21 July 2017
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General Info: Uses and Effects
Elixophyllin contains an active substance called Theophylline.
The mechanism of action of Theophylline is not fully known despite the numerous therapeutic effects attributed to this medicine. The assumed mechanisms of action of this drug are as follows:
- Inhibition of phosphodiesterase enzyme, resulting in an increase in the concentration of cAMP.
- Antagonism exerted on adenosine receptors (complete inhibition of adenosine effects).
- Inhibition of intracellular calcium release.
- Stimulation of the release of catecholamine.
- Anti-inflammatory activity - probably related to the inhibition of sub-mucosal activity.
However, further more detailed studies are needed to confirm exact mechanisms of Elixophyllin effects.
Contraindications: Important to Know
Use of Elixophyllin is absolutely contraindicated in patients with known hypersensitivity to Theophylline, or other drugs that belong to the xanthine group or to any of the excipients of Elixophyllin. This drug is also contraindicated in children younger than 6 months as there is no sufficient data to confirm its safety in babies. The concurrent administration of Theophylline and ephedrine to children is contraindicated.
Elixophyllin should not be used in patients who suffer from porphyria, as these patients may experience worsening of symptoms. It should not be also used in patients who suffered recent myocardial infarction as this medicine may cause cardiac side effects. Patients with acute tachyarrhythmias should not use Elixophyllin due to the risk of symptoms exacerbations.
Fever can reduce Theophylline clearance. It may be necessary to reduce the dose in patients with fever in order to avoid Elixophyllin accumulation in the body, thus leading to side effects.
Extra precaution is required when administering this medicine in children because of the higher potential for serious adverse events and higher chance of large number of interactions.
Smoking and drinking alcohol can increase Elixophyllin clearance, which may require an increase in dose. It is recommended that patients with congestive heart failure, chronic alcoholics, and patients with liver dysfunction or viral infection be closely monitored, as they may have lower clearance of Elixophyllin, which may lead to increased plasma concentrations.
Elixophyllin Theophylline should be used with extra precaution in following situations:
- Unstable angina pectoris;
- Severe hypertension (above 180 mmHg);
- Hypertrophic obstructive cardiomyopathy;
- Peptic or duodenal ulcer;
- Severe liver disorders;
- Severe kidney disorders.
The use of Elixophyllin in the elderly patients with chronic disorders is associated with an increased risk of toxicity, and therefore monitoring of the Theophylline concentration during the treatment is highly recommended.
In patients who are receiving electroconvulsive therapy, extra precaution is needed, as this drug can cause seizures. The status epileptics can also occur.
Instructions on Taking
Elixophyllin Theophylline is used for the symptomatic and prophylactic treatment of reversible bronchospasm associated with asthma and chronic obstructive pulmonary disease (HOBP), when previous conventional therapy wasn't successful.
Elixophyllin should not be used as a first-line therapy for asthma in children. The drug is intended for oral use.
Patients should be warned that they should not chew the capsules or melt them in the mouth, as this may change release of the drug and affects its levels in the blood.
Children: Elixophyllin should not be used in the therapy in children under 6 years of age. In this case, other pharmaceutical forms of Theophylline should be used. The recommended dosage for children aged 6-12 years (weighing 20-35kg) is 125-250mg twice daily (every 12 hours). The recommended dose for children older than 12 years is 250-500mg twice daily (every 12 hours).
Adults: There is a tendency of decrease in Theophylline clearance with the age, which leads to an increase in its serum concentration. Therefore, elderly may need a dose reduction, and it is also advised to careful monitor these patients especially at the beginning of the treatment.
It is best to determine the appropriate dose based on the clinical assessment of each patient. In some cases it may be useful to measure the concentration of Theophylline in plasma.
The usual initial dose should be the lowest dosage recommended for specific group of patients. If optimal bronchodilator effects are not achieved, the dose may be increased gradually. The total dose should not exceed 24mg/kg of body weight for children and 13mg/kg for adults. In any case, the measurement of plasma Theophylline concentration 4-8 hours after the administration and for at least 3 days after each change in dose provides more precise determination of the effective dose for each patient, as there are individual differences in the rate of elimination of the drug.
The recommended dosage in adult patients is 250-500mg twice daily (every 12 hours).
Side effects most commonly occur if Elixophyllin is used in excess doses.
Most common reported side effects are: headache, anxiety, irritability, dizziness, insomnia, palpitations, allergic reactions, digestive disorders (nausea, vomiting, diarrhea and abdominal pain). These adverse reactions are especially common at the beginning of the treatment and are usually transient and mild.
You should inform your doctor if you notice irregular heart rate, palpitations, chest pain, or rapid heartbeat.
However, Elixophyllin is usually well-tolerated and rarely causes severe side effects.
Interactions with Other Drugs
Elixophyllin should not be used concomitantly with medicines containing xanthine derivatives. If it is necessary to use Aminophylline in patients who are already using Elixophyllin, it is necessary to monitor the concentration of Theophylline in plasma.
Elixophyllin is known to interact with many drugs. Drugs that increase Theophylline clearance may require a dose increase in order to provide the therapeutic effect are as follows:
- Barbiturates (especially phenobarbital or pentobarbital);
- Hypericum perforatum;
The concomitant use with any of above-mentioned drugs requires regular monitoring of concentration of Theophylline and adjusting the dose.
Drugs that reduce Theophylline clearance and that may require a dose reduction in order to avoid adverse effects are as follows:
- Macrolide antibiotics;
- Oral contraceptives;
Xanthines can potentiate hypokalemia if they are used with beta-2 agonists, steroids or water pills. Special caution is required in patients with severe asthma. Therefore, monitoring of potassium levels in blood is recommended in these situations.
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