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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › Xanthines and adrenergics
choline theophyllinate and adrenergics
R03DB02
Forms & Strengths
- Combination oral tablets containing choline theophyllinate (oxitriphylline) and an adrenergic bronchodilator (such as ephedrine or bambuterol depending on regional formulation)
Adult Dosing
- Typically 1 tablet orally every 6 to 8 hours as needed for bronchospasm
- Dose titration required based on clinical response and serum theophylline levels (target 10-20 mcg/mL)
Pediatric Dosing
- Safety and efficacy not well established in pediatric patients under 12 years of age; use generally discouraged or requires individualized specialist dosing
Indications
- Reversible bronchospasm associated with chronic obstructive pulmonary disease (COPD) and bronchial asthma
Mechanism of Action
- Choline theophyllinate acts as a phosphodiesterase inhibitor, increasing cAMP to cause bronchial smooth muscle relaxation and CNS stimulation
- Adrenergic component stimulates beta-2 receptors in the lungs to promote bronchodilation
Contraindications
- Hypersensitivity to xanthines, sympathomimetics, or any component of the formulation
- Acute myocardial infarction
- Tachyarrhythmias
- Concurrent use with other xanthine derivatives
Adverse Reactions
- Tachycardia and palpitations
- Nervousness, tremor, and anxiety
- Insomnia and headache
- Nausea, vomiting, and gastrointestinal irritation
Drug Interactions
- CYP1A2 inhibitors (e.g., cimetidine, ciprofloxacin) increase theophylline levels and toxicity risk
- CYP1A2 inducers (e.g., rifampin, smoking) decrease theophylline levels
- Beta-blockers antagonize the bronchodilatory effects of the adrenergic component
- Additive CNS stimulation and cardiovascular toxicity with other sympathomimetics or xanthines
Curated Content: Needs Vetting Before Put to Clinical Use