THEOPHYLLINE, EPHEDRINE & BARBITURATES

Brand & Generic Names

Azma Aid	T.E.P.
Phedral-C.T.	Theodrine
Primatene "P" Formula	Theodrine Pediatric
Tedral	Theofed
Tedral SA	Theofedral
Tedrigen

Basic Information

• Habit forming? Yes
• Prescription needed? Some yes, others no
• Available as generic? Some yes, others no
• Drug class: Bronchodilator, barbiturate, sympathomimetic, sedative

Uses

• Treatment for bronchial asthma symptoms.
• Decreases congestion of breathing passages.
• Suppresses allergic reactions.
• Reduces anxiety or nervous tension (low dose).

Dosage & Usage Information

How to take:
Tablet or elixir--Swallow with liquid.
Extended-release tablets--Swallow each dose whole. If you take regular tablets, you may chew or crush them.

When to take:
Most effective taken on empty stomach 1 hour before or 2 hours after eating. However, may take with food to lessen stomach upset.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Relaxes and expands bronchial tubes.
Prevents cells from releasing allergy-causing chemicals (histamines).
Decreases blood vessel size and blood flow, thus causing decongestion.
May partially block nerve impulses at nerve-cell connections.

Time lapse before drug works:
15 to 30 minutes.

Don't take with:
Non-prescription drugs with ephedrine, pseudoephedrine or epinephrine.
Non-prescription drugs for cough, cold, allergy or asthma without consulting doctor.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Restlessness, irritability, anxiety, confusion, hallucinations, vomiting blood, delirium, muscle tremors, convulsions, rapid and irregular pulse, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Difficult breathing, Discontinue. Seek uncontrollable rapid emergency treatment. heart rate, loss of consciousness.

Common:

• Headache, irritability, nervousness, restlessness, insomnia, nausea, vomiting, abdominal pain, irregular heartbeat, "hangover" effect.
• Dizziness, light- headedness, paleness, heartburn.

Infrequent:

• Rash; hives; red or flushed face; appetite loss; diarrhea; cough; confusion; slurred speech; eyelid, face, lip swelling; joint pain.
• Frequent urination.

Rare:

Agitation; sore throat, fever, mouth sores; jaundice.

Warnings & Precautions

Don't take if:

• You are allergic to any bronchodilator or barbiturate.
• You are allergic to ephedrine or any sympathomimetic* drug.
• You have an active peptic ulcer or porphyria.

Before you start, consult your doctor:

• If you have gastritis, peptic ulcer, high blood pressure or heart disease, diabetes, overactive thyroid gland, difficulty urinating, epilepsy, kidney or liver damage, asthma, anemia, chronic pain.
• If you have taken any MAO inhibitor in past 2 weeks, taken digitalis preparations in the last 7 days.
• If you have had impaired kidney or liver function.
• If you take medication for gout.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:

• Adverse reactions and side effects may be more frequent and severe than in younger persons. Use small doses.
• More likely to develop high blood pressure, heart rhythm disturbances, angina and to feel drug's stimulant effects.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine.

Infants & children:
Use only under medical supervision.

Prolonged use:

• Stomach irritation.
• Excessive doses--Rare toxic psychosis.
• Men with enlarged prostate gland may have more urination difficulty.
• May cause addiction, anemia, chronic intoxication.
• May lower body temperature, making exposure to cold temperatures hazardous.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:

• May be unnecessary to finish medicine. Follow doctor's instructions.
• If you develop withdrawal symptoms of hallucinations, agitation or sleeplessness after discontinuing, call doctor right away.

Others:
Potential for abuse.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Allopurinol	Decreased allopurinol effect.
Anticoagulants*,	Decreased anticoagulant effect.
Anticonvulsants*	Changed seizure patterns.
Antidepressants,	Decreased antidepressant effect.
tricyclic (TCA)*	Possible dangerous oversedation.
Antidiabetics*,	Increased phenobarbital effect.
oral	effect.
Antihistamines*	Dangerous sedation. Avoid.
Antihypertensives*	Decreased antihypertensive effect.
Aspirin	Decreased aspirin effect.
Beta-adrenergic	Decreased effect of drugs.
Carteolol	Increased barbiturate effect.
	Dangerous sedation.
Ciprofloxacin	Increased possibility of central
	nervous system poisoning, such as
	nausea, vomiting, restlessness,
	palpitations.
Clarithromycin	Increased concentration of
	theophylline.
Contraceptives*,	Decreased contraceptive
oral	effect.
Cortisone drugs*	Decreased cortisone effect.
Digitalis	Serious heart rhythm
preparations*	disturbances.
Doxycycline	Decreased doxycycline effect.
Dronabinol	Increased effect of drugs. Avoid.
Ephedrine	Increased effect of drugs.
Epinephrine	Increased effect of drugs.
Ergot preparations*	Serious blood pressure rise.
Erythromycins*	Increased bronchodilator effect.
Finasteride	Decreased theophylline effect.
Furosemide	Increased furosemide effect.
Griseofulvin	Decreased griseofulvin effect.
Guanethidine	Decreased effect of drugs.
Indapamide	Increased indapamide effect.
Lincomycins*	Increased bronchodilator effect.
Lithium	Decreased lithium effect.
MAO inhibitors*	Increased ephedrine effect.
	Dangerous blood pressure rise.
Mind-altering drugs*	Dangerous sedation. Avoid.
Narcotics*	Dangerous sedation. Avoid.
Nicardipine	May increase theophylline effect
	and toxicity.
Nicotine	Increased bronchodilator effect.
Nitrates*	Possible decreased effect of drugs.
Non-steroidal	Decreased anti-inflammatory
anti-inflammatory	effect.
Probenecid	Decreased effect of drugs.
Propranolol	Decreased bronchodilator effect.
Pseudoephedrine	Increased pseudoephedrine effect.
Rauwolfia alkaloids*	Rapid heartbeat.
Sotalol	Increased barbiturate effect.
	Dangerous sedation.
Sulfinpyrazone	Decreased sulfinpyrazone effect.
Terazosin	Decreased effect of terazosin.
Ticlopidine	Increased theophylline effect.
Troleandomycin	Increased bronchodilator effect.
Valproic acid	Increased barbiturate effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Possible fatal oversedation. Avoid.
Caffeine drinks.	Nervousness or insomnia.
Cocaine:	High risk of heartbeat
	irregularities and high blood
	pressure.
Foods:	None expected.
Marijuana:	Rapid heartbeat, possible heart-
	rhythm disturbance.
Tobacco:	Decreased bronchodilator effect.