Description and indication for use
Aminophylline is a xanthine derivative used
as a central nervous system stimulant in the management of Apnoea of
Prematurity. Aminophylline is converted
to theophylline in vivo.
Dose
For apnoea of prematurity:
Loading dose:
10 mg/kg IV.
Maintenance dose:
| Week 1 of life | 2.5 mg/kg/dose | 12 hourly |
| Week 2 of life | 3 mg/kg/dose | 12 hourly |
| >2 Weeks of life | 4 mg/kg/dose | 12 hourly |
If baby weighs 1kg
or less, the maintenance dose is given 24 hours after loading dose.
If baby weighs more than 1kg, the
maintenance dose is given 12 hours after loading dose.
Dose may be adjusted according to response,
side effects, post-conceptional age and serum levels.
Therapeutic range: 40 to 80 micromol/L (of Theophylline).
Sampling Time: immediately prior to next
dose (may take 2-7 days to reach steady state).
Reconstitution
Ampoule = 250
mg in 10 mL (25 mg/mL).
IV:
Withdraw 1 mL of 25 mg/mL solution and add
to 9 mL of water for injection in a 10 mL syringe = 25 mg in 10 mL = 2.5 mg/mL.
Use another syringe to withdraw required
dose.
Remaining solution in ampoule should be
used immediately or discarded.
Not for IM use.
Route and method of administration
IV:
| Loading dose: | give over 60 minutes by continuous infusion |
| Maintenance doses: | give over 20 minutes by continuous infusion |
(As per Guidelines for IV Drug infusions page 117.)
Side effects
Tachycardia.
Irritability.
GI tract upset.
Hypotension.
Compatible solutions
Glucose 5%.
Glucose 10%.
Sodium chloride 0.9% and sodium chloride
0.45%.
Incompatibilities
Aminophylline
must not be mixed together with the following drugs:
Cefotaxime, Insulin, Dobutamine, Penicillin G, Morphine, Phenytoin, Vancomycin.
Administer alone or refer to
Pharmacy for more information.
Special considerations
Caution in patients with GI bleeding.
Drug interactions
| Phenobarbitone and Frusemide | May reduce theophylline levels |
| Propranolol, Cimetidine and Erythromycin | May increase theophylline levels |
| Erythromycin | Effectiveness of Erythromycin may be reduced due to decreased serum levels. |
| Phenytoin | Both drugs, if given together, may have decreased serum levels and hence reduced effectiveness. |
| Pancuronium | Reduced effectiveness of Pancuronium |
Nursing responsibilities