Theophylline

Theophylline is a bronchodilator used in the treatment of heart failure, pulmonary edema, bronchial asthma and chronic obstructive pulmonary disease (COPD).

Availability
Theophylline is available as tablet, long-acting tablet or capsule and liquid.

How this medicine should be used
Theophylline is not FDA approved for use in veterinary medicine; however, it is a commonly accepted practice to use this medication in dogs and cats. The usual dose of theophylline in dogs is 2.25-5mg/pound every 8 hours. The usual dose in cats is 2mg/pound every 8-12 hours. When the long acting dosage forms are given to dogs, the dose is 10mg/pound every 12 hours. Give theophylline on an empty stomach, 1 hour before or 2 hours after a meal. If using the long acting form, do not chew, crush or allow to dissolve on food.

Side effects
Side effects when using theophylline include nausea, vomiting, diarrhea, central nervous system excitement, fever, rash and palpitations. Side effects usually subside with dosage adjustments and/or continued therapy.

Special precautions
Theophylline should not be used in patients allergic to this class of medication. Do not use in pregnant or lactating animals. Theophylline should be used with caution in patients with severe heart disease, liver or kidney disease, hyperthyroidism, hypertension or stomach ulcers. Certain medications such as phenobarbital and phenytoin may decrease the effect of theophylline. Certain medications such as cimetidine, erythromycin, levothyroxine and quinolone antibiotics such as Baytril may cause an increase in the effect of theophylline. Always tell your veterinarian and pharmacist what other medications your pet is taking.

In the event of an overdose
Contact your veterinarian or veterinary emergency room. Symptoms of overdose may include increased heart rate, seizures, increased temperature and death.

Storage
Keep this medication in the container it came in, tightly closed. Store this medication at room temperature, away from excess heat, light and moisture. Do not store in the bathroom. Throw away any medication that is outdated or no longer needed. Keep this medication out of the reach of children and pets.

Why is this medication prescribed?

Theophylline is used to prevent and treat wheezing, shortness of breath, and difficulty breathing caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air passages in the lungs, making it easier to breathe.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Theophylline comes as a tablet, capsule, solution, and syrup to take by mouth. It usually is taken every 6, 8, 12, or 24 hours. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take theophylline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Take this medication with a full glass of water on an empty stomach, at least 1 hour before or 2 hours after a meal. Do not chew or crush the extended-release (long-acting) tablets; swallow them whole. Extended-release capsules (e.g., Theo-Dur Sprinkles) may be swallowed whole or opened and the contents mixed with soft food and swallowed without chewing.

Theophylline controls symptoms of asthma and other lung diseases but does not cure them. Continue to take theophylline even if you feel well. Do not stop taking theophylline without talking to your doctor.

Other uses for this medicine

Theophylline is sometimes used to treat breathing problems in premature infants. Talk to your doctor about the possible risks of using this drug for your baby's condition.

What special precautions should I follow?

Before taking theophylline,

• tell your doctor and pharmacist if you are allergic to theophylline or any other drugs.
• tell your doctor and pharmacist what prescription medications you are taking, especially allopurinol (Zyloprim), azithromycin (Zithromax), carbamazepine (Tegretol), cimetidine (Tagamet), ciprofloxacin (Cipro), clarithromycin (Biaxin), diuretics ('water pills'), erythromycin, lithium (Eskalith, Lithobid), oral contraceptives, phenytoin (Dilantin), prednisone (Deltasone), propranolol (Inderal), rifampin (Rifadin), tetracycline (Sumycin), and other medications for infections or heart disease.
• tell your doctor and pharmacist what nonprescription medications and vitamins you are taking, including ephedrine, epinephrine, phenylephrine, phenylpropanolamine, or pseudoephedrine. Many nonprescription products contain these drugs (e.g., diet pills and medications for colds and asthma), so check labels carefully. Do not take these medications without talking to your doctor; they can increase the side effects of theophylline.
• tell your doctor if you have or have ever had seizures, ulcers, heart disease, an overactive or underactive thyroid gland, high blood pressure, or liver disease or if you have a history of alcohol abuse.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking theophylline, call your doctor.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of theophylline.

What special dietary instructions should I follow?

Drinking or eating foods high in caffeine, like coffee, tea, cocoa, and chocolate, may increase the side effects caused by theophylline. Avoid large amounts of these substances while you are taking theophylline.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you become severely short of breath, call your doctor.

What side effects can this medication cause?

Theophylline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away.

• upset stomach
• stomach pain
• diarrhea
• headache
• restlessness
• insomnia
• irritability

If you experience any of the following symptoms, call your doctor immediately:

• vomiting
• increased or rapid heart rate
• irregular heartbeat
• seizures
• skin rash

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to theophylline.

Do not change from one brand of theophylline to another without talking to your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

American Society of Health-System Pharmacists, Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Consumer Medication Information. Copyright, 2011. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

The following brand names are from RxNorm, a standardized nomenclature for clinical drugs produced by the National Library of Medicine:

Brand names

• Aerolate III
• Aerolate JR
• Aerolate Sr.
• Aquaphyllin
• Asmalix
• Bronkodyl
• Elixophyllin
• Quibron T-SR
• Quibron-T
• Respbid
• Slo-Phyllin
• Slo-bid
• Slo-bid Gyrocaps
• T-Phyl
• Theo-24
• Theo-Dur Sprinkle
• Theo-Time
• Theo-X
• Theobid
• Theocap
• Theochron
• Theoclear
• Theoclear-80
• Theodur
• Theolair
• Theosol-80
• Theovent
• Truxophyllin
• Uni-Dur
• Uniphyl

Brand names of combination products

• Ami-rax (containing Ephedrine, Hydroxyzine, and Theophylline)
• Asbron G (containing Guaifenesin and Theophylline)
• Bronchial brand of guaifenesin-theophylline (containing Guaifenesin and Theophylline)
• Broncodur (containing Guaifenesin and Theophylline)
• Broncomar (containing Guaifenesin, Pseudoephedrine, and Theophylline)
• Broncomar GG (containing Guaifenesin and Theophylline)
• Ed Bron G (containing Guaifenesin and Theophylline)
• Elixophyllin KI (containing Potassium Iodide and Theophylline)
• Elixophyllin-GG (containing Guaifenesin and Theophylline)
• Equibron G (containing Guaifenesin and Theophylline)
• Glyceryl T (containing Guaifenesin and Theophylline)
• H-Quib (containing Guaifenesin and Theophylline)
• Hydrophed (containing Ephedrine, Hydroxyzine, and Theophylline)
• Marax (containing Ephedrine, Hydroxyzine, and Theophylline)
• Primatene Dual Action (containing Ephedrine, Guaifenesin, and Theophylline)
• Q-B (containing Guaifenesin and Theophylline)
• Quadrinal (containing Ephedrine, Phenobarbital, Potassium Iodide, and Theophylline)
• Quibron (containing Guaifenesin and Theophylline)
• Quibron 300 (containing Guaifenesin and Theophylline)
• Slo-Phyllin GG (containing Guaifenesin and Theophylline)
• Solu-Phyllin GG (containing Guaifenesin and Theophylline)
• Tedrigen (containing Ephedrine, Phenobarbital, and Theophylline)
• Theo G (containing Guaifenesin and Theophylline)
• Theocon (containing Guaifenesin and Theophylline)
• Theodrine (containing Ephedrine, Phenobarbital, and Theophylline)
• Theolate (containing Guaifenesin and Theophylline)
• Theomar G.G. (containing Guaifenesin and Theophylline)
• Theomax (containing Ephedrine, Hydroxyzine, and Theophylline)
• Theophyll-GG (containing Guaifenesin and Theophylline)
• Uni Bronchial (containing Guaifenesin and Theophylline)