Theophylline has a narrow therapeutic index and troublesome interactions (especially with macrolides & nicotine). N.B.
PRESCRIBE BY BRAND - Be aware that oral modified release brands of theophylline and aminophylline are NOT interchangeable. All patients need to be maintained on the same brand as initally prescribed for them.
N.B. BTS guidelines state liquid preparations are not recommended for the prophylaxis of wheeze
Theophylline (Uniphyllin® Continus)
Tablet MR (200mg, 300mg, 400mg)
PRESCRIBE BY BRAND, but currently Uniphyllin Continus is only brand available. Slo-Phyllin capsules and Nuelin SA tablets discontinued 2019- see details.
Discontinued. 225mg stocks expected to be exhausted by 30th March 2021 & 350mg by 5th April 2021. No new patients to be started. See here for further details and switching guidance.
Tablets cannot be crushed. Switch to theophylline (100mg aminophylline = 80mg theophylline)
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Non Formulary section
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Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data. Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting. Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
Medicines which should normally be prescribed by specialists only. eg hospital only.
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
*Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
Primary care/ non specialist may initiate as per APC guideline.
The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
Medicines suitable for routine use within primary care.
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.