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Aminophylline overdose

Theophylline overdose; Xanthine overdose

Aminophylline and theophylline are medicines used to treat lung diseases such as asthma. They help prevent and treat wheezing and other breathing problems, including respiratory distress associated with premature birth. Aminophylline or theophylline overdose occurs when someone takes more than the normal or recommended amount of these medicines. This can be done by accident or on purpose.

Aminophylline may interact with other medications, resulting in higher blood levels and increasing the risk of side effects.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Aminophylline and theophylline can be poisonous in large doses.

Where Found

Aminophylline and theophylline are found in medicines that treat lung diseases such as:

• Asthma
• Bronchitis
• Emphysema
• COPD (chronic obstructive pulmonary disease)

Other products may also contain aminophylline and theophylline.

Symptoms

The most serious life-threatening symptoms of theophylline overdose are seizures and disturbances in heart rhythm.

Symptoms in adults may include:

STOMACH AND INTESTINES

• Diarrhea
• Increased appetite
• Increased thirst
• Nausea
• Vomiting (possibly with blood)

HEART AND BLOOD

• High or low blood pressure
• Irregular heartbeat
• Rapid heart rate
• Pounding heartbeat (palpitations)

LUNGS

• Breathing difficulty

MUSCLES AND JOINTS

• Muscle twitching and cramping

NERVOUS SYSTEM

• Abnormal movements
• Confused thinking, poor judgment and agitation (psychosis when extreme)
• Convulsions (seizures)
• Dizziness
• Fever
• Headache
• Irritability, restlessness
• Sweating
• Trouble sleeping

Symptoms in babies may include:

STOMACH AND INTESTINES

• Nausea
• Vomiting

HEART AND BLOOD

• Irregular heartbeat
• Low blood pressure
• Rapid heartbeat
• Shock

LUNGS

• Rapid, deep breathing

MUSCLES AND JOINTS

• Muscle cramps
• Twitching

NERVOUS SYSTEM

• Convulsions (seizures)
• Irritability
• Tremors

Home Care

Seek medical help right away. Do NOT make the person throw up unless poison control or a health care provider tells you to do so.

Before Calling Emergency

Have this information ready:

• Person's age, weight, and condition
• Name of the medicine (ingredients and strengths, if known)
• Time it was swallowed
• Amount swallowed

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)

Treatment may include:

• Activated charcoal
• Intravenous fluids (IV, given through a vein)
• Laxative
• Medicine to treat symptoms
• Shock to the heart, for serious heart rhythm disturbances
• Breathing support, which may include oxygen or a ventilator (tube through the mouth into the lungs and breathing machine)
• Dialysis (kidney machine), in severe cases

Outlook (Prognosis)

Convulsions and irregular heartbeats may be difficult to control. Some symptoms may occur up to 12 hours after the overdose.

Death may occur with large overdoses, especially in very young or old people.

References

Aronson JK. Theophylline and related compounds. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:813-831.

Aronson JK. Xanthines. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:530-531.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Page CP, Edwards AM, Holgate ST. Xanthines, phosphodiesterase inhibitors, and chromones. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier, 2020: chap 94.

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Review Date: 7/1/2023  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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