, 1990, 81(4):1205-9.
International Brand Names
Lexi-Comp.com
Last full review/revision June 2011
Content last modified June 2011
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