Parenteral Manual

Aminophylline

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
THEOPHYLLINE ETHYLENEDIAMINE
Classification: 
Bronchodilator
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Treatment of reversible bronchoconstriction (asthma and COPD)
  • Treatment of neonatal apnea  
  • 100 mg aminophylline = 80 mg theophylline
Reconstitution and Stability: 
  • Available as a 25 mg/mL solution
  • Stable at room temperature
  • Diluted solutions stable 48 hours
Compatibility: 

- Solutions Compatible: dextrose solutions up to D20W, NS, ringer's solution, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: fluconazole, KCl (up to 40 mmol/L), morphine, meropenem.

Incompatible: ciprofloxacin, dobutamine, ondansetron

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO, causes intense pain
IV Direct NO not recommended in pediatrics
IV Intermittent Infusion YES
Usual dilution: 10 mg/mL
Infusion time: 20-30 minutes 
(Do not exceed 25 mg/min= 1500 mg/hour)
IV Continuous Infusion

YES
Usual dilution: 1 mg/mL
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Adult/Pediatric: (based on aminophylline)

  • Loading dose: 6 mg/kg (for patients NOT currently receiving theophylline or aminophylline) OR
                               3 mg/kg (for patients receiving theophylline or aminophylline) 
     -Loading dose given over 20 - 30 minutes
  • Maintenance dose (continuous infusion):

6 weeks - 6 months    

0.5 mg/kg/hr

6 months - 1 year

0.6 - 0.7 mg/kg/hr

1-9 years

1-1.2 mg/kg/hr

9-12 years (+ young adult smoker)

0.9 mg/kg/hr

12-16 years

 0.7 mg/kg/hr

Adults (healthy, nonsmoking)

0.7 mg/kg/hr
  •  Titrated by patient response and serum theophylline levels        
  •   In presence of cardiac or liver failure the usual loading dose can be given, but maintenance dose is reduced by 50%
  • In Oncology for Methotrexate induced leukoencephalopathy:  2.5 mg/kg/dose IV over 1 hour
Potential hazards of parenteral administration: 
  • Rapid IV injection may cause headache, flushing, lightheadedness, vomiting, dizziness and hypotension, bradycardia
Notes: 
  • The usual first signs of toxicity are flushing, GI upset, tachycardia, extrasystoles, irritability, restlessness, but more serious side effects may occur without warning
  • Seizures can occur without preceding minor symptoms at high blood levels (greater than 110 micromol/L)
  • Therapeutic range is 55-110 micromol/L [10-20 mcg/mL] in most patients (steady state levels taken 24 hours after last dosage change)
  • Therapeutic range in neonatal apnea 55-70 micromol/L [6-13 mcg/mL], time to steady state in neonates = 72 hours
  • Potential for numerous drug interactions-consult Pharmacy
  • Monitor serum theophylline levels, HR, RR, # of apnea spells, blood gases, pulmonary function tests

Dosage Form

Time to Draw Level

IV bolus

1 hour after start of load

IV continuous infusion

12-24 hours after initiation of infusion

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