Toxic interaction between fluvoxamine and sustained release theophylline in an 11-year-old boy

An 11-year-old boy with asthma had been receiving a controlled release theophylline preparation. He was prescribed fluvoxamine for a depressive disorder and within a week complained of severe headaches, tiredness and vomiting. His serum theophylline concentration had increased from 14.2 mg/L (shortl...

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Bibliographic Details
Published inDrug safety Vol. 6; no. 6; p. 460
Main Author Sperber, A D
Format Journal Article
LanguageEnglish
Published New Zealand 01.11.1991
Subjects
Administration, Oral
Child
Delayed-Action Preparations
Drug Interactions
Fluvoxamine - administration & dosage
Fluvoxamine - adverse effects
Humans
Male
Theophylline - administration & dosage
Theophylline - adverse effects
Theophylline - blood
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Summary:An 11-year-old boy with asthma had been receiving a controlled release theophylline preparation. He was prescribed fluvoxamine for a depressive disorder and within a week complained of severe headaches, tiredness and vomiting. His serum theophylline concentration had increased from 14.2 mg/L (shortly before fluvoxamine was started) to 27.4 mg/L. Fluvoxamine was withdrawn and theophylline concentrations decreased. Clomipramine was substituted for fluvoxamine with no further problems, and a later theophylline concentration was 13.7 mg/L. Competitive inhibition of hepatic microsomal enzymes by fluvoxamine may have been responsible for the elevated theophylline concentrations and toxicity observed in this case.
ISSN:0114-5916
DOI:10.2165/00002018-199106060-00006