What is a special consideration when using theophylline as a treatment?

Theophylline is a medication primarily used for respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). When using theophylline as a treatment, a significant consideration is its propensity for numerous drug interactions. Theophylline is metabolized in the liver by cytochrome P450 enzymes, particularly CYP1A2 and CYP3A4. This means that any medication that affects these enzymes can either increase the theophylline levels (potentially leading to toxicity) or decrease them (possibly resulting in ineffective treatment).

Certain medications, including some antibiotics, anti-seizure drugs, and other respiratory therapies, can interact with theophylline. For instance, ciprofloxacin can increase theophylline levels, while rifampin can lower them. As such, healthcare providers must carefully review a patient’s entire medication regimen when prescribing theophylline to avoid any adverse interactions that could compromise treatment efficacy or patient safety.

In contrast, the other options present considerations that are less critical regarding theophylline's use. While it may not be safe for infants under 12 months, the risk of drug interactions is more pressing in clinical practice. Theophylline is generally not recommended to be taken with alcohol due to its potential to exacerbate side effects