Effect of Formoterol on the Plasma Levels of Theophylline after the Oral Administration to the Children with Respiratory Diseases

소아 호출기 환자에서 경구 투여된 Formoterol이 Theophylline의 혈중농도에 미치는 영향의 연구

Theophylline and $\beta$-adrenergic agonists are frequently used together in patients with respiratory diseases. However the clinical impact of $\beta_2$-adrenergic agonists on the blood concentration of theophylline is not fully evaluated. Formoterol, a newly available oral ${\beta}_2$-adrenergic agonist is frequently used in pediatric respiratory patients. The objective of this study was to investigate the effect of oral formoterol on theophylline's blood concentration. Randomized prospective study was conducted. Twenty-four children were enrolled on the study. Their age ranged 2 to 73 months (mean 35.8 months). Theophylline group (12 patients) received 10 mg/kg/day of for theophylline orally. Theophylline/formoterol group (12 patients) received 10 mg/kg/day of theophylline and $4\;{\mu}g/kg/day$ of formoterol orally. All medications were administered at least for 5 days starting on admission day. Theophylline's trough concentrations were obtained on days 3 and day 5. Pulse rates were recorded before the study medications were given on admission, and days 3 and day 5. Statistical significance was calculated by two-tailed Student's t-test. Theophylline's levels in children given theophylline and formoterol together were lower an those given theophylline alone ($6.38\pm0.90\;{\mu}g/ml\;vs\;7.43\pm0.77\;{\mu}g/ml$ on day 3(p<0.05), $5.62\pm0.56\;{\mu}g/ml\;vs.\;6.78\pm0.61\;{\mu}g/ml$ on day 5 (p<0.05)). In both groups, theophylline's trough concentration on day 5 were lower than day 3. There was no significant side effects in both groups. In conclusion, the new ${\beta}_2$ selective adrenergic agonist formoterol reduced serum theophylline levels in children with respiratory diseases. Further investigation is needed to clarify the long term effect of this drug interaction.