Interaction between Theophylline and Ciprofloxacin
Major
Metabolism
| ID | DDInter1791 and DDInter384 |
| Interaction |
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.
abdominal distension
Acidosis
agranulocytoses
respiratory alkalosis
allergic alveolitis
Anxiety
atrial flutter
back injury
bacterial pneumonia
bleb
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| 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. |
| References | |
| Alternative for Theophylline |
R03D
|
| Alternative for Ciprofloxacin |
J01R
S03A
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.