aminophylline

Adult Dosing .

Dosage forms:  INJ

asthma/COPD, maintenance tx

[380-760 mg/day IV divided q6-8h]

Start: 380 mg/day x3 days, then 507 mg/day x3 days, then 760 mg/day if tolerated; Max: 1015 mg/day, 507 mg/day if reduced clearance; Info: adjust dose based on serum levels; reduced clearance risk factors include elderly, hepatic impairment, CHF, fever, sepsis w/ multi-organ failure, shock, and hypothyroidism; 380 mg aminophylline equivalent to 300 mg theophylline

acute bronchospasm, adjunct tx

[healthy nonsmoker]

Dose: 0.5 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h, then 0.7 mg/kg/h IV x12h; Info: not recommended per NIH or GOLD guidelines; adjust dose based on serum levels; 0.5 mg/kg/h aminophylline equivalent to 0.4 mg/kg/h theophylline

[smoker]

Dose: 0.8 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h, then 1 mg/kg/h IV x12h; Info: not recommended per NIH or GOLD guidelines; adjust dose based on serum levels; 0.8 mg/kg/h aminophylline equivalent to 0.64 mg/kg/h theophylline

[elderly]

Dose: 0.3 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h, then 0.6 mg/kg/h IV x12h; Info: not recommended per NIH or GOLD guidelines; adjust dose based on serum levels; 0.3 mg/kg/h aminophylline equivalent to 0.24 mg/kg/h theophylline

[pt w/ reduced clearance]

Dose: 0.25 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h, then 0.5 mg/kg/h IV x12h; Info: not recommended per NIH or GOLD guidelines; adjust dose based on serum levels; reduced clearance risk factors include hepatic impairment, CHF, fever, sepsis w/ multi-organ failure, shock, and hypothyroidism; 0.25 mg/kg/h aminophylline equivalent to 0.2 mg/kg/h theophylline

renal dosing

[see below]

renal impairment: no adjustment

HD/PD: not defined

hepatic dosing

[adjust dose amount]

cirrhosis/acute hepatitis: decr. usual dose, amount not defined

Peds Dosing .

Dosage forms:  INJ

asthma, maintenance tx

[<45 kg]

Start: 15.2-17.7 mg/kg/day up to 380 mg IV divided q4-6h x3 days, then 20.3 mg/kg/day up to 507 mg x3 days, then 25.3 mg/kg/day up to 760 mg if tolerated; Max: 1015 mg/day, 507 mg/day if reduced clearance; Info: adjust dose based on serum levels; reduced clearance risk factors include hepatic impairment, CHF, fever, sepsis w/ multi-organ failure, shock, and hypothyroidism; 380 mg aminophylline equivalent to 300 mg theophylline

[>45 kg]

see Adult Dosing

acute bronchospasm, adjunct tx

[<6 wk old]

Dose: 0.25 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels; 0.25 mg/kg/h aminophylline equivalent to 0.2 mg/kg/h theophylline

[6 wk old-6 mo]

Dose: 0.6 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels; 0.6 mg/kg/h aminophylline equivalent to 0.5 mg/kg/h theophylline

[6 mo-1 yo]

Dose: 0.75-0.8 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels; 0.75 mg/kg/h aminophylline equivalent to 0.6 mg/kg/h theophylline

[1-9 yo]

Dose: 1 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h, then 1.2 mg/kg/h IV x12h; Info: not recommended per NIH guidelines; adjust dose based on serum levels; 1 mg/kg/h aminophylline equivalent to 0.8 mg/kg/h theophylline

[9-12 yo or young smoker]

Dose: 0.9 mg/kg/h IV; Start: load 6 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels; 0.9 mg/kg/h aminophylline equivalent to 0.7 mg/kg/h theophylline

[>12 yo]

see Adult Dosing

apnea of prematurity (off-label)

[1-2 mg/kg/dose IV q6-8h]

Start: 5-6 mg/kg/dose IV x1; Info: adjust dose based on serum levels

renal dosing

[0-3 mo]

renal impairment: decr. usual dose, amount not defined; Info: monitor theophylline serum levels frequently

HD/PD: no adjustment; no supplement

[>3 mo]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[adjust dose amount]

cirrhosis/acute hepatitis: decr. usual dose, amount not defined