• Administer around the clock to maintain therapeutic plasma levels. Administer once-a-day doses in the morning.

» Do not refrigerate elixirs or solutions; crystals may form. Crystals should dissolve when liquid is warmed to room temperature.

» Wait at least 4–6 hr after stopping IV therapy to begin immediate-release oral dosage; for extended-release oral dosage form, give 1st oral dose at time of IV discontinuation.

• PO: Administer oral preparations with food or a full glass of water to minimize GI irritation. Food slows but does not reduce the extent of absorption. May be administered 1 hr before or 2 hr after meals for more rapid absorption. Swallow tablets whole; do not crush, break, or chew enteric-coated or extended-release tablets (extended-release tablets may be broken if scored). Pedi: Use calibrated measuring device to ensure accurate dose of liquid preparations.

• Continuous Infusion: IV theophylline in 5% dextrose are packed in a moisture-barrier overwrap. Remove immediately before administration and squeeze bag to check for leaks. Discard if solution is not clear.

• Loading Dose: Administer over 20–30 min. If patient has had another form of theophylline before loading dose, obtain serum theophylline level and reduce loading dose proportionately.

• Rate: Do not exceed 20/min. Rapid administration may cause chest pain, dizziness, hypotension, tachypnea, flushing, arrhythmias, or a reaction to the solution or administration technique (chills; fever; redness, pain, or swelling at injection site). Infusion rate may be ↑ after 12 hr. Administer via infusion pump to ensure accurate dosage. Monitor ECG continuously; tachyarrhythmias may occur.

• Y-Site Compatibility:

» acyclovir

» alfentanil

» amikacin

» aminophylline

» amphotericin B liposome

» ascorbic acid

» atropine

» aztreonam

» bivalirudin

» bumetanide

» buprenorphine

» butorphanol

» calcium chloride

» calcium gluconate

» carboplatin

» caspofungin

» cefazolin

» cefotetan

» cefoxitin

» ceftriaxone

» chloramphenicol

» chlorpromazine

» cisatracurium

» cisplatin

» clindamycin

» cyanocobalamin

» cyclophosphamide

» cyclosporine

» cytarabine

» dactinomycin

» daptomycin

» dexamethasone sodium phosphate

» dexmedetomidine

» digoxin

» diltiazem

» diphenhydramine

» dobutamine

» docetaxel

» dopamine

» doxorubicin hydrochloride

» doxycycline

» enalaprilat

» epinephrine

» epirubicin

» epoetin alfa

» ertapenem

» erythromycin lactobionate

» esmolol

» etoposide

» etoposide phosphate

» famotidine

» fenoldopam

» fentanyl

» fluconazole

» fludarabine

» fluorouracil

» folic acid

» furosemide

» gemcitabine

» gentamicin

» glycopyrrolate

» granisetron

» heparin

» hydrocortisone sodium succinate

» hydromorphone

» ifosfamide

» imipenem/cilastatin

» indomethacin

» insulin

» isoproterenol

» ketorolac

» labetalol

» levofloxacin

» lidocaine

» linezolid

» lorazepam

» magnesium sulfate

» mannitol

» mechlorethamine

» meperidine

» metaraminol

» methotrexate

» methoxamine

» methyldopa

» methylprednisolone sodium succinate

» metoclopramide

» metoprolol

» metronidazole

» micafungin

» midazolam

» milrinone

» minocycline

» mitoxantrone

» morphine

» multiple vitamins

» nafcillin

» nalbuphine

» naloxone

» nesiritide

» nitroglycerin

» nitroprusside

» norepinephrine

» ondansetron

» oxacillin

» oxaliplatin

» oxytocin

» paclitaxel

» palonosetron

» pantoprazole

» papaverine

» pemetrexed

» penicillin G

» pentamidine

» pentazocine

» pentobarbital

» phenobarbital

» phentolamine

» phenylephrine

» phytonadione

» piperacillin/tazobactam

» potassium chloride

» procainamide

» prochlorperazine

» promethazine

» propranolol

» protamine

» pyridoxime

» quinapristin/dalfopristin

» ranitidine

» remifentanil

» rituximab

» rocuronium

» sodium acetate

» sodium bicarbonate

» streptokinase

» succinylcholine

» sufentanil

» tacrolimus

» teniposide

» thiamine

» thiotepa

» ticarcillin/clavulanate

» tigecycline

» tirofiban

» tobramycin

» tolazoline

» trastuzumab

» trimethaphan

» vancomycin

» vasopressin

» vecuronium

» verapamil

» vincristine

» vinorelbine

» voriconazole

• Y-Site Incompatibility:

» azathioprine

» cefepime

» dantrolene

» diazepam

» diazoxide

» ganciclovir

» hetastarch

» phenytoin

» trimethoprim/sulfamethoxazole

• Additive Incompatibility: Admixing is not recommended because of dose titration and incompatibilities.