Brezofil

Indications

Brezofil is indicated for the treatment of:

• Bronchial Asthma
• Bronchospasm
• Chronic Obstructive Pulmonary Disease (COPD)
• Pulmonary Conditions with a Spastic Bronchial Component

Always use this medication under the guidance of a registered healthcare professional.

Pharmacology

Brezofil contains Doxophylline, a unique bronchodilator that differentiates itself from Theophylline by featuring a dioxolane group at position 7. Doxophylline selectively inhibits phosphodiesterase type 4, promoting relaxation of bronchial smooth muscle. Unlike Theophylline, it exhibits lower affinity for adenosine A1 and A2 receptors, which may contribute to its improved safety profile. Additionally, Doxophylline has been shown to inhibit platelet-activating factor (PAF) and reduce leukotriene production.

Dosage & Administration

• Elderly Patients: 200 mg tablet taken two to three times daily.
• Adults: 400 mg tablet taken two to three times daily or as directed by a physician.
• Children:
  • Aged >12 years: 10 ml syrup or 200 mg tablet taken two to three times daily.
  • Aged 6-12 years: 6-9 mg/kg of body weight twice daily. For example, for a child weighing 10 kg, administer 3 ml (60 mg) twice daily, or as directed by a physician.

If the required daily dosage is 400 mg, a single daily dose of Doxophylline SR tablet may be prescribed.

Always use this medication under the guidance of a registered healthcare professional.

Interactions

Brezofil should not be used alongside other xanthine medications. It is advisable to limit the intake of caffeine-containing foods and beverages. Exercise caution when administering Brezofil with ephedrine or other sympathomimetics. Various medications, including erythromycin, TAO, lincomycin, clindamycin, allopurinol, cimetidine, the influenza vaccine, and propranolol, may reduce the liver’s ability to clear xanthine derivatives, leading to increased plasma levels. Conversely, phenytoin, other anticonvulsants, and cigarette smoking may accelerate the clearance of xanthine derivatives, potentially necessitating dosage adjustments.

Contraindications

Doxophylline is contraindicated in individuals with known hypersensitivity to the drug or other xanthine derivatives. It should not be used in patients experiencing acute myocardial infarction, hypotension, or during lactation.

Side Effects

Patients receiving xanthine derivatives may experience side effects such as nausea, vomiting, epigastric pain, headaches, irritability, insomnia, tachycardia, extrasystoles, and tachypnea. In rare instances, hyperglycemia or albuminuria may occur. Severe cardiac arrhythmias and tonic-clonic seizures may occur in the event of an overdose, which can be a sign of intoxication. If side effects manifest, treatment may need to be discontinued, but can be resumed at lower doses upon the physician’s discretion once all symptoms of toxicity have resolved.

Pregnancy & Lactation

Animal studies have indicated that Doxophylline does not affect pre and postnatal growth. However, due to insufficient clinical evidence regarding its effects during pregnancy, its use must be assessed on a case-by-case basis, weighing the potential risks and benefits. The drug is contraindicated during lactation.

Effects on Driving and Operating Machinery

Brezofil does not impair alertness and does not affect the ability to drive or operate machinery.

Precautions & Warnings

Various factors can reduce the liver’s clearance of xanthine derivatives, leading to increased plasma concentrations. These factors include age, congestive heart failure, chronic obstructive pulmonary disease, severe liver disease, concurrent infections, and co-administration of medications like erythromycin, TAO, lincomycin, clindamycin, allopurinol, cimetidine, the influenza vaccine, and propranolol. In such cases, it may be necessary to adjust the medication dosage. Monitoring blood levels is recommended to ensure the drug remains within the therapeutic range.

Caution is advised when administering this medication to patients with cardiac disease, hypertension, the elderly, severe hypoxemia, hyperthyroidism, chronic corpulmonale, congestive heart failure, liver disease, peptic ulcers, and renal impairment. Special attention is needed in patients with congestive heart failure due to slower drug clearance, which may lead to prolonged elevated blood levels even after treatment has stopped. There is no risk of addiction or dependence.

Overdose Effects

In cases of overdose, severe cardiac arrhythmias and tonic-clonic seizures may occur. These symptoms may indicate initial intoxication. Side effects may necessitate discontinuation of the drug; however, it may be resumed at lower doses once symptoms of toxicity have subsided. As no specific antidote exists, symptomatic treatment for cardiovascular collapse should be initiated in the event of an overdose.

Therapeutic Class

Bronchodilator; Methyl Xanthine Derivative

Storage Conditions

Store in a dry place away from light and heat. Keep out of reach of children. Brezofil should only be used upon the prescription of a specialist physician.