Theophylline is metabolised by cytochrome P450 in the liver, principally by CYP1A2. Many drugs interact with theophylline by inhibition or potentiation of its metabol- ism. Theophylline has a narrow therapeutic range, and small increases in serum levels can result in toxicity. Moreover, symptoms of serious toxicity such as convulsions and arrhythmias can occur before minor symptoms suggestive of toxicity. Furthermore, age, cigarette smoking, chronic obstructive airways disease, congestive heart failure, and liver disease (cirrhosis, acute hepatitis) can also affect theophylline clearance. Within the context of interactions, aminophylline is expected to behave like theophylline, because it is a complex of theophylline with ethylenediamine.
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