Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1991 Jun;35(6):1137–1141. doi: 10.1128/aac.35.6.1137

Effect of a new quinolone, sparfloxacin, on the pharmacokinetics of theophylline in asthmatic patients.

K Takagi 1, K Yamaki 1, M Nadai 1, T Kuzuya 1, T Hasegawa 1
PMCID: PMC284300  PMID: 1929255

Abstract

Recently, it has become evident that some quinolones affect the processing of theophylline in the human system. The effect of a new quinolone, sparfloxacin, on the pharmacokinetics and metabolism of theophylline was investigated in six asthmatic patients receiving chronic theophylline therapy (a sustained-release theophylline tablet formulation of 200 to 300 mg twice daily at 12-h intervals). To these patients, sparfloxacin (200 mg once daily) was coadministered for 1 week. Plasma and urine samples were analyzed by high-performance liquid chromatography for theophylline and its metabolites. Plasma theophylline concentration-time curves and the urinary excretion of theophylline and its major metabolites before and after coadministration of sparfloxacin were compared. The total body clearance of theophylline after coadministration of sparfloxacin, 42.81 +/- 6.64 ml/h/kg (mean +/- standard error of the mean), was not significantly different from that after the administration of theophylline alone, 47.11 +/- 7.61 ml/h/kg. Also, no significant change in the urinary excretion of theophylline and its metabolites was observed for subjects receiving or not receiving sparfloxacin. These findings indicate that a once-daily dose of 200 mg of sparfloxacin has no significant effect on the pharmacokinetics and metabolism of theophylline and that it would be safe to coadminister this quinolone to asthmatic patients receiving chronic theophylline therapy.

Full text

PDF
1138

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnett G., Segura J., de la Torre R., Carbó M. Pharmacokinetic determination of relative potency of quinolone inhibition of caffeine disposition. Eur J Clin Pharmacol. 1990;39(1):63–69. doi: 10.1007/BF02657060. [DOI] [PubMed] [Google Scholar]
  2. Beckmann J., Elsässer W., Gundert-Remy U., Hertrampf R. Enoxacin--a potent inhibitor of theophylline metabolism. Eur J Clin Pharmacol. 1987;33(3):227–230. doi: 10.1007/BF00637553. [DOI] [PubMed] [Google Scholar]
  3. Birkett D. J., Dahlqvist R., Miners J. O., Lelo A., Billing B. Comparison of theophylline and theobromine metabolism in man. Drug Metab Dispos. 1985 Nov-Dec;13(6):725–728. [PubMed] [Google Scholar]
  4. Carbó M., Segura J., De la Torre R., Badenas J. M., Camí J. Effect of quinolones on caffeine disposition. Clin Pharmacol Ther. 1989 Mar;45(3):234–240. doi: 10.1038/clpt.1989.23. [DOI] [PubMed] [Google Scholar]
  5. Edwards D. J., Bowles S. K., Svensson C. K., Rybak M. J. Inhibition of drug metabolism by quinolone antibiotics. Clin Pharmacokinet. 1988 Sep;15(3):194–204. doi: 10.2165/00003088-198815030-00004. [DOI] [PubMed] [Google Scholar]
  6. Edwards D. J., Waite N. M., Svensson C. K. Effect of enoxacin and 4-oxo-enoxacin on antipyrine disposition in the rat. Drug Metab Dispos. 1988 Jul-Aug;16(4):653–655. [PubMed] [Google Scholar]
  7. Gregoire S. L., Grasela T. H., Jr, Freer J. P., Tack K. J., Schentag J. J. Inhibition of theophylline clearance by coadministered ofloxacin without alteration of theophylline effects. Antimicrob Agents Chemother. 1987 Mar;31(3):375–378. doi: 10.1128/aac.31.3.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Grygiel J. J., Birkett D. J. Cigarette smoking and theophylline clearance and metabolism. Clin Pharmacol Ther. 1981 Oct;30(4):491–496. doi: 10.1038/clpt.1981.193. [DOI] [PubMed] [Google Scholar]
  9. Grygiel J. J., Wing L. M., Farkas J., Birkett D. J. Effects of allopurinol on theophylline metabolism and clearance. Clin Pharmacol Ther. 1979 Nov;26(5):660–667. doi: 10.1002/cpt1979265660. [DOI] [PubMed] [Google Scholar]
  10. Harder S., Staib A. H., Beer C., Papenburg A., Stille W., Shah P. M. 4-quinolones inhibit biotransformation of caffeine. Eur J Clin Pharmacol. 1988;35(6):651–656. doi: 10.1007/BF00637602. [DOI] [PubMed] [Google Scholar]
  11. Hasegawa T., Nadai M., Kuzuya T., Muraoka I., Apichartpichean R., Takagi K., Miyamoto K. The possible mechanism of interaction between xanthines and quinolone. J Pharm Pharmacol. 1990 Nov;42(11):767–772. doi: 10.1111/j.2042-7158.1990.tb07018.x. [DOI] [PubMed] [Google Scholar]
  12. Ho G., Tierney M. G., Dales R. E. Evaluation of the effect of norfloxacin on the pharmacokinetics of theophylline. Clin Pharmacol Ther. 1988 Jul;44(1):35–38. doi: 10.1038/clpt.1988.109. [DOI] [PubMed] [Google Scholar]
  13. Jackson J. E., Powell J. R., Wandell M., Bentley J., Dorr R. Cimetidine decreases theophylline clearance. Am Rev Respir Dis. 1981 Jun;123(6):615–617. doi: 10.1164/arrd.1981.123.6.615. [DOI] [PubMed] [Google Scholar]
  14. Jonkman J. H., Koëter G. H., Schoenmaker R., de Vries K., Greving J. E., de Zeeuw R. A. Correlation of serum and saliva theophylline concentration after administration of a sustained release preparation. Eur J Clin Pharmacol. 1981;20(1):73–78. doi: 10.1007/BF00554670. [DOI] [PubMed] [Google Scholar]
  15. Jonkman J. H., Upton R. A. Pharmacokinetic drug interactions with theophylline. Clin Pharmacokinet. 1984 Jul-Aug;9(4):309–334. doi: 10.2165/00003088-198409040-00002. [DOI] [PubMed] [Google Scholar]
  16. Kuzuya T., Takagi K., Apichartpichean R., Muraoka I., Nadai M., Hasegawa T. Kinetic interaction between theophylline and a newly developed quinolone, NY-198. J Pharmacobiodyn. 1989 Jul;12(7):405–409. doi: 10.1248/bpb1978.12.405. [DOI] [PubMed] [Google Scholar]
  17. Landay R. A., Gonzalez M. A., Taylor J. C. Effect of phenobarbital on theophylline disposition. J Allergy Clin Immunol. 1978 Jul;62(1):27–29. doi: 10.1016/0091-6749(78)90068-4. [DOI] [PubMed] [Google Scholar]
  18. Marquis J. F., Carruthers S. G., Spence J. D., Brownstone Y. S., Toogood J. H. Phenytoin-theophylline interaction. N Engl J Med. 1982 Nov 4;307(19):1189–1190. doi: 10.1056/NEJM198211043071906. [DOI] [PubMed] [Google Scholar]
  19. Mizuki Y., Kamaura M., Yamaguchi T., Sekine Y., Hashimoto M. Interaction of enoxacin with theophylline in rats. Arzneimittelforschung. 1989 May;39(5):593–597. [PubMed] [Google Scholar]
  20. Nadai M., Hasegawa T., Kuzuya T., Muraoka I., Takagi K., Yoshizumi H. Effects of enoxacin on renal and metabolic clearance of theophylline in rats. Antimicrob Agents Chemother. 1990 Sep;34(9):1739–1743. doi: 10.1128/aac.34.9.1739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Raoof S., Wollschlager C., Khan F. A. Ciprofloxacin increases serum levels of theophylline. Am J Med. 1987 Apr 27;82(4A):115–118. [PubMed] [Google Scholar]
  22. Spangler D. L., Kalof D. D., Bloom F. L., Wittig H. J. Theophylline bioavailability following oral administration of six sustained-release preparations. Ann Allergy. 1978 Jan;40(1):6–11. [PubMed] [Google Scholar]
  23. Takagi K., Hasegawa T., Ogura Y., Suzuki R., Yamaki K., Watanabe T., Kitazawa S., Satake T. Comparative studies on interaction between theophylline and quinolones. J Asthma. 1988;25(2):63–71. doi: 10.3109/02770908809071356. [DOI] [PubMed] [Google Scholar]
  24. Takagi K., Hasegawa T., Ogura Y., Yamaki K., Suzuki R., Satake T., Imaeda N., Mizukami Y. Absorption of theophylline from a sustained-release theophylline tablet formulation, Theo-Dur. Int J Clin Pharmacol Ther Toxicol. 1987 Oct;25(10):530–535. [PubMed] [Google Scholar]
  25. Tang-Liu D. D., Williams R. L., Riegelman S. Nonlinear theophylline elimination. Clin Pharmacol Ther. 1982 Mar;31(3):358–369. doi: 10.1038/clpt.1982.46. [DOI] [PubMed] [Google Scholar]
  26. Teunissen M. W., Brorens I. O., Geerlings J. M., Breimer D. D. Dose-dependent elimination of theophylline in rats. Xenobiotica. 1985 Feb;15(2):165–171. doi: 10.3109/00498258509045346. [DOI] [PubMed] [Google Scholar]
  27. Weinberger M., Hendeles L., Bighley L. The relation of product formulation to absorption of oral theophylline. N Engl J Med. 1978 Oct 19;299(16):852–857. doi: 10.1056/NEJM197810192991603. [DOI] [PubMed] [Google Scholar]
  28. Wijnands W. J., Vree T. B., van Herwaarden C. L. The influence of quinolone derivatives on theophylline clearance. Br J Clin Pharmacol. 1986 Dec;22(6):677–683. doi: 10.1111/j.1365-2125.1986.tb02957.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Wijnands W. J., van Herwaarden C. L., Vree T. B. Enoxacin raises plasma theophylline concentrations. Lancet. 1984 Jul 14;2(8394):108–109. doi: 10.1016/s0140-6736(84)90283-6. [DOI] [PubMed] [Google Scholar]
  30. Zarowitz B. J., Szefler S. J., Lasezkay G. M. Effect of erythromycin base on theophylline kinetics. Clin Pharmacol Ther. 1981 May;29(5):601–605. doi: 10.1038/clpt.1981.84. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES