Theophylline 5% Dextrose Injection Viaflex Uses

How do you administer this medicine?
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What is Theophylline 5% Dextrose Injection Viaflex?

Theophylline 5% Dextrose Injection Viaflex injection is used together with other medicines to treat the acute symptoms of asthma, bronchitis, emphysema, and other lung diseases in a hospital setting.

Theophylline 5% Dextrose Injection Viaflex belongs to a group of medicines known as bronchodilators. Bronchodilators are medicines that relax the muscles in the bronchial tubes (air passages) of the lungs. They relieve cough, wheezing, shortness of breath, and troubled breathing by increasing the flow of air through the bronchial tubes.

Theophylline 5% Dextrose Injection Viaflex is available only with your doctor's prescription.

Theophylline 5% Dextrose Injection Viaflex indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Intravenous Theophylline 5% Dextrose Injection Viaflex is indicated as an adjunct to inhaled beta-2 selective agonists and systemically administered corticosteroids for the treatment of acute exacerbations of the symptoms and reversible airflow obstruction associated with asthma and other chronic lung diseases, e.g., emphysema and chronic bronchitis.

How should I use Theophylline 5% Dextrose Injection Viaflex?

Use Theophylline 5% Dextrose Injection Viaflex as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Theophylline 5% Dextrose Injection Viaflex.

Uses of Theophylline 5% Dextrose Injection Viaflex in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Reversible airflow obstruction:

Oral: Treatment of symptoms and reversible airflow obstruction associated with chronic asthma, or other chronic lung diseases (eg, emphysema, chronic bronchitis).

Injection: Treatment of acute exacerbations of the symptoms and reversible airflow obstruction associated with asthma and other chronic lung diseases (eg, chronic bronchitis, emphysema) as an adjunct to inhaled beta-2 selective agonists and systemically administered corticosteroids. Guideline recommendations:

Guideline recommendations:

Asthma: The 2019 Global Initiative for Asthma Guidelines (GINA) and the 2007 National Heart, Lung and Blood Institute Asthma Guidelines recommends against Theophylline 5% Dextrose Injection Viaflex as a long-term control medication for asthma in children ≤5 years of age. Additionally, GINA guidelines do not recommend Theophylline 5% Dextrose Injection Viaflex for asthma in children 6 to 11 years of age.

Oral Theophylline 5% Dextrose Injection Viaflex is a potential alternative option (not preferred) in adolescents and adults as a long-term control medication in mild asthma or as an add-on long-term control medication in moderate to severe asthma; however, a stepwise approach using inhaled corticosteroids (+/- inhaled long-acting beta agonists depending on asthma severity) is preferred to Theophylline 5% Dextrose Injection Viaflex due to efficacy concerns and potential for adverse events (GINA 2019). Both guidelines recommend against Theophylline 5% Dextrose Injection Viaflex for the treatment of asthma exacerbations due to poor efficacy and safety concerns (GINA 2019; NAEPP 2007).

COPD: Based on the Global Initiative for Chronic Obstructive Lung Disease Guidelines (2019), use of Theophylline 5% Dextrose Injection Viaflex in patients with COPD is controversial and lacks data. Theophylline 5% Dextrose Injection Viaflex may favorably impact functional impairment in COPD patients, but exact effects are unclear. Studies that demonstrated improvement were done with slow-release preparations. Theophylline 5% Dextrose Injection Viaflex is not a preferred agent for COPD exacerbations due to its potential for toxicity.

Off Label Uses

Bradycardia, heart transplantation

Data from small observational studies suggest that Theophylline 5% Dextrose Injection Viaflex may be beneficial for the treatment of bradycardia following heart transplantation.

Theophylline 5% Dextrose Injection Viaflex description

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Theophylline 5% Dextrose Injection Viaflex is a chiral compound. The racemic mixture can be divided into its optical antipodes: levo- and dextro-amphetamine. Theophylline 5% Dextrose Injection Viaflex is the parent compound of its own structural class, comprising a broad range of psychoactive derivatives, e.g., MDMA (Ecstasy) and the N-methylated form, methamphetamine. Theophylline 5% Dextrose Injection Viaflex is a homologue of phenethylamine.

Theophylline 5% Dextrose Injection Viaflex dosage

General Considerations

The steady-state peak serum Theophylline 5% Dextrose Injection Viaflex concentration is a function of the infusion rate and the rate of Theophylline 5% Dextrose Injection Viaflex clearance in the individual patient. Because of marked individual differences in the rate of Theophylline 5% Dextrose Injection Viaflex clearance, the dose required to achieve a serum Theophylline 5% Dextrose Injection Viaflex concentration in the 10-20 mcg/mL range varies fourfold among otherwise similar patients in the absence of factors known to alter Theophylline 5% Dextrose Injection Viaflex clearance. For a given population there is no single Theophylline 5% Dextrose Injection Viaflex dose that will provide both safe and effective serum concentrations for all patients. Administration of the median Theophylline 5% Dextrose Injection Viaflex dose required to achieve a therapeutic serum Theophylline 5% Dextrose Injection Viaflex concentration in a given population may result in either sub-therapeutic or potentially toxic serum Theophylline 5% Dextrose Injection Viaflex concentrations in individual patients. The dose of Theophylline 5% Dextrose Injection Viaflex must be individualized on the basis of peak serum Theophylline 5% Dextrose Injection Viaflex concentration measurements in order to achieve a dose that will provide maximum potential benefit with minimal risk of adverse effects.

When Theophylline 5% Dextrose Injection Viaflex is used as an acute bronchodilator, the goal of obtaining a therapeutic serum concentration is best accomplished with an intravenous loading dose. Because of rapid distribution into body fluids, the serum concentration (C) obtained from an initial loading dose (LD) is related primarily to the volume of distribution (V), the apparent space into which the drug diffuses:

C = LD/V

If a mean volume of distribution of about 0.5 L/kg is assumed (actual range is 0.3 to 0.7 L/kg), each mg/kg (ideal body weight) of Theophylline 5% Dextrose Injection Viaflex administered as a loading dose over 30 minutes results in an average 2 mcg/mL increase in serum Theophylline 5% Dextrose Injection Viaflex concentration. Therefore, in a patient who has received no Theophylline 5% Dextrose Injection Viaflex in the previous 24 hours, a loading dose of intravenous Theophylline 5% Dextrose Injection Viaflex of 4.6 mg/kg, calculated on the basis of ideal body weight and administered over 30 minutes, on average, will produce a maximum post-distribution serum concentration of 10 mcg/mL with a range of 6-16 mcg/mL. When a loading dose becomes necessary in the patient who has already received Theophylline 5% Dextrose Injection Viaflex, estimation of the serum concentration based upon the history is unreliable, and an immediate serum level determination is indicated. The loading dose can then be determined as follows:

D = (Desired C - Measured C)(V)

where D is the loading dose, C is the serum Theophylline 5% Dextrose Injection Viaflex concentration, and V is the volume of distribution. The mean volume of distribution can be assumed to be 0.5 L/kg and the desired serum concentration should be conservative (e.g., 10 mcg/mL) to allow for the variability in the volume of distribution. A loading dose should not be given before obtaining a serum Theophylline 5% Dextrose Injection Viaflex concentration if the patient has received any Theophylline 5% Dextrose Injection Viaflex in the previous 24 hours.

A serum concentration obtained 30 minutes after an intravenous loading dose, when distribution is complete, can be used to assess the need for and size of subsequent loading doses, if clinically indicated, and for guidance of continuing therapy. Once a serum concentration of 10 to 15 mcg/mL has been achieved with the use of a loading dose(s), a constant intravenous infusion is started. The rate of administration is based upon mean pharmacokinetic parameters for the population and calculated to achieve a target serum concentration of 10 mcg/mL. For example, in nonsmoking adults, initiation of a constant intravenous Theophylline 5% Dextrose Injection Viaflex infusion of 0.4 mg/kg/hr at the completion of the loading dose, on average, will result in a steady-state concentration of 10 mcg/ mL with a range of 7-26 mcg/mL. The mean and range of steady-state serum concentrations are similar when the average child (age 1 to 9 years) is given a loading dose of 4.6 mg/kg Theophylline 5% Dextrose Injection Viaflex followed by a constant intravenous infusion of 0.8 mg/kg/ hr. Since there is large interpatient variability in Theophylline 5% Dextrose Injection Viaflex clearance, serum concentration will rise or fall when the patient's clearance is significantly different from the mean population value used to calculate the initial infusion rate. Therefore, a second serum concentration should be obtained one expected half-life after starting the constant infusion (e.g., approximately 4 hours for children age 1 to 9 and 8 hours for nonsmoking adults; See Table II for the expected half-life in additional patient populations) to determine if the concentration is accumulating or declining from the post loading dose level. If the level is declining as a result of a higher than average clearance, an additional loading dose can be administered and/or the infusion rate increased. In contrast, if the second sample demonstrates a higher level, accumulation of the drug can be assumed, and the infusion rate should be decreased before the concentration exceeds 20 mcg/mL. An additional sample is obtained 12 to 24 hours later to determine if further adjustments are required and then at 24-hour intervals to adjust for changes, if they occur. This empiric method, based upon mean pharmacokinetic parameters, will prevent large fluctuations in serum concentration during the most critical period of the patient's course.

In patients with cor pulmonale, cardiac decompensation, or liver dysfunction, or in those taking drugs that markedly reduce Theophylline 5% Dextrose Injection Viaflex clearance (e.g., cimetidine), the initial Theophylline 5% Dextrose Injection Viaflex infusion rate should not exceed 17 mg/hr unless serum concentrations can be monitored at 24-hour intervals. In these patients, 5 days may be required before steady-state is reached.

Theophylline 5% Dextrose Injection Viaflex distributes poorly into body fat, therefore, mg/kg dose should be calculated on the basis of ideal body weight. Table VI contains initial Theophylline 5% Dextrose Injection Viaflex infusion rates following an appropriate loading dose recommended for patients in various age groups and clinical circumstances. Table VII contains recommendations for final Theophylline 5% Dextrose Injection Viaflex dosage adjustment based upon serum Theophylline 5% Dextrose Injection Viaflex concentrations. Application of these general dosing recommendations to individual patients must take into account the unique clinical characteristics of each patient. In general, these recommendations should serve as the upper limit for dosage adjustments in order to decrease the risk of potentially serious adverse events associated with unexpected large increases in serum Theophylline 5% Dextrose Injection Viaflex concentration.

Table VI : Initial Theophylline 5% Dextrose Injection Viaflex infusion rates following an appropriate loading dose.

Patient population Age Theophylline 5% Dextrose Injection Viaflex infusion rate (mg/kg/hr)*†
Neonates Postnatal age up to 24 days 1 mg/kg q12h/‡
Postnatal age beyond 24 days 1.5 mg/kg q 12h/‡
Infants 6-52 weeks old mg/kg/hr = (0.008) (age in weeks) + 0.21
Young children 1-9 years 0.8
Older children 9-12 years 0.7
Adolescents (cigarette or marijuana smokers) 12-16 years 0.7
Adolescents (nonsmokers) 12-16 years 0.5§
Adults (otherwise healthy nonsmokers) 16-60 years 0.4§
Elderly >60 years 0.3¶
Cardiac decompensation, cor pulmonale, liver dysfunction, sepsis with multi-organ failure, or shock 0.2¶
* To achieve a target concentration of 10 mcg/mL. Use ideal body weight for obese patients.

† Lower initial dosage may be required for patients receiving other drugs that decrease Theophylline 5% Dextrose Injection Viaflex clearance (e.g., cimetidine).

Theophylline 5% Dextrose Injection Viaflex interactions

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What other drugs will affect Theophylline 5% Dextrose Injection Viaflex?

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Theophylline 5% Dextrose Injection Viaflex interacts with a wide variety of drugs. The interaction may be pharmacodynamic, i.e., alterations in the therapeutic response to Theophylline 5% Dextrose Injection Viaflex or another drug or occurrence of adverse effects without a change in serum Theophylline 5% Dextrose Injection Viaflex concentration. More frequently, however, the interaction is pharmacokinetic, i.e., the rate of Theophylline 5% Dextrose Injection Viaflex clearance is altered by another drug resulting in increased or decreased serum Theophylline 5% Dextrose Injection Viaflex concentrations. Theophylline 5% Dextrose Injection Viaflex only rarely alters the pharmacokinetics of other drugs. The drugs listed in Table III have the potential to produce clinically significant pharmacodynamic or pharmacokinetic interactions with Theophylline 5% Dextrose Injection Viaflex. The information in the “Effect” column of Table III assumes that the interacting drug is being added to a steady-state Theophylline 5% Dextrose Injection Viaflex regimen. If Theophylline 5% Dextrose Injection Viaflex is being initiated in a patient who is already taking a drug that inhibits Theophylline 5% Dextrose Injection Viaflex clearance (e.g., cimetidine, erythromycin), the dose of Theophylline 5% Dextrose Injection Viaflex required to achieve a therapeutic serum Theophylline 5% Dextrose Injection Viaflex concentration will be smaller. Conversely, if Theophylline 5% Dextrose Injection Viaflex is being initiated in a patient who is already taking a drug that enhances Theophylline 5% Dextrose Injection Viaflex clearance (e.g., rifampin), the dose of Theophylline 5% Dextrose Injection Viaflex required to achieve a therapeutic serum Theophylline 5% Dextrose Injection Viaflex concentration will be larger. Discontinuation of a concomitant drug that increases Theophylline 5% Dextrose Injection Viaflex clearance will result in accumulation of Theophylline 5% Dextrose Injection Viaflex to potentially toxic levels, unless the Theophylline 5% Dextrose Injection Viaflex dose is appropriately reduced. Discontinuation of a concomitant drug that inhibits Theophylline 5% Dextrose Injection Viaflex clearance will result in decreased serum Theophylline 5% Dextrose Injection Viaflex concentrations, unless the Theophylline 5% Dextrose Injection Viaflex dose is appropriately increased.

The drugs listed in Table IV have either been documented not to interact with Theophylline 5% Dextrose Injection Viaflex or do not produce a clinically significant interaction (i.e., < 15% change in Theophylline 5% Dextrose Injection Viaflex clearance).

The listings of drugs in Tables III and IV are current as of September 1, 1995. New interactions are continuously being reported for Theophylline 5% Dextrose Injection Viaflex, especially with new chemical entities. The clinician should not assume that a drug does not interact with Theophylline 5% Dextrose Injection Viaflex if it is not listed in Table III. Before addition of a newly available drug in a patient receiving Theophylline 5% Dextrose Injection Viaflex, the package insert of the new drug and/or the medical literature should be consulted to determine if an interaction between the new drug and Theophylline 5% Dextrose Injection Viaflex has been reported.

Table III : Clinically significant drug interactions with Theophylline 5% Dextrose Injection Viaflex.

albuterol, systemic and inhaled lomefloxacin mebendazole
amoxicillin medroxyprogesterone
ampicillin, with or without sulbactam methylprednisolone metronidazole
atenolol metoprolol
azithromycin nadolol
caffeine, dietary ingestion nifedipine

nizatidine

cefaclor norfloxacin
co-trimoxazole

(trimethoprim and sulfamethoxazole)

ofloxacin
omeprazole

prednisone, prednisolone

diltiazem ranitidine
dirithromycin rifabutin
enflurane roxithromycin
famotidine sorbitol (purgative doses do not inhibit Theophylline 5% Dextrose Injection Viaflex absorption)
felodipine
finasteride
hydrocortisone
insoflurane sucralfate
isoniazid terbutaline, systemic
isradipine terfenadine
influenza vaccine tetracycline
ketoconazole tocainide
* Refer to PRECAUTIONS, Drug Interactions for information regarding table.

The Effect of Other Drugs on Theophylline 5% Dextrose Injection Viaflex Serum Concentration Measurements

Most serum Theophylline 5% Dextrose Injection Viaflex assays in clinical use are immunoassays which are specific for Theophylline 5% Dextrose Injection Viaflex. Other xanthines such as caffeine, dyphylline, and pentoxifylline are not detected by these assays. Some drugs (e.g., cefazolin, cephalothin), however, may interfere with certain HPLC techniques. Caffeine and xanthine metabolites in neonates or patients with renal dysfunction may cause the reading from some dry reagent office methods to be higher than the actual serum Theophylline 5% Dextrose Injection Viaflex concentration.

Theophylline 5% Dextrose Injection Viaflex side effects

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What are the possible side effects of Theophylline 5% Dextrose Injection Viaflex?

Adverse reactions associated with Theophylline 5% Dextrose Injection Viaflex are generally mild when peak serum Theophylline 5% Dextrose Injection Viaflex concentrations are < 20 mcg/mL and mainly consist of transient caffeine-like adverse effects such as nausea, vomiting, headache, and insomnia. When serum Theophylline 5% Dextrose Injection Viaflex concentrations exceed 20 mcg/mL, however, Theophylline 5% Dextrose Injection Viaflex produces a wide range of adverse reactions including persistent vomiting, cardiac arrhythmias, and intractable seizures which can be lethal.

Other adverse reactions that have been reported at serum Theophylline 5% Dextrose Injection Viaflex concentrations < 20 mcg/mL include diarrhea, irritability, restlessness, fine skeletal muscle tremors, and transient diuresis. In patients with hypoxia secondary to COPD, multifocal atrial tachycardia and flutter have been reported at serum Theophylline 5% Dextrose Injection Viaflex concentrations ≥ 15 mcg/mL. There have been a few isolated reports of seizures at serum Theophylline 5% Dextrose Injection Viaflex concentrations < 20 mcg/mL in patients with an underlying neurological disease or in elderly patients. The occurrence of seizures in elderly patients with serum Theophylline 5% Dextrose Injection Viaflex concentrations < 20 mcg/mL may be secondary to decreased protein binding resulting in a larger proportion of the total serum Theophylline 5% Dextrose Injection Viaflex concentration in the pharmacologically active unbound form. The clinical characteristics of the seizures reported in patients with serum Theophylline 5% Dextrose Injection Viaflex concentrations < 20 mcg/mL have generally been milder than seizures associated with excessive serum Theophylline 5% Dextrose Injection Viaflex concentrations resulting from an overdose (i.e., they have generally been transient, often stopped without anticonvulsant therapy, and did not result in neurological residua).

Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia.

If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.

Theophylline 5% Dextrose Injection Viaflex contraindications

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What is the most important information I should know about Theophylline 5% Dextrose Injection Viaflex?

Theophylline 5% Dextrose Injection Viaflex

Oral Solution, USP is contraindicated in patients with a history of hypersensitivity to Theophylline 5% Dextrose Injection Viaflex or other components in the product.

Active ingredient matches for Theophylline 5% Dextrose Injection Viaflex:

Theophylline anhydrous


List of Theophylline 5% Dextrose Injection Viaflex substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Eiso 5.34 mg/1 mL x 1 mL
Eiso 5.34 mg/1 mL x 60 mL
Eiso 5.34 mg/1 mL x 120 mL
Theolin S.R. 250 mg x 500's
Theolin S.R. 250 mg x 50 x 10's
Theophylline Anhydrous tablet, extended release 400 mg/1 (Rhodes Pharmaceuticals L.P. (US))
Theophylline Anhydrous tablet, extended release 600 mg/1 (Rhodes Pharmaceuticals L.P. (US))
Theophylline Beacons 100 mg x 1000's
TR-PHYLLIN cap 125 mg x 10's (Sun (Symbiosis))
TR-PHYLLIN cap 250 mg x 10's (Sun (Symbiosis))
Xanlin 5.34 mg/1 mL x 60 mL
Xanlin 5.34 mg/1 mL x 120 mL

References

  1. DailyMed. "THEOPHYLLINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "theophylline". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "theophylline". http://www.drugbank.ca/drugs/DB00277 (accessed September 17, 2018).

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