aminophylline

(C) Vancouver General Hospital.
This monograph may not be reproduced without permission.
For further information, please contact a Pharmacist.

NAME OF DRUG
aminophylline

CLASSIFICATION

Bronchodilator

ALTERNATE NAME

THEOPHYLLINE, ETHYLENEDIAMINE

INDICATIONS

symptomatic treatment of reversible bronchoconstriction

RECONSTITUTION AND STABILITY

stable at room temperature
DO NOT use if crystals are present

COMPATIBILITY

compatible with most commonly used IV solutions
compatible via Y-site with amikacin, calcium gluconate, ceftazidime, dexamethasone, diphenhydramine, dopamine, erythromycin, fluconazole, furosemide, heparin, hydrocortisone, labetalol, levofloxacin, lidocaine, magnesium sulphate, methylprednisolone, metoclopramide, metronidazole, morphine, MVI, nitroglycerin, piperacillin-tazobactam, potassium chloride, potassium phosphate, propofol, ranitidine, sodium bicarbonate
incompatible with amiodarone, corticotropin, diltiazem, dobutamine, epinephrine, hyaluronidase, hydralazine, hydroxyzine, insulin, isoproterenol, levorphanol, meperidine, norepinephrine, ondansetron, prochlorperazine, verapamil

ROUTES OF ADMINISTRATION

IV intermittent - in 50-100 mL of compatible IV solution administered at a rate of 25 mg/minute
IV infusion - in 500-1000 mL of compatible IV solution
rate of administration depends on age and clinical condition (see dosage)

VH & HSC ADMINISTRATION POLICY

D - Direct IV route restricted to physicians. Nuclear medicine technologists may administer direct IV under the supervision of a cardiologist who must be immediately available but not necessarily in the same room at the time the drug is being given.

Aminophylline may be administered by nuclear technologists provided that: 1) an intravenous dose of 50-100mg aminophylline is employed to reverse the side effects of IV persantine; 2) the patient is currently under ECG monitoring; 3) a physician is immediately available; 4) a prescription is written and signed by the physician; and 5) full resuscitative equipment is immediately available

H - The IV infusion administration rate must be controlled by an automated infusion control device.

AMINOPHYLLINE INFUSION RATE CHART

Aminophylline 500 mg ( = 400 mg theophylline) in 500 mL D5W

Dose (mg/hr)
Dose (mg/hr)
Rate (mL/hr)

Aminophylline Theophylline

10 mg/hr 8 mg/hr 10 mL/hr

15
12 15

20 16 20

25 20 25

30 24 30

35 28 35

40 32 40

45 36 45

50 40 50

55 44 55

60 48 60

65 52 65

70 56 70

75 60 75

80 64 80

DOSAGE

Loading Dose: Recommended rate 25 mg/minute

Adults and children who have not received theophylline containing products within previous 24 hours: 6 mg/kg aminophylline (4.7 mg/kg theophylline)

Adults and children who have received theophylline containing products within 24 hours: reduce the loading dose by 50% (3mg/kg aminophylline)

Maintenance dose:

Patient population Aminophylline infusion (mg/kg/hr)

Children 9 - 12 0.8

Adolescents 12 - 16
smokers
non-smokers
0.8
0.6

Adults
smokers
non-smokers
Cardiac decompensation, cor pulmonale and/or liver dysfunction
0.8
0.5
0.25

NOTE: dosage must be individualized by monitoring theophylline plasma concentration

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

rapid IV administration may result in hypotension, syncope, cardiac arrest, and death

IMPORTANT IMPLICATIONS

400 mg theophylline is equivalent to 500 mg aminophylline

therapeutic serum levels: 55-110 umol/L (10-20 mcg/mL)

each 1.25 mg/kg aminophylline results in a plasma theophylline increase of approximately 11 umol/L (2 mcg/mL)

adverse effects include anorexia, nausea, vomiting, restlessness, irritability, insomnia, headache

serious arrhythmias and convulsions may occur at levels greater than 193 umol/L (35 mcg/mL) and are often not preceded by less serious signs of toxicity

Rev. July 2006

Dose (mg/hr)	Dose (mg/hr)	Rate (mL/hr)
Aminophylline	Theophylline
10 mg/hr	8 mg/hr	10 mL/hr
15	12	15
20	16	20
25	20	25
30	24	30
35	28	35
40	32	40
45	36	45
50	40	50
55	44	55
60	48	60
65	52	65
70	56	70
75	60	75
80	64	80

Patient population	Aminophylline infusion (mg/kg/hr)
Children 9 - 12	0.8
Adolescents 12 - 16 smokers non-smokers	0.8 0.6
Adults smokers non-smokers Cardiac decompensation, cor pulmonale and/or liver dysfunction	0.8 0.5 0.25