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Cipro Iv Minibags and Theophylline Sustained-Release Capsules

Determining the interaction of Cipro Iv Minibags and Theophylline Sustained-Release Capsules and the possibility of their joint administration.

Check result:

Cipro Iv Minibags <> Theophylline Sustained-Release Capsules

Relevance: 14.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Ciprofloxacin may significantly increase the blood levels of theophylline, which may lead to potentially serious and life-threatening side effects. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you develop nausea, vomiting, diarrhea, loss of appetite, headache, tremor, confusion, restlessness, insomnia, seizures, heart palpitations, and/or irregular heartbeat, as these may be signs and symptoms of excessive theophylline levels. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Coadministration with ciprofloxacin may significantly increase the serum concentrations of theophylline and the associated risk of toxicity. The mechanism is ciprofloxacin inhibition of theophylline metabolism via CYP450 1A2. Case reports and pharmacokinetic studies indicate that ciprofloxacin 500 mg to 750 mg twice daily can reduce the clearance of theophylline by approximately 20% to 65%, resulting in toxic theophylline levels and/or clinical toxicity in some patients. Up to fourfold increases in theophylline serum levels have been reported, with onset of clinical toxicity as early as two to three days and typically within a week of initiating ciprofloxacin. However, the interaction is subject to a high degree of interpatient variability and does not consistently produce clinically significant pharmacokinetic changes. Serious and severe reactions have included cardiac arrest, seizure, status epilepticus, respiratory failure, and even death. Seizures may also occur in the absence of toxic theophylline levels due to additive inhibitory effect of ciprofloxacin and theophylline on gamma-aminobutyric acid (GABA) receptor sites. Because elderly patients and patients with chronic obstructive pulmonary disease, congestive heart failure, or cirrhosis generally have lower theophylline clearance rates, they may be particularly vulnerable to theophylline toxicity. Theophylline does not appear to alter the pharmacokinetics of ciprofloxacin and other quinolones.

MANAGEMENT: The use of theophylline or its salts in combination with ciprofloxacin should generally be avoided. If coadministration is required, theophylline dosage may need to be reduced. Pharmacologic response and serum levels should be closely monitored following initiation, discontinuation or change of dosage of ciprofloxacin, and the theophylline dosage adjusted accordingly. Patients should be advised to contact their physician if they experience signs and symptoms suggestive of theophylline toxicity such as nausea, vomiting, diarrhea, anorexia, headache, tremor, irritability, confusion, insomnia, seizure, palpitation, and arrhythmia. Other quinolones including gemifloxacin, levofloxacin, moxifloxacin, and ofloxacin have been reported to cause minor or no changes in theophylline levels at normally recommended dosages and may be safer alternatives in theophylline-treated patients.

References

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Davis RL, Quenzer RW, Kelly HW, Powell JR "Effect of the addition of ciprofloxacin on theophylline pharmacokinetics in subjects inhibited by cimetidine." Ann Pharmacother 26 (1992): 11-3
Bem JL, Mann RD "Danger of interaction between ciprofloxacin and theophylline." Br Med J (Clin Res Ed) 296 (1988): 1131
Edwards DJ, Bowles SK, Svensson CK, Rybak MJ "Inhibition of drug metabolism by quinolone antibiotics." Clin Pharmacokinet 15 (1988): 194-204
Bader MB "Role of ciprofloxacin in fatal seizures." Chest 101 (1992): 883-4
Semel JD, Allen N "Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole." South Med J 84 (1991): 465-8
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Mizuki Y, Fujiwara I, Yamaguchi T "Pharmacokinetic interactions related to the chemical structures of fluoroquinolones." J Antimicrob Chemother 37 ( Suppl (1996): 41-55
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Cipro Iv Minibags

Generic Name: ciprofloxacin

Brand name: Cipro IV, Cipro, Cipro XR, Proquin XR

Synonyms: Cipro I.V. (injection)

What is Cipro Iv Minibags?

Theophylline Sustained-Release Capsules

Generic Name: theophylline

Brand name: Elixophyllin, Theo-24, Respbid, T-Phyl, Aerolate III, Slo-Bid Gyrocaps, Slo-Phyllin, Theobid, Theo-Dur, Theolair, Theovent, Bronkodyl, Theo-X, Theo-Time, Theochron, Slo-Phyllin 125, Theoclear LA-130, Aerolate JR, Theolair-SR, Theoclear LA-260, Quibron-T, Quibron-T/SR, Uniphyl, Uni-Dur, Aerolate SR, Slo-Phyllin 80, Theoclear-80, Theo-Dur Sprinkles, Theosol-80, Asmalix, Aquaphyllin, Truxophyllin, Slo-Phyllin 250, TheoCap

Synonyms: Theophylline

What is Theophylline Sustained-Release Capsules?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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