Oxtriphylline
Mechanism :
After ingestion, theophylline is released from oxtriphylline, and theophylline relaxes the smooth muscle of the bronchial airways and pulmonary blood vessels and reduces airway responsiveness to histamine, methacholine, adenosine, and allergen. Theophylline competitively inhibits type III and type IV phosphodiesterase (PDE), the enzyme responsible for breaking down cyclic AMP in smooth muscle cells, possibly resulting in bronchodilation. Theophylline also binds to the adenosine A2B receptor and blocks adenosine mediated bronchoconstriction. In inflammatory states, theophylline activates histone deacetylase to prevent transcription of inflammatory genes that require the acetylation of histones for transcription to begin.
Indication :
Contraindications :
Stomach ulcer; seizures; high blood pressure, a heart condition, or any type of heart disease; fluid in your lungs; a thyroid condition; liver disease; or kidney disease.
Dosing :
1-9 years:
6.2 mg/kg orally every 6 hours.
9-16 years:
4.7 mg/kg orally every 6 hours.
Adverse Effect :
Seizures, arrhythmias, nausea, decreased appetite, weight loss, restlessness, tremor, insomnia, headache, light-headedness, dizziness.
Interaction :
Aciclovir: Aciclovir may increase the effect and toxicity of oxtriphylline.
Adenosine: This xanthine decreases the effect of adenosine.
Barbiturates: Decreases the effect of oxtriphylline.
Atracurium: Theophylline decreases the effect of muscle relaxant.
Carbamazepine: May decrease the serum concentration of oxtriphylline.
Carteolol: Antagonism of action and increased effect of theophylline.
Cimetidine: Cimetidine may increase the serum concentration of oxtriphylline by decreasing its metabolism.
Ciprofloxacin, Clarithromycin, Disulfiram, Erythromycin, Ethinyl estradiol Enoxacin, Fluvoxamine, Grepafloxacin: May increase the effect and toxicity of oxtriphylline.
Doxacurium chloride: Theophylline decreases the effect of muscle relaxant.
Ethotoin, Fosphenytoin: Decreased effect of both products.
Halothane: Increased risk of cardiac arrhythmia.
Interferon Alfa-2a, Recombinant: Interferon increases the effect and toxicity of theophylline.
Interferon Alfa-2b, Recombinant: Interferon increases the effect and toxicity of theophylline.
Interferon Alfa-n1: Interferon increases the effect and toxicity of theophylline.
Isoniazid: Isoniazid may increase the effect and toxicity of oxtriphylline.
Josamycin: The macrolide, josamycin, may increase the effect and toxicity of the theophylline derivative, oxtriphylline.
Lithium: Theophylline decreases serum levels of lithium.
Mephenytoin: Decreased effect of both products.
Mestranol: The contraceptive increases the effect and toxicity of theophylline.
Methohexital: The barbiturate, methohexital, decreases the effect of oxtriphylline.
Methylphenobarbital: The barbiturate, methylphenobarbital, decreases the effect of oxtriphylline.
Metocurine: Theophylline decreases the effect of muscle relaxant.
Mexiletine: Mexiletine increases the effect and toxicity of theophylline.
Mivacurium: Theophylline decreases the effect of muscle relaxant.
Nadolol: Antagonism of action and increased effect of theophylline.
Norfloxacin: Norfloxacin may increase the effect of oxtriphylline.
Pancuronium: Theophylline decreases the effect of muscle relaxant.
Pefloxacin: Pefloxacin may increase the effect of oxtriphylline.
Peginterferon alfa-2a: Interferon increases the effect and toxicity of theophylline.
Peginterferon alfa-2b: Interferon increases the effect and toxicity of theophylline.
Penbutolol: Antagonism of action and increased effect of theophylline.
Pentobarbital: The barbiturate, pentobarbital, decreases the effect of oxtriphylline.
Pentoxifylline: Pentoxifylline increases the effect and toxicity of theophylline.
Phenobarbital: The barbiturate, phenobarbital, decreases the effect of oxtriphylline.
Phenytoin: Decreased effect of both products.
Pindolol: Antagonism of action and increased effect of theophylline.
Primidone: The barbiturate, primidone, decreases the effect of oxtriphylline.
Propafenone: Propafenone increases the effect of theophylline.
Propranolol: Antagonism of action and increased effect of theophylline.
Quinidine Barbiturate: The barbiturate, quinidine barbiturate, decreases the effect of oxtriphylline.
Rifampicin, Ritonavir: decreases the effect of theophylline.
Sotalol: Antagonism of action and increased effect of theophylline.
St. John's Wort: St. John's Wort decreases the effect of theophylline.
Talbutal: The barbiturate, talbutal, decreases the effect of oxtriphylline.
Terbinafine, Tacrine, Rofecoxib, Thiabendazole, Ticlopidine: Increases the effect and toxicity of theophylline.
Timolol: Antagonism of action and increased effect of theophylline.
Troleandomycin: The macrolide, troleandomycin, may increase the effect and toxicity of the theophylline derivative, oxtriphylline.
Tubocurarine & Vecuronium: Theophylline decreases the effect of muscle relaxant. Verapamil and Zileuton: Increases the effect of theophylline.
Hepatic Dose :
Oral: Dose reduction and frequent monitoring of serum theophylline concentration are required in patients with decreased hepatic function
IV: Initial: 0.2 mg/kg/hour; maximum daily dose: 400 mg/day unless serum concentrations indicate need for larger dose.