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Doxofylline should not be administered together with other xanthine derivatives, including beverages and foods containing excessive amounts of caffeine. Toxic synergism with ephedrine has been documented for xanthines.
Concomitant therapy with erythromycin, troleandomycin, lincomycin, clindamycin, and other antibiotics of the same group, allopurinol, propranolol, digoxin and anti-flu vaccine may decrease the hepatic clearance of xanthines causing an increase in blood levels. A lower dose of Doxofylline may be needed.
Phenytoin, other anticonvulsants 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.
