Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

A Randomized, Controlled, Double-Blind Trial Comparing Two Loading Doses of Aminophylline

Journal of Perinatology volume 22, pages 275–278 (2002)Cite this article

Abstract

OBJECTIVE: To compare 8 mg/kg and 6 mg/kg loading doses of aminophylline.

STUDY DESIGN: Sixty-one preterm infants weighing <1500 g were enrolled once a decision to administer intravenous aminophylline was made. A standard maintenance dose was used. Serum levels of theophylline were drawn 8 hours after the loading dose and before the fifth maintenance dose.

RESULTS: After the initial loading dose, the 8 mg/kg group achieved recommended serum theophylline levels (7–12 μg/ml) more frequently than the 6mg/kg group (39% vs 3%, p=0.002). Subsequent levels were similar between the groups. There were no increases in side effects with the higher loading dose.

CONCLUSION: If a clinical decision to start intravenous aminophylline therapy in preterm infants has been made, the use of an 8 mg/kg loading dose appears to be a better and safe way to quickly achieve serum theophylline levels within the recommended range.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Henderson-Smart DJ, Steer P . Methylxanthine treatment for apnea in preterm infants Cochrane Database Syst Rev 2000 2: CD000140

  2. Shannon DC, Gotay F, Stein IM, Rogers MC, Todres ID, Moylan FMB . Prevention of apnea and bradycardia in low-birthweight infants Pediatrics 1975 55: 589–94

    CAS  PubMed  Google Scholar 

  3. Aranda JV, Turmen T . Methylxanthines in apnea of prematurity Clin Perinatol 1979 6: 1 87–108

    Article  CAS  Google Scholar 

  4. Muttitt SC, Tierney AJ, Finer NN . The dose response of theophylline in the treatment of apnea of prematurity J Pediatr 1988 112: 115–21

    Article  CAS  Google Scholar 

  5. Siberry GK, Iannone R . The Harriet Lane Handbook St. Louis: Mosby 2000 p 625–6

    Google Scholar 

  6. Young TE, Mangum B . Neofax Raleigh: Acorn Publishing 2001 p 160–1

    Google Scholar 

  7. Bhatt DR, Reber DJ, Wirtschafter DD, Parikh AN, Thomas JC . Neonatal Drug Formulary Los Angeles: Neonatal Drug Formulary 1997 p 20–2

    Google Scholar 

  8. Taketomo CK, Hodding JH, Kraus DM . Pediatric Dosage Handbook Hudson: Lexi-Comp 2000–2001 p 61–3

    Google Scholar 

  9. Gal P, Gilman JT . Concerns about the food and drug administration guidelines for neonatal theophylline dosing Ther Drug Monit 1986 8: 1 1–3

    Article  CAS  Google Scholar 

  10. Maxwell-Rubin M, Paap CM, Godley PJ . Adequacy of recommended aminophylline loading doses in children Am J Hosp Pharm 1994 51: 1667–71

    CAS  PubMed  Google Scholar 

  11. Schmidt B . Methylxanthine therapy in premature infants: sound practice, disaster, or fruitless byway? J Pediatr 1999 135: 526–8

    Article  CAS  Google Scholar 

  12. Chaudhuri M, Garg SK, Narang A, Bhakoo ON . Kinetics of theophylline in apnea of prematurity in small for gestational age babies Indian Pediatr 1996 33: 181–7

    CAS  PubMed  Google Scholar 

  13. Jones RAK, Baillie E . Dosage schedule for intravenous aminophylline in apnoea of prematurity, based on pharmacokinetic studies Arch Dis Child 1979 54: 190–3

    Article  CAS  Google Scholar 

  14. Aranda JV, Sitar DS, Parsons WD, Loughnan PM, Neims AH . Pharmacokinetic aspects of theophylline in premature newborns N Engl J Med 1976 295: 413–6

    Article  CAS  Google Scholar 

  15. Giacoia G, Jusko WJ, Menke J, Koup JR . Theophylline pharmacokinetics in premature infants with apnea J Pediatr 1976 89: 5 829–32

    Article  CAS  Google Scholar 

  16. Lagercrantz H, Rane A, Tunell R . Plasma concentration–effect relationship of theophylline in treatment of apnea in preterm infants Eur J Clin Pharmacol 1980 18: 65–8

    Article  CAS  Google Scholar 

  17. Gilman JT, Gal P, Levine RS, Hersh CB, Erkan NV . Factors influencing theophylline disposition in 179 newborns Ther Drug Monit 1986 8: 4–10

    Article  CAS  Google Scholar 

  18. Aranda JV, Turmen T, Sasynuik BI . Pharmacokinetics of diuretics and methylxanthines in the neonate Eur J Clin Pharmacol 1980 18: 55–63

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Memorial Hermann Children's Hospital, Houston, TX, USA

    Christine Hochwald PharmD & Jocelin Chang PharmD

  2. Department of Pediatrics, UT Houston School of Medicine, Houston, TX, USA

    Kathleen Kennedy MD & Fernando Moya MD

Authors
  1. Christine Hochwald PharmD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathleen Kennedy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jocelin Chang PharmD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fernando Moya MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Reprints: Department of Pharmacy Services, Memorial Hermann Hospital, 6411 Fannin Street, Houston, TX 77030, USA

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hochwald, C., Kennedy, K., Chang, J. et al. A Randomized, Controlled, Double-Blind Trial Comparing Two Loading Doses of Aminophylline. J Perinatol 22, 275–278 (2002). https://doi.org/10.1038/sj.jp.7210737

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7210737

Search

Advanced search

Quick links