Cardiac Arrhythmias during the Combined Use of β-Adrenergic Agonist Drugs and Theophylline

Theophylline and salbutamol in combination in patients with obstructive pulmonary disease and concurrent heart disease: effect on cardiac arrhythmias

“…Our data do not support such a conclusion; the addition of theophylline to a salbutamol regimen did not increase the frequency or alter the severity of these ventricular or supraventricular arrhythmias. This finding is in agreement with those of several other recent studies [6, 7, 8, 16, 18]. Although these studies have not been especially designed to assess the effects of combined theophylline and salbutamol use in patients with obstructive pulmonary disease with concurrent heart disease, some patients in the studies of Dutt et al [18] and Eidelman et al [8] also had coronary artery disease or heart failure.…”

“…Even deaths of asthma patients have been attributed to the combined use of inhaled beta‐agonists and oral theophylline [5]. An increased frequency of arrhythmia has been observed during the use of these drugs, although this has been considered to be clinically insignificant [6–8]. Most studies, however, have been conducted in young, otherwise healthy subjects.…”

Pharmacology and Therapeutics of Bronchodilators

“…Considering that increased theophylline concentrations can lead to an increased propensity for central and cardiac stimulation, it is prudent to avoid using a combination of theophylline and cardiac medications, especially antidysrhythmic drugs (Aronson, 2006). Combined therapy with theophylline and a ␤ 2 -AR agonist in young, otherwise healthy asthmatic subjects does not lead to an increase in the total number of ectopic beats but may increase the degree of complexity of ventricular premature beats (Coleman et al, 1986). …”

Bronchodilators in subjects with asthma-related comorbidities

“…In young, otherwise healthy asthmatic subjects, combined therapy with theophylline and an oral β-adrenergic agonist (terbutaline) does not lead to an increase in the total number of ectopic beats but may increase the degree of complexity of ventricular premature beats [26]. A further study demonstrated that combined intravenous therapy with aminophylline and terbutaline in patients with status asthmaticus was associated with the development of severe cardiac arrhythmias in 24% of patients, but these arrhythmias were hemodynamically well tolerated and resolved spontaneously without any antiarrhythmic treatment [27].…”