ADMINISTRATION OF ERYTHROMYCIN TO PATIENTS ON THEOPHYLLINE

[摘要] There appears to be a significant risk of developing toxic theophylline levels when patients on high doses of oral theophylline are started on erythromicin preparations. This was demonstrated for the 3 commonly used erythromycin salts (estolate, stearate and ethyl succinates). Whether it occurs when the erythromycin base is used is not established. Using a modified high-pressure liquid chromatographic procedure to measure serum theophylline in small quantities of capillary blood the effects on serum theophylline in patients on lower doses of theophylline did not appear to have any clinical importance. Careful monitoring of serum theophylline in all patients who are on high doses, such as 20 mg/kg per 24 h or above, of this bronchodilator in whom erythromycin preparations are started is recommended. Rather than excluding erythromycin preparations from the therapeutic program, lowering the dose of oral theophylline during the period in which erythromycin is used was recommended.