Other Xanthines
Severe
Database
Additive cardiac/CNS toxicity
Avoid combination
Source: Kimi deep-research + Cla
Drug reference
doxofylline
Methylxanthine bronchodilator (dioxolane analog) · Bronchodilator
START
400 mg PO 2–3 times daily after food
TYPICAL MAX
1200 mg/day
STOP IF
Significant arrhythmia, seizure, or severe hypotension
WATCH
ECG/HR, K, GI symptoms; xanthine-class CNS effects
CDSCO approvedATC R03DA11
KDIGO 2024 + manufacturer label
- ONSET
- 45min · absorption
- PEAK
- 1h · Tmax
- t½
- 6.5h · t½
- DURATION
- 12h · BID-TID
EXCRETION
Renal — metabolites; ~4% unchanged
route + CYP
INTERACTIONS
1 major
SEVERE in our sources
PREGNANCY
Limited data; use only if clearly needed.
FDA category + note
Top interactionssee all 5 →
- Other XanthinesSevereDatabaseKimi deep-research + Cla
Mechanism
Methylxanthine that inhibits phosphodiesterase III/IV (less adenosine antagonism than theophylline), producing bronchodilation; lower CNS / cardiac toxicity than theophylline.
Indications
Chronic obstructive pulmonary diseaseAsthma (maintenance, regions where licensed)
Dosing
- Adult
- 400 mg PO 2–3 times daily after food.
- Pediatric
- ≥12 y: as adult.
- Renal adjustment
- Caution in severe impairment; no fixed adjustment.
- Hepatic adjustment
- Reduce dose in significant impairment.
- Geriatric
- Reduce dose; tachyarrhythmia risk.
- Max dose
- 1200 mg/day
Pharmacokinetics
Onset
Bronchodilation 30–60 min
Peak effect
~1 h (Tmax)
Duration
~12 h
Half-life
~6–7 h
Bioavailability
Well absorbed orally
Protein binding
~48%
Metabolism
Hepatic
Excretion
Renal (metabolites; ~4% unchanged)
Contraindications
- Acute myocardial infarction
- Severe arrhythmia
- Severe hypotension
- Hypersensitivity to xanthines
- Caution: peptic ulcer, seizure disorders
Side effects
Common
Nausea/vomitingHeadachePalpitationsInsomniaTremor
Serious
- Tachyarrhythmia
- Seizures (overdose)
- Severe hypotension
- GI bleeding (rare)
Pregnancy & lactation
Pregnancy
Limited data; use only if clearly needed.
Lactation
Limited data; caution.
Drug interactions
Ciprofloxacin
Moderate
Database
Increased xanthine levels
Monitor; reduce dose
Source: Kimi deep-research + Cla
Beta Blockers
Moderate
Database
Antagonism of bronchodilation
Use cardioselective β-blocker if needed
Source: Kimi deep-research + Cla
Lithium
Moderate
Database
Increased lithium clearance
Monitor lithium levels
Source: Kimi deep-research + Cla
Smoking
Moderate
Database
Induces xanthine metabolism
Dose adjustments after stopping smoking
Source: Kimi deep-research + Cla
7 additional unreviewed or low-confidence interactions hidden because their provenance or source detail is insufficient.
Related guidelines
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Textbook-sourced·Sources: Goodman & Gilman 14e·Updated: 2026-05-20·Cockpit curated: 2026-05-20