What is Teokap-SR?



Teokap-SR injection is used together with other medicines to treat the acute symptoms of asthma, bronchitis, emphysema, and other lung diseases in a hospital setting.

Teokap-SR belongs to a group of medicines known as bronchodilators. Bronchodilators are medicines that relax the muscles in the bronchial tubes (air passages) of the lungs. They relieve cough, wheezing, shortness of breath, and troubled breathing by increasing the flow of air through the bronchial tubes.

Teokap-SR is available only with your doctor’s prescription.

TEOKAP-SR INDICATIONS

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol.

Oral

Acute bronchospasm

Adult: Patients not taking Teokap-SR or other xanthine medication: Loading dose: 5 mg/kg.

Child: ≥1 yr Same as adult dose.

Elderly: Lower doses should be used.

Hepatic impairment: Reduce dose.

Oral

Chronic bronchospasm

Adult: 300-1,000 mg in divided doses 6-8 hrly. As modified-release preparation: 175-500 mg 12 hrly.

Child: <6 yr Not recommended; 6-12 yr 20-35 kg: 120-250 mg bid; >12 yr 250-500 mg bid.

Elderly: Lower doses should be used.

Hepatic impairment: Reduce dose.

Intravenous

Acute severe bronchospasm

Adult: Patients not taking Teokap-SR or other xanthine medication: Loading dose: 4-5 mg/kg by infusion over 20-30 min. Maintenance dose: 0.4-0.6 mg/kg/hr.

Child: Patients not taking Teokap-SR or other xanthine medication: Loading dose: 4-5 mg/kg by infusion over 20-30 min. Maintenance dose: 1-9 yr Initially, 0.8-1 mg/kg/hr; >9-12 yr Initially, 0.7-0.77 mg/kg/hr.

Elderly: Lower doses should be used.

Hepatic impairment: Reduce dose.

Incompatibility: Y-site: Cefepime, hetastarch in normal saline, phenytoin, ceftazidime. Syringe: Ceftriaxone.

Special Populations: Reduce dose in patients w/ cor pulmonale, heart failure, liver disease and fever. Smokers and those who consume alcohol may require higher maintenance dose.

HOW SHOULD I USE TEOKAP-SR?

Use Teokap-SR sustained-release capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Some foods may change the effectiveness or increase the side effects of Teokap-SR sustained-release capsules. Talk to your doctor about how you should take Teokap-SR sustained-release capsules with regard to food. Do not suddenly change your diet or eating habits without first checking with your doctor.
  • Swallow Teokap-SR sustained-release capsules whole. Do not break, crush, or chew before swallowing.
  • Take Teokap-SR sustained-release capsules at about the same time(s) each day. If you are using more than 1 dose per day, try to take the second dose 10 to 12 hours after your first dose and before the evening meal. Check with your doctor or pharmacist if you have questions about how to take Teokap-SR sustained-release capsules.
  • If you are using 1 dose per day, take Teokap-SR sustained-release capsules in the morning unless your doctor tells you otherwise.
  • Continue to take Teokap-SR sustained-release capsules even if you feel well. Do not miss any doses.
  • If you miss a dose of Teokap-SR sustained-release capsules, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Teokap-SR sustained-release capsules.

USES OF TEOKAP-SR IN DETAILS

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition.

Use: Labeled Indications

Reversible airflow obstruction:

Oral: Treatment of symptoms and reversible airflow obstruction associated with chronic asthma, or other chronic lung diseases (eg, emphysema, chronic bronchitis).

Injection: Treatment of acute exacerbations of the symptoms and reversible airflow obstruction associated with asthma and other chronic lung diseases (eg, chronic bronchitis, emphysema) as an adjunct to inhaled beta-2 selective agonists and systemically administered corticosteroids. Guideline recommendations:

Guideline recommendations:

Asthma: The 2019 Global Initiative for Asthma Guidelines (GINA) and the 2007 National Heart, Lung and Blood Institute Asthma Guidelines recommends against Teokap-SR as a long-term control medication for asthma in children ≤5 years of age. Additionally, GINA guidelines do not recommend Teokap-SR for asthma in children 6 to 11 years of age.

Oral Teokap-SR is a potential alternative option (not preferred) in adolescents and adults as a long-term control medication in mild asthma or as an add-on long-term control medication in moderate to severe asthma; however, a stepwise approach using inhaled corticosteroids (+/- inhaled long-acting beta agonists depending on asthma severity) is preferred to Teokap-SR due to efficacy concerns and potential for adverse events (GINA 2019). Both guidelines recommend against Teokap-SR for the treatment of asthma exacerbations due to poor efficacy and safety concerns (GINA 2019; NAEPP 2007).

COPD: Based on the Global Initiative for Chronic Obstructive Lung Disease Guidelines (2019), use of Teokap-SR in patients with COPD is controversial and lacks data. Teokap-SR may favorably impact functional impairment in COPD patients, but exact effects are unclear. Studies that demonstrated improvement were done with slow-release preparations. Teokap-SR is not a preferred agent for COPD exacerbations due to its potential for toxicity.

Off Label Uses

Bradycardia, heart transplantation

Data from small observational studies suggest that Teokap-SR may be beneficial for the treatment of bradycardia following heart transplantation.

Teokap-SR is a chiral compound. The racemic mixture can be divided into its optical antipodes: levo- and dextro-amphetamine. Teokap-SR is the parent compound of its own structural class, comprising a broad range of psychoactive derivatives, e.g., MDMA (Ecstasy) and the N-methylated form, methamphetamine. Teokap-SR is a homologue of phenethylamine.

TEOKAP-SR DOSAGE

Teokap-SR injection is used together with other medicines
Teokap-SR injection is used together with other medicines

General Considerations

Teokap-SR (Teokap-SR anhydrous capsule) ®, like other extended-release Teokap-SR products, is intended for patients with relatively continuous or recurring symptoms who have a need to maintain therapeutic serum levels of Teokap-SR. It is not intended for patients experiencing an acute episode of bronchospasm (associated with asthma, chronic bronchitis, or emphysema). Such patients require rapid relief of symptoms and should be treated with an immediate-release or intravenous Teokap-SR preparation (or other bronchodilators) and not with extended-release products.

Patients who metabolize Teokap-SR at a normal or slow rate are reasonable candidates for once-daily dosing with Teokap-SR (Teokap-SR anhydrous capsule) ®. Patients who metabolize Teokap-SR rapidly (e.g., the young, smokers, and some nonsmoking adults) and who have symptoms repeatedly at the end of a dosing interval, will require either increased doses given once a day or preferably, are likely to be better controlled by a schedule of twice-daily dosing. Those patients who require increased daily doses are more likely to experience relatively wide peak-trough differences and may be candidates for twice-a-day dosing with Teokap-SR (Teokap-SR anhydrous capsule) .

Patients should be instructed to take this medication each morning at approximately the same time and not to exceed the prescribed dose.

Recent studies suggest that dosing of extended-release Teokap-SR products at night (after the evening meal) results in serum concentrations of Teokap-SR which are not identical to those recorded during waking hours and may be characterized by early trough and delayed peak levels. This appears to occur whether the drug is given as an immediate-release, extended-release, or intravenous product. To avoid this phenomenon when two doses per day are prescribed, it is recommended that the second dose be given 10 to 12 hours after the morning dose and before the evening meal. 

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