Dangerous Drug Interaction: Theophylline-Quinolones
aminophylline (Phyllocontin)
oxtriphylline (Choledyl SA)
theophylline (Accurbron, Aquaphyllin, Asmalix, Bronkodyl, Elixomin, Elixophyllin, Lanophyllin, Quibron T Dividose, Quibron-T/SR Dividose, Respbid, Slo-Bid Gyrocaps, Slo-Phyllin, Slo-Phyllin 125, Slo-Phyllin Gyrocaps, Sustaire, Theo-24, Theo-Dur, Theo-Sav, Theo-X, Theobid Duracaps, Theochron, Theoclear-80, Theoclear LA, Theocron, Theolair, Theolair-SR, Theospan-SR, Theostat 80, Theovent, T-Phyl, Uni-Dur, Uniphyl, Uniphyl CR) |
alatrofloxacin (Tolectin, Tolectin DS)
cinoxacin (Cinobac)
ciprofloxacin (Cipro)
enoxacin (Penetrex)
gatifloxacin (Tequin)
levofloxacin (Levaquin)
lomefloxacin (Maxaquin)
moxifloxacin (Avelox)
nalidixic acid (NegGram)
norfloxacin (Noroxin)
ofloxacin (Floxin)
sparfloxacin (Zagam)
trovafloxacin (Trovan, Trovan IV) |
| Brand names appear in parentheses above and are trademarks of their respective manufacturers/owners. |
Impact: Potential for theophylline toxicity.1
Mechanism of Interaction: Inhibit hepatic metabolism of theophylline.
Alternatives to Patient Management: Obtain theophylline level prior to initiation of a quinolone. Of the quinolones, enoxacin17 and ciprofloxacin17,18 reduce theophylline clearance by 30-84%. Consider switching to gatifloxacin, levofloxacin, moxifloxacin, or trovafloxacin; these agents appear not to inhibit theophylline metabolism.17
Monitoring/Precautions: Monitor theophylline levels. Maintain level within targeted range of 5-15mcg/mL; however, theophylline toxicity may result even when the level is within the targeted range. Signs and symptoms of theophylline toxicity include: seizures, nausea, and vomiting.
References: Follow this link for a complete list of references.
The above information serves only as a guide for use by qualified medical practitioners in understanding, handling and avoiding frequent and potentially dangerous drug interactions that occur in long-term care. This presentation is not intended to instruct a practitioner how to treat any medical condition, nor is it intended to replace a practitioner's best clinical judgment. AMDA expressly disclaims responsibility and liability for any adverse effects, damages or other consequences resulting from the use of any of the information contained in this presentation.
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