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Levacet

Interactions

Theophylline Derivatives/Cimetidine

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:

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

What might happen:

The blood levels of your theophylline derivative may increase and cause toxic effects.

What you should do about this interaction:

If you experience loss of appetite, nausea, vomiting, nervousness, agitation, headache, fast and/or irregular heartbeat, or seizures, contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible. This interaction may be worse if you have heart failure, liver disease, kidney disease, or are on large doses of a theophylline derivative.Your healthcare professionals may already be aware of this drug 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.Roberts RK, Grice J, Wood L, Petroff V, McGuffie C. Cimetidine impairs the elimination of theophylline and antipyrine. Gastroenterology 1981 Jul; 81(1):19-21.

2.Campbell MA, Plachetka JR, Jackson JE, Moon JF, Finley PR. Cimetidine decreases theophylline clearance. Ann Intern Med 1981 Jul;95(1):68-9.

3.Reitberg DP, Bernhard H, Schentag JJ. Alteration of theophylline clearance and half-life by cimetidine in normal volunteers. Ann Intern Med 1981 Nov; 95(5):582-5.

4.Bauman JH, Kimelblatt BJ, Caraccio TR, Silverman HM, Simon GI, Beck GJ. Cimetidine-theophylline interaction: report of four patients. Ann Allergy 1982 Feb;48(2):100-2.

5.Cluxton RJ Jr, Rivera JO, Ritschel WA, Pesce AJ, Hanenson IB. Cimetidine-theophylline interaction. Ann Intern Med 1982 May;96(5):684.

6.Fenje PC, Isles AF, Baltodano A, MacLeod SM, Soldin S. Interaction of cimetidine and theophylline in two infants. Can Med Assoc J 1982 May 15; 126(10):1178.

7.Jackson JE, Powell JR, Wandell M, Bentley J, Dorr R. Cimetidine decreases theophylline clearance. Am Rev Respir Dis 1981 Jun;123(6):615-7.

8.Lalonde RL, Koob RA, McLean WM, Balsys AJ. The effects of cimetidine on theophylline pharmacokinetics at steady state. Chest 1983 Feb;83(2):221-4.

9.Powell JR, Rogers JF, Wargin WA, Eshelman FN. The influence of cimetidine vs ranitidine on theophylline pharmacokinetics. Clin Pharmacol Ther 1982 Feb;31(2):261.

10.Schwartz JI, Bachmann KA, Bond LW, Mahajan VK. Impact of cimetidine on the pharmacokinetics of theophylline. Clin Pharm 1982 Nov-Dec;1(6):534-8.

11.Mauro VF, Mauro LS, Hageman JH. Alteration of pentoxifylline pharmacokinetics by cimetidine. J Clin Pharmacol 1988 Jul;28(7):649-54.

12.Weinberger MM, Smith G, Milavetz G, Hendeles L. Decreased clearance of theophylline due to cimetidine. N Engl J Med 1981 Mar 12;304(11):672.

13.Wood L, Grice J, Petroff V, McGuffie C, Roberts RK. Effect of cimetidine on the disposition of theophylline. Aust N Z J Med 1981 Oct;10(5):586.

14.Roberts RK, Grice J, McGuffie C. Cimetidine-theophylline interaction in patients with chronic obstructive airways disease. Med J Aust 1984 Mar 3; 140(5):279-80.

15.Powell JR, Rogers JF, Wargin WA, Cross RE, Eshelman FN. Inhibition of theophylline clearance by cimetidine but not ranitidine. Arch Intern Med 1984 Mar;144(3):484-6.

16.Dal Negro R, Pomari C, Zoccatelli O, Trevisan F, Carloni C, Turco P. Pharmacokinetics of theophylline and the H2-antagonist drugs cimetidine and ranitidine. Int J Clin Pharmacol Ther Toxicol 1984 Apr;22(4):221-6.

17.Gugler R, Wolf M, Hansen HH, Jensen JC. The inhibition of drug metabolism by cimetidine in patients with liver cirrhosis. Klin Wochenschr 1984 Dec 3;62(23):1126-31.

18.Cusack BJ, Dawson GW, Mercer GD, Vestal RE. Cigarette smoking and theophylline metabolism: effects of cimetidine. Clin Pharmacol Ther 1985 Mar;37(3):330-6.

19.Dal Negro R, Turco P, Zoccatelli O, Trevisan F, Pomart C. H2-antagonist derangement of the kinetics of sustained-release oral theophylline. Int J Clin Pharmacol Ther Toxicol 1985 Jun;23(6):329-32.

20.Cohen IA, Johnson CE, Berardi RR, Hyneck ML, Achem SR. Cimetidine-theophylline interaction: effects of age and cimetidine dose. Ther Drug Monit 1985;7(4):426-34.

21.Chremos AM, Lin JH, Yeh KC, Chiou R, Bayne WF, Lipschutz K, Williams RL. Famotidine (F) does not interfere with the disposition of theophylline (T) in man . Comparision to cimetidine. Clin Pharmacol Ther 1986 Feb; 39(2):187.

22.Krstenansky PM, Javaheri S, Thomas JP, Thomas RL. Effect of continuous cimetidine infusion on steady-state theophylline concentration. Clin Pharm 1989 Mar;8(3):206-9.

23.Lalonde RL, Koob RA, McLean WM, Balsys AJ. Influence of cimetidine on theophylline pharmacokinetics at steady state. Clin Pharmacol Ther 1982 Feb;31(2):241-42.

24.DeAngelis C, Walker SE, Bartle WR. Effect of low-dose cimetidine on theophylline metabolism. Clin Pharm 1983 Nov-Dec;2(6):563-7.

25.Green AW, Ebling WF, Gardner MJ, Jusko WJ. Cimetidine-methylprednisolone-theophylline metabolic interaction. Am J Med 1984 Dec;77(6):1115-8.

26.Broughton LJ, Rogers HJ. Decreased systemic clearance of caffeine due to cimetidine. Br J Clin Pharmacol 1981 Aug;12(2):155-9.

27.May DC, Jarboe CH, VanBakel AB, Williams WM. Effects of cimetidine on caffeine disposition in smokers and nonsmokers. Clin Pharmacol Ther 1982 May;31(5):656-61.

28.Breen KJ, Bury R, Desmond PV, Mashford ML, Morphett B, Westwood B, Shaw RG. Effects of cimetidine and ranitidine on hepatic drug metabolism. Clin Pharmacol Ther 1982 Mar;31(3):297-300.

29.Kelly HW, Powell JR, Donohue JF. Ranitidine at very large doses does not inhibit theophylline elimination. Clin Pharmacol Ther 1986 May; 39(5):577-81.

30.Fernandes E, Melewicz FM. Ranitidine and theophylline. Ann Intern Med 1984 Mar;100(3):459.

31.Dobbs JH, Smith RN. Ranitidine and theophylline. Ann Intern Med 1984 May; 100(5):769.

32.Gardner ME, Sikorski GW. Ranitidine and theophylline. Ann Intern Med 1985 Apr;102(4):559.

33.Skinner MH, Lenert L, Blaschke TF. Theophylline toxicity subsequent to ranitidine administration: a possible drug-drug interaction. Am J Med 1989 Jan;86(1):129-32.

34.Roy AK, Cuda MP, Levine RA. Induction of theophylline toxicity and inhibition of clearance rates by ranitidine. Am J Med 1988 Oct; 85(4):525-7.

35.Verdiani P, Di Carlo S, Baronti A. Famotidine effects on theophylline pharmacokinetics in subjects affected by COPD. Comparison with cimetidine and placebo. Chest 1988 Oct;94(4):807-10.

36.Dal Negro R, Pomari C, Turco P. Famotidine and theophylline pharmacokinetics. An unexpected cimetidine- like interaction in patients with chronic obstructive pulmonary disease. Clin Pharmacokinet 1993 Mar; 24(3):255-8.

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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