Effect of aminophylline on urine flow in children with tacrolimus-induced renal insufficiency

Reversal of acute tacrolimus-induced renal vasoconstriction by theophylline in rats*

“…Fortunately, therapeutic drug monitoring is widely available for both agents. As THEO and TAC are both known to induce seizures, combined use of these agents in humans may be associated with an increased incidence of seizures, although we have not observed this phenomenon (6).…”

“…Clinical and experimental studies have demonstrated that although TAC induces less systemic vasoconstriction and hypertension than cyclosporine, both induce comparable renal vasoconstriction and thus nephrotoxicity (3)(4)(5). Acutely, this vasoconstriction complicates the care of critically ill patients by limiting drug delivery to the kidney and, in severe toxicity, precipitating oliguria and pulmonary edema (6). Chronically, this nephrotoxicity can lead to end-stage renal disease and dialysis (7).…”

Additive diuretic response of concurrent aminophylline and furosemide in children: a case series and a brief literature review

“…Our findings contrasted with those of Pretzlaff et al [28], who showed that all variables had returned to baseline levels by 4-6 h, although agreeing with the findings of Bell et al [25], who demonstrated an increase in urinary output during the day after the patients received theophylline. Aminophylline has a half-life of 8-9 h in adults and would therefore have a residual action during the post-administration period [21]. Thus, the rise in all these variables with progressive return toward baseline levels after withdrawal of drug therapy suggests a true pharmacological effect.…”

“…This level of theophylline is less than the target level required to treat critically ill children with status asthmaticus. Concentrations attained with this use are higher at 12-17 mg/l [21,28]. Therefore it is possible that theophylline improves urine output in critically ill children with furosemideresistant oliguria, at relatively low dosages (theophylline concentration, 2-4 mg/l) and without incurring significant toxicity, as classically.…”

“…Studies in adult and pediatric patients have demonstrated a diuretic effect of aminophylline resulting from increased renal blood flow and the inhibition of solute reabsorption in various segments of the nephron [15]. Clinically, these drugs have been used with furosemide or other loop diuretics to induce diuresis in adults [16,17] and children [15,[18][19][20][21][22][23][24][25][26][27][28][29]. Nevertheless, most of the studies describe neonates [15,[18][19][20][23][24][25][26][27][28][29].…”