Troleandomycin, asthma

Uses Chronic asthma Actions Topical steroid Dose Two inhalations tid-qid or 4 inhal bid Caution [C, ] Contra Component aU gy Disp Met-dose inhaler SE Cough, oral candidiasis Interactions T Risk of GI bleed W/ ASA, NSAIDs T effects W/ sakneterol, troleandomycin -1- effects W/barbiturates, hydantoins, pheny-toin, rifampin T effects OF diuretics, insulin, oral hypoglycemics, K supl, salicylates, somatrem, live virus vaccines EMS May affect glucose(hyperglycemia) monitor ECG for hypokalemia (flattened T waves) concurrent ASA/NSAID use may t risk of GI bleeding OD Acute OD unlikely to cause life-threatening Sxs, chronic OD may lead to S/Sxs of muscle weakness, and osteoporosis symptomatic and supportive... 

Spector S, Katz F, Farr R. Troleandomycin effectiveness in steroid-dependent asthma and bronchitis. J Allergy CUn Immunol 1974 54 367. 

Zeiger RS, Schatz M, Sperling W, Simon RA, Stevenson DD. Efficacy of troleandomycin in outpatients with severe, corticosteroid-dependent asthma. J Allergy Clin Immunol 1980 66(6) 438-46. 

Kamada, A. K., Hill, M. R., Ikle, D. N., Brenner, A. M., and Szefler, S. J. (1993). Efficacy and safety of low-concentration troleandomycin therapy in children with severe, steroid-requiring asthma. J. Allergy Clin. Immunol. 91, 873-882. 

Troleandomydn. A pharmacokinetic study in 4 children and 6 adult corticosteroid-dependent asthmatics found that troleandomycin 14 mg/kg daily for one week increased the half-life of methylprednisolone by 88%, from 2.46 to 4.63 hours, and reduced the total body clearance by 64%. All 10 had Cushingoid symptoms (cushingoid facies and weight gain), which resolved when the methylprednisolone dosage was reduced, without any loss in the control of the asthma. Another study found that the dose of methylprednisolone could be reduced by 50% in the presence of troleandomycin, without loss of disease control. Other studies have found similar effects. However, a randomised, placebo-controlled 2-year study found that although troleandomycin modestly reduced the lequiied dose... 

A series of 8 patients with severe ehronic asthma found that troleandomycin 250 mg four times daily caused an average reduction in the clearance of theophylline (given as intravenous aminophylline) of 50%. One patient had a theophylline-induced seizure after 10 days, with a serum theophylline level of 43 mg/mL (reference range 10 to 20 mg/L). The theophylline half-life in this patient had increased from 4.6 to 11.3 hours. Other studies in healthy subjects and patients given oral theophylline with troleandomycin have also found reductions in theophylline clearance and marked rises in serum theophylline levels and half-life, even at low troleandomycin doses. ... 

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See also in sourсe #XX -- [ ]

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