Doximar

Indications

Doximar is prescribed for the treatment of the following conditions:

• Bronchial asthma
• Bronchospasm
• Chronic Obstructive Pulmonary Disease (COPD)
• Pulmonary diseases with spastic bronchial components

Note: Always take medication as directed by a licensed physician.

Pharmacology

Doxophylline, the active ingredient in Doximar, is a modern bronchodilator that stands out for its structural distinction from Theophylline, due to a dioxolane group at position 7. It works by selectively inhibiting phosphodiesterase-4, relaxing bronchial smooth muscles. Unlike Theophylline, Doxophylline exhibits reduced affinity for adenosine A1 and A2 receptors, contributing to its improved safety profile. It also inhibits platelet-activating factor (PAF) and reduces leukotriene production, further enhancing its therapeutic benefits.

Dosage & Administration

• Adults: 400 mg tablet, 2-3 times daily, or as prescribed.
• Elderly: 200 mg tablet, 2-3 times daily.
• Children:
  • Over 12 years: 10 ml syrup or 200 mg tablet, 2-3 times daily.
  • 6-12 years: 6-9 mg/kg body weight twice daily (e.g., for a 10 kg child, 3 ml syrup or 60 mg twice daily).

For a daily dose of 400 mg, Doxophylline SR tablets can be taken once daily, or as advised by the physician.

Note: Always follow a physician’s recommendations when determining dosage.

Drug Interactions

Doximar should not be taken with other xanthine-based medications. Minimize caffeine intake from food and beverages. Exercise caution when combined with ephedrine or sympathomimetic drugs. Concurrent use of drugs like erythromycin, TAO, lincomycin, clindamycin, allopurinol, cimetidine, influenza vaccine, or propranolol can reduce the hepatic clearance of xanthine derivatives, increasing plasma levels.

Conversely, phenytoin, other anticonvulsants, and smoking may accelerate xanthine clearance, necessitating a dosage adjustment.

Contraindications

Doximar is contraindicated in:

• Patients allergic to Doxophylline or other xanthine derivatives.
• Those with acute myocardial infarction or hypotension.
• Lactating women.

Side Effects

Potential side effects include:

• Common: Nausea, vomiting, epigastric pain, headache, irritability, insomnia, tachycardia, and respiratory issues.
• Rare: Hyperglycemia and albuminuria.
• Overdose: Severe cardiac arrhythmias and tonic-clonic seizures, which may necessitate discontinuation of treatment.

Use in Pregnancy & Lactation

Animal studies show no interference with prenatal or postnatal development. However, due to insufficient clinical data in humans, the risk-benefit ratio must be carefully evaluated during pregnancy. Contraindicated during lactation.

Precautions & Warnings

Certain conditions may reduce the hepatic clearance of xanthine derivatives, leading to higher plasma drug levels. These include:

• Advanced age
• Congestive cardiac failure
• Chronic liver disease
• Severe COPD
• Concomitant infections

Recommendations:

• Monitor plasma drug concentrations in such patients to maintain a therapeutic range.
• Use cautiously in patients with cardiac disease, hypertension, hyperthyroidism, liver or renal impairment, or peptic ulcers.

Overdose Effects

Symptoms of overdose include severe cardiac arrhythmias and seizures, which may indicate drug toxicity. Treatment involves symptomatic care to manage cardiovascular collapse. Discontinuation and dose adjustments may be necessary.

Therapeutic Class

• Bronchodilator
• Methylxanthine derivatives

Storage Instructions

Store in a cool, dry place, away from heat and light. Keep out of reach of children. Use only as prescribed by a specialist physician.