Doxiva Syrup - (100mg/5ml) contains Doxophylline INN 100 mg per 5 ml. It is manufactured by NIPRO JMI Pharma Ltd. in Bangladesh. 

Indications:

Doxiva (Doxophylline) is a bronchodilator used to treat conditions involving bronchospasm, such as: 

• Bronchial asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Other pulmonary diseases with a spastic bronchial component. 

Pharmacology:

Doxophylline is a novel xanthine derivative. It works by selectively inhibiting phosphodiesterase-4 (PDE4), which leads to relaxation of the bronchial smooth muscles and widening of the airways. Unlike some other xanthine derivatives like Theophylline, Doxophylline has a lower affinity for adenosine A1 and A2 receptors, which may account for its better safety profile. It also inhibits platelet-activating factor (PAF) and the generation of leukotrienes, which contribute to inflammation. 

Dosage and Administration:

The dosage varies based on age and clinical response. 

• Adults: 400 mg (20 ml of syrup) daily, preferably in the evening. The dose may be increased to 400 mg twice daily based on clinical response. 
• Children (above 12 years of age): 10 ml syrup (200 mg) two or three times daily. 
• Children (6-12 years of age): 6-9 mg/kg body weight twice daily. For example, a 10 kg child would take 3 ml (60 mg) twice daily. 
• Elderly patients with co-existing heart, liver, or kidney conditions: A recommended dosage is 200 mg (10 ml syrup) twice daily. 

Contraindications:

Doxiva is contraindicated in: 

• Acute myocardial infarction (recent heart attack). 
• Hypotension (low blood pressure). 
• Known hypersensitivity to Doxophylline or other xanthine derivatives. 
• Lactating women (breastfeeding mothers). 

Side Effects:

Doxiva is generally well tolerated. Common side effects are usually mild and similar to those from excessive caffeine intake: 

• Nausea, vomiting 
• Headache 
• Upset stomach, heartburn, epigastric pain 
• Irritability 
• Insomnia (difficulty sleeping) 
• Tachycardia (fast heart rate), extrasystoles (skipped heartbeats) 
• Tachypnea (rapid breathing) 
• Rarely, hyperglycemia (high blood sugar) or albuminuria (protein in urine). 

Precautions and Warnings:

• The half-life of Doxophylline can be prolonged in patients with liver disease, congestive heart failure, and those taking certain other drugs (e.g., erythromycin, cimetidine, allopurinol, propranolol). A lower dose may be needed in these cases. 
• Phenytoin, other anticonvulsants, and smoking may increase the clearance of Doxophylline, potentially requiring higher doses. 
• Use with caution in patients with cardiac disease, hypertension, severe hypoxemia (low blood oxygen), hyperthyroidism, chronic cor pulmonale, peptic ulcer, and renal impairment. 
• It does not provide immediate relief for sudden breathing problems; always keep a fast-acting inhaler for emergencies. 
• Do not discontinue use without consulting your doctor. 

Pregnancy and Lactation:

• Pregnancy: Animal studies suggest no fetal harm, but due to limited human experience, it should be used in pregnant women only if clearly needed after a careful risk-benefit assessment by a doctor. 
• Lactation: Doxiva is contraindicated in nursing mothers. 

Drug Interactions:

• Other xanthine derivatives: Should not be administered concurrently due to potential for additive effects and toxicity. 
• Ephedrine: Toxic synergism has been documented with xanthines. 
• Drugs that may decrease hepatic clearance of Doxophylline (leading to increased levels): Erythromycin, lincomycin, clindamycin, allopurinol, cimetidine, ranitidine, propranolol, and anti-flu vaccine. 
• Drugs that may increase Doxophylline clearance (leading to decreased levels): Phenytoin and other anticonvulsants, as well as smoking. 

Storage Conditions:

Store in a dry place, away from light and heat (below 25°C). Keep out of the reach of children. Use only on the prescription of a specialist physician. 

Note: This information is for general knowledge and informational purposes only and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication.