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Interactions

Theophyllines/Quinolones

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

If these two medicines are taken together, your body may not process theophylline properly.

What might happen:

Your blood levels of theophylline may increase and cause toxic effects.

What you should do about this interaction:

If you experience loss of appetite, nausea, irritability with unrest, anxiety, trouble sleeping, headache, seizures, or a fast heartbeat, contact your healthcare professional (e.g. doctor or pharmacist). Your doctor may want to adjust the dose of your medicine or change your antibiotic. Older age may make this interaction worse.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Wijnands WJ, Vree TB, van Herwaarden CL. The influence of quinolone derivatives on theophylline clearance. Br J Clin Pharmacol 1986 Dec; 22(6):677-83.

2.Nix DE, DeVito JM, Whitbread MA, Schentag JJ. Effect of multiple dose oral ciprofloxacin on the pharmacokinetics of theophylline and indocyanine green. J Antimicrob Chemother 1987 Feb;19(2):263-9.

3.Raoof S, Wollschlager C, Khan FA. Ciprofloxacin increases serum levels of theophylline. Am J Med 1987 Apr 27;82(4A):115-8.

4.Rybak MJ, Bowles SK, Chandrasekar PH, Edwards DJ. Increased theophylline concentrations secondary to ciprofloxacin. Drug Intell Clin Pharm 1987 Nov;21(11):879-81.

5.Thomson AH, Thomson GD, Hepburn M, Whiting B. A clinically significant interaction between ciprofloxacin and theophylline. Eur J Clin Pharmacol 1987;33(4):435-6.

6.Niki Y, Soejima R, Kawane H, Sumi M, Umeki S. New synthetic quinolone antibacterial agents and serum concentration of theophylline. Chest 1987 Oct;92(4):663-9.

7.Sano M, Yamamoto I, Ueda J, Yoshikawa E, Yamashina H, Goto M. Comparative pharmacokinetics of theophylline following two fluoroquinolones co-administration. Eur J Clin Pharmacol 1987;32(4):431-2.

8.Sano M, Kawakatsu K, Ohkita C, Yamamoto I, Takeyama M, Yamashina H, Goto M. Effects of enoxacin, ofloxacin and norfloxacin on theophylline disposition in humans. Eur J Clin Pharmacol 1988;35(2):161-5.

9.Holden R. Probable fatal interaction between ciprofloxacin and theophylline. BMJ 1988 Nov 19;297(6659):1339.

10.Bachmann KA, Schwartz JI, Jauregui L. Predicting the ciprofloxacin-theophylline interaction from single plasma theophylline measurements. Br J Clin Pharmacol 1988 Aug;26(2):191-4.

11.Davis RL, Kelly HW, Quenzer RW, Standefer J, Steinberg B, Gallegos J. Effect of norfloxacin on theophylline metabolism. Antimicrob Agents Chemother 1989 Feb;33(2):212-4.

12.Robson RA, Begg EJ, Atkinson HC, Saunders DA, Frampton CM. Comparative effects of ciprofloxacin and lomefloxacin on the oxidative metabolism of theophylline. Br J Clin Pharmacol 1990 Apr;29(4):491-3.

13.Semel JD, Allen N. Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole. South Med J 1991 Apr;84(4):465-8.

14.Davis RL, Quenzer RW, Kelly HW, Powell JR. Effect of the addition of ciprofloxacin on theophylline pharmacokinetics in subjects inhibited by cimetidine. Ann Pharmacother 1992 Jan;26(1):11-3.

15.Grasela TH Jr, Dreis MW. An evaluation of the quinolone-theophylline interaction using the Food and Drug Administration spontaneous reporting system. Arch Intern Med 1992 Mar;152(3):617-21.

16.Van Slooten A, Forrest A, Collins D, Schentag JJ. Use of pharmacostatistical analysis to test for a lomefloxacin-theophylline interaction. Clin Pharmacol Ther 1992, feb;51(2):160.

17.Loi CM, Parker BM, Cusack BJ, Vestal R. Individual and combined effects of cimetidine and ciprofloxacin on theophylline metabolism in male nonsmokers. Br J Clin Pharmacol 1993 Sep;36(3):195-200.

18.O'Mahony MS, FitzGerald MX. Cystic fibrosis and seizures. Lancet 1991 Jul 27;338(8761):259.

19.Bader MB. Role of ciprofloxacin in fatal seizures. Chest 1992 Mar; 101(3):883-4.

20.Spivey JM, Laughlin PH, Goss TF, Nix DE. Theophylline toxicity secondary to ciprofloxacin administration. Ann Emerg Med 1991 Oct;20(10):1131-4.

21.Rockwood RP, Embardo LS. Theophylline, ciprofloxacin, erythromycin: a potentially harmful regimen. Ann Pharmacother 1993 May;27(5):651-2.

22.Schwartz J, Jauregui L, Lettieri J, Bachmann K. Impact of ciprofloxacin on theophylline clearance and steady-state concentrations in serum. Antimicrob Agents Chemother 1988 Jan;32(1):75-7.

23.Cipro (ciprofloxacin hydrochloride) US prescribing information. Bayer Corporation August, 2013.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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