Use with caution in patients with hypertension, heart disease, hypoxemia, hyperthyroidism, chrome right ventricular failure, congestive heart failure, liver disease, renal disease, in those with history of peptic ulcer, and in the elderly.
Frequently, patients with congestive heart failure have markedly prolonged drug plasma levels following discontinuation of the drug.
The half-life of xanthine derivatives is influenced by a number of known variables. It may be prolonged in patients with liver disease, in patients with congestive heart failure, in those affected with chronic obstructive lung disease or concomitant infections, and in those patients taking certain other drugs (erythromycin, troleandomycin, lincomycin and other antibiotics of the same group, allopurinol, cimetidine, propranolol, and anti-flu vaccine). In these cases, a lower dose of Doxofylline may be needed.
Phenytoins, other anti-convulsants and smoking may cause an increase in clearance with a shorter mean half-life: in these cases, higher doses of Doxofylline may be needed.
Laboratory monitoring of plasma concentration of Doxofylline is recommended in all the previously mentioned situations.
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