Formulary
Aminophylline: Indications, Dosing, Side Effects and Interactions
Aminophylline clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Aminophylline: Indications, Dosing, Side Effects and Interactions
Aminophylline clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Severe acute asthma in patients not previously treated with theophylline**
- **Child** (By Slow Intravenous Injection): 5 mg/kg (max. per dose 500 mg), to be followed by intravenous infusion.
- **Adult** (By Slow Intravenous Injection): 250-500 mg (max. per dose 5 mg/kg), to be followed by intravenous infusion.
**Severe acute asthma**
- **Child** (By Intravenous Infusion): 12-17 years 500-700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration.
- **Adult** (By Intravenous Infusion): 500-700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration.
- **Elderly** (By Intravenous Infusion): 300 micrograms/kg/hour, adjusted according to plasma-theophylline concentration.
**Severe acute exacerbation of chronic obstructive pulmonary disease in patients not previously treated with theophylline**
- **Adult** (By Slow Intravenous Injection): 250-500 mg (max. per dose 5 mg/kg), to be followed by intravenous infusion.
**Severe acute exacerbation of chronic obstructive pulmonary disease**
- **Adult** (By Intravenous Infusion): 500-700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration.
- **Elderly** (By Intravenous Infusion): 300 micrograms/kg/hour, adjusted according to plasma-theophylline concentration.
**Severe acute asthma in patients not previously treated with theophylline for aminophylline**
- **Child** (By slow intravenous injection): 5 mg/kg (max. per dose 500 mg), to be followed by intravenous infusion.
**Severe acute asthma for aminophylline**
- **Child 1 month-11 years** (By intravenous infusion): 1 mg/kg/hour, adjusted according to plasma-theophylline concentration.
- **Child 12-17 years** (By intravenous infusion): 500-700 micrograms/kg/hour, adjusted according to plasma-theophylline concentration.
Cautions
Arrhythmias following rapid intravenous injection; cardiac arrhythmias or other cardiac disease; elderly (increased plasma-theophylline concentration) (in adults); epilepsy; fever; hypertension; peptic ulcer; risk of hypokalaemia; thyroid disorder
Side effects
Frequency not known Abdominal pain; anxiety; arrhythmia (more common when given too rapidly by intravenous injection); confusion; delirium; diarrhoea; dizziness; electrolyte imbalance; gastrointestinal haemorrhage; gastrooesophageal reflux disease; headache; hyperthermia; hyperventilation; hypotension (more common when given too rapidly by intravenous injection); insomnia; mania; metabolic disorder; nausea; pain; palpitations; seizure (more common when given too rapidly by intravenous injection); skin reactions; tachycardia (more common when given too rapidly by intravenous injection); thirst; tremor; vertigo; visual impairment; vomiting Side-effects, further information Potentially serious hypokalaemia may result from beta 2 -agonist therapy. Particular caution is required in severe asthma, because this effect may be potentiated by concomitant treatment with theophylline and its derivatives, corticosteroids, and diuretics, and by hypoxia. Plasma-potassium concentration should therefore be monitored in severe asthma. Overdose Theophylline and related drugs in overdose can cause vomiting (which may be severe and intractable), agitation, restlessness, dilated pupils, sinus tachycardia, and hyperglycaemia. More serious effects are haematemesis, convulsions, and supraventricular and ventricular arrhythmias. Severe hypokalaemia may develop rapidly. For specific details on the management of poisoning, see Theophylline , under Emergency treatment of poisoning .
Interactions
**Other interactions (13):**
- The following drugs may increase plasma theophylline concentrations: Fluvoxamine The concomitant use of theophylline and fluvoxamine should usually be avoided.
- Lithium Aminophylline increases the excretion of lithium and may decrease its therapeutic effectiveness.
- Benzodiazepines: Theophylline may reduce the effects of benzodiazepines.
- General anaesthetics Increased risk of convulsions with ketamine; increased risk of arrhythmias with halothane Pancuronium Resistance to neuromuscular block with pancuronium has been reported in...
- Sympathomimetics Aminophylline may exhibit synergistic toxicity with ephedrine and other sympathomimetics and concurrent use may dispose the patient to cardiac arrhythmias.
- Beta-blockers Antagonism of bronchodilator effects.
Pregnancy
Neonatal irritability and apnoea have been reported. Theophylline can be taken as normal during pregnancy as it is particularly important that asthma should be well controlled during pregnancy.
Breast feeding
Present in milk-irritability in infant reported. Theophylline can be taken as normal during breast-feeding.
Hepatic impairment
Manufacturer advises caution (risk of reduced clearance). Dose adjustments Manufacturer advises maintenance dose reduction-consult product literature.
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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