Theophylline, Ephedrine, and Hydroxyzine (Systemic)

Brand Names : Marax, Marax-DF

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For theophylline, ephedrine, and hydroxyzine combination medicine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to aminophylline, oxtriphylline, or theophylline; ephedrine or medicines like ephedrine such as albuterol, amphetamines, epinephrine, isoproterenol, metaproterenol, norepinephrine, phenylephrine, phenylpropanolamine, pseudoephedrine, or terbutaline; or hydroxyzine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - Make certain your health care professional knows if you are on any special diet, such as a high-protein, low-carbohydrate or low-protein, high-carbohydrate diet.

Pregnancy - Theophylline is used to treat asthma in pregnant women. Although there are no studies on birth defects in humans, problems have not been reported. However, some studies in animals have shown that theophylline can cause birth defects when given in doses many times the human dose.

Because your ability to clear theophylline from your body may decrease later in pregnancy, your doctor may want to take blood samples during your pregnancy to measure the amount of medicine in the blood. This will help your doctor decide whether the dose of this medicine should be changed.

Theophylline crosses the placenta. Use of this medicine during pregnancy may cause unwanted effects, such as fast heartbeat, irritability, jitteriness, or vomiting, in the newborn infant if the amount of medicine in your blood is too high.

Ephedrine has been shown to cause birth defects in humans when used during the first trimester.

Hydroxyzine is not recommended during the first months of pregnancy because it has been shown to cause birth defects in rats when given in doses up to many times the usual human dose.

Breast-feeding - Theophylline and ephedrine pass into breast milk and may cause unwanted effects such as irritability in babies of mothers taking this medicine. Hydroxyzine has been reported to cause unusual excitement or irritability in nursing babies.

Children - Theophylline, ephedrine, and hydroxyzine combination medicine is not recommended for use in children up to 2 years of age. Although there is no specific information about the use of theophylline, ephedrine, and hydroxyzine combination medicine in children 2 years of age and older, it is not expected to cause different side effects or problems in these children than it does in adults.

Older adults - Patients older than 60 years of age may be especially sensitive to the effects of theophylline, ephedrine, and hydroxyzine combination medicine. This may increase the chance of side effects during treatment.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking theophylline, ephedrine, and hydroxyzine combination medicine, it is especially important that your health care professional know if you are taking any of the following:

• Beta-adrenergic blocking agents including those used in the eyes (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Betoptic, Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], levobunolol [e.g., Betagan], metipranolol [e.g., OptiPranolol], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren, Timoptic]) - These medicines may prevent theophylline from working properly

• Central nervous system (CNS) depressants (medicines that cause drowsiness) - The effects of these medicines or hydroxyzine may be increased

• Cimetidine (e.g., Tagamet) or
• Ciprofloxacin (e.g., Cipro) or
• Clarithromycin (e.g., Biaxin) or
• Enoxacin (e.g., Penetrex) or
• Erythromycin (e.g., E-Mycin) or
• Fluvoxamine (e.g., Luvox) or
• Mexiletine (e.g., Mexitil) or
• Pentoxifylline (e.g., Trental) or
• Tacrine (e.g., Cognex) or
• Thiabendazole or
• Ticlopidine (e.g., Ticlid) or
• Troleandomycin (e.g., TAO) - These medicines may increase the effects of theophylline

• Cocaine or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - The effects of ephedrine on the heart and blood vessels may be increased

• Guanadrel or
• Guanethidine or
• Methyldopa (e.g., Aldomet) - These medicines may increase the chance of high blood pressure caused by ephedrine

• Medicines that lower the acidity of urine, such as antacids containing calcium or magnesium, carbonic anhydrase inhibitors (e.g., Diamox, Neptazine), citrates (e.g., Bicitra, Polycitra), or sodium bicarbonate (e.g., baking soda) - These medicines may increase the chance of side effects of ephedrine

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Taking ephedrine while you are taking or within 2 weeks of taking monoamine oxidase (MAO) inhibitors may increase the effects of MAO inhibitors

• Moricizine (e.g., Ethmozine) or
• Phenytoin (e.g., Dilantin) or
• Rifampin (e.g., Rifadin) - These medicines may decrease the effects of theophylline

• Rauwolfia alkaloids (e.g., reserpine) - These medicines may prevent ephedrine from working properly

• Smoking tobacco or marijuana - Starting or stopping smoking may change the effectiveness of theophylline

Other medical problems - The presence of other medical problems may affect the use of theophylline, ephedrine, and hydroxyzine combination medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Coronary insufficiency - Ephedrine may make the condition worse

• Enlarged prostate or
• Urinary tract blockage or difficult urination - Hydroxyzine may make urinary problems worse

• Glaucoma - Ephedrine and hydroxyzine may make the condition worse

• Heart failure or
• Liver disease or
• Underactive thyroid - The effects of theophylline may be increased

• High blood pressure - Use of ephedrine may cause severe high blood pressure

• Convulsions (seizures) - Theophylline may make this condition worse