Drug Profile

Pregnancy Warning

Theophylline caused malformations and death in developing fetuses in animal studies. Because of the potential for serious adverse effects to the fetus, these drugs should not be used by pregnant women.

Breast-Feeding Warning

Theophylline is excreted in human milk. The concentration of theophylline in breast milk is the same as the serum concentration of the mother. Newborns and children under one year are at increased risk. Because of the potential for serious adverse effects in nursing infants, you should not take these drugs while nursing.

Do not stop any asthma medication without first consulting your physician. Abruptly stopping a medication may result in acutely deteriorating asthma control.

Additional Precautions for Asthma

Avoid exposure to things that trigger your allergies or asthma, such as animals, bedding, chemicals, cosmetics, drugs, dust, mold, foods, pollens, or smoke. Wearing a mask reduces inhalation of drugs, pollens, and smoke.

Aspirin can trigger asthma in people who are aspirin-allergic, as can beta-blockers. Infections aggravate lung problems. During epidemics of respiratory illnesses, avoid crowded places and wash your hands frequently to help prevent infection. If you have asthma, get a flu vaccination.

Note: The information in this profile addresses the care of asthma that is not serious enough to need emergency treatment.

Warning

Extreme caution should be used when fluoroquinolones such as ciprofloxacin (CILOXAN, CIPRO), enoxacin (PENETREX), lomefloxacin (MAXAQUIN), norfloxacin (CHIBROXIN, NOROXIN), and ofloxacin (FLOXIN, OCUFLOX) are to be prescribed in conjunction with aminophylline or theophylline, particularly in elderly patients. Aminophylline doses should be adjusted, perhaps reduced by 30 to 50% at the start of fluoroquinolone therapy. The reduction in dose must be guided by the clinical conditions of the patient, the use of other medications, and the baseline level of the aminophylline in the blood. In addition, blood aminophylline levels should be obtained following the initiation of a fluoroquinolone no later than two days into therapy.

Tell your doctor if you have or have had:

• an allergy to caffeine or any other xanthine, such as theobromine (found in chocolate or theophylline)
• rapid heartbeat
• heart failure
• pregnancy or are breast-feeding
• stomach inflammation
• ulcers
• gastroesophageal reflux
• prolonged fever
• respiratory infections
• seizures
• liver problems
• underactive thyroid

Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.

• Do not use more often or in a higher dose than prescribed by your doctor. Do not change brands or dosage forms without checking with your doctor or pharmacist first.
• See your doctor regularly to check on progress.
• Reduce your intake of charcoal-broiled foods and foods that contain caffeine, such as chocolate, cocoa, tea, coffee, and colas.
• Call your doctor immediately if you get a fever because this increases your chance of developing adverse effects from the drug.
• Notify your doctor if you have started or stopped other medicines, started or stopped smoking, or made an extended change in your diet.
• If you plan to have any surgery, including dental surgery, tell your doctor that you take this drug.

• If you miss a dose, take it as soon as you remember, but skip it if it is almost time for the next dose. Do not take double doses.
• Do not share your medication with others.
• Take the drug at the same time(s) each day.
• For liquids and immediate-release capsules or tablets: Take on an empty stomach with a glass of water. If the drug upsets your stomach, take with food instead.
• For once-a-day dosage forms: Take either in the morning at least one hour before eating or in the evening without food. Be consistent as to whether you take with or without food.
• For enteric-coated tablets or delayed-release tablets: Swallow whole.
• For extended-release forms: Capsules may be opened and the contents mixed with applesauce, jelly, or ketchup, then swallowed without chewing.
• Do not store in the bathroom. Do not expose to heat, moisture, or strong light. Keep out of reach of children.

The following drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods are listed in Evaluations of Drug Interactions 2003 as causing “highly clinically significant” or “clinically significant” interactions when used together with any of the drugs in this section. In some sections with multiple drugs, the interaction may have been reported for one but not all drugs in this section, but we include the interaction because the drugs in this section are similar to one another. We have also included potentially serious interactions listed in the drug’s FDA-approved professional package insert or in published medical journal articles. There may be other drugs, especially those in the families of drugs listed below, that also will react with this drug to cause severe adverse effects. Make sure to tell your doctor and pharmacist the drugs you are taking and tell them if you are taking any of these interacting drugs:

adenosine, alcohol, allopurinol, aminoglutethimide, ANTABUSE, ANTURANE, ATAVAN, BIAXIN, caffeine, CALAN, carbamazepine, charcoal, CIPRO, ciprofloxacin, clarithromycin, COGNEX, CYTADREN, DALMANE, diazepam, DILANTIN, dipyridamole, disulfiram, EES, enoxacin, erythromycin, estrogen-containing oral contraceptives, ETHOZINE, FLUOTHANE, flurazepam, fluvoxamine, halothane, Hypericum perforatum, INDERAL, interferon alpha, INTRON A, KETALAR, ketamine, lithium, LITHOBID, lorazepam, LUMINAL, LUVOX, methotrexate, mexiletine, MEXITIL, MINTEZOL, modafinil, moricizine, NORVIR, pancuronium, PAVULON, PENETREX, pentoxifylline, PERSANTINE, phenobarbital, phenytoin, propafenone, propranolol, PROVIGIL, RIFADIN, rifampin, ritonavir, ROFERON-A, RYTHMOL, St. John’s wort, sulfinpyrazone, tacrine, TAO, TEGRETOL, thiabendazole, TICLID, ticlopidine, TRENTAL, troleandomycin, VALIUM, verapamil, VERELAN, ZYLOPRIM.

Call your doctor immediately if you experience:

• heartburn and/or vomiting
• skin rash or hives (aminophylline)

Call your doctor if these symptoms continue:

• headache
• fast heartbeat
• trouble sleeping
• increased urination
• anxiety
• nausea, vomiting
• nervousness
• trembling

Signs of overdose:

• dark or bloody vomit, continuing vomiting
• severe or continuing abdominal pain
• continuing nervousness or restlessness
• confusion or change in behavior
• diarrhea
• dizziness or lightheadedness
• convulsions
• fast and irregular heartbeat
• trembling

If you suspect an overdose, call this number to contact your poison control center: (800) 222-1222.

Ask your doctor which of these tests should be done periodically while you are taking this drug:

• blood levels of aminophylline or theophylline
• lung function tests
• caffeine concentrations