Theophylline (Theo-Dur, Uniphyl) and Ketamine Therapy | Tovani Health
Theo-Dur (Theophylline) (also: Uniphyl, Theo-24, Elixophyllin) — Methylxanthine bronchodilator (asthma / COPD)
Verdict at Tovani Health
Compatible; the methylxanthine sympathomimetic stack and narrow therapeutic index are both real considerations.
Theophylline and ketamine are compatible with monitoring. Two specifics: theophylline is a methylxanthine (same family as caffeine but more potent at lower mg doses) and produces measurable HR/BP elevation that stacks with ketamine's transient pressor; and theophylline has a narrow therapeutic index where modest changes in level produce toxicity (nausea, tachyarrhythmia, seizures). The KAP-relevant note is also that smoking cessation, fluoroquinolone antibiotics (cipro), and fluvoxamine all raise theophylline levels via CYP1A2 — separate concerns from KAP but worth knowing about.
If you take Theo-Dur regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or modest dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Theo-Dur interacts with ketamine
Theophylline is a non-selective adenosine receptor antagonist and PDE inhibitor with bronchodilator, cardiac stimulant, and CNS stimulant effects. CYP1A2 substrate. Ketamine doesn't affect CYP1A2, but theophylline's intrinsic sympathomimetic effect stacks with ketamine's transient pressor response.
What we do at intake
Disclose dose, formulation (immediate vs sustained release), and recent serum theophylline level if you have one. Tell us about cipro, fluvoxamine, or smoking-cessation start dates.
Bottom line
Theophylline and ketamine are compatible with monitoring. Two specifics: theophylline is a methylxanthine (same family as caffeine but more potent at lower mg doses) and produces measurable HR/BP elevation that stacks with ketamine's transient pressor; and theophylline has a narrow therapeutic index where modest changes in level produce toxicity (nausea, tachyarrhythmia, seizures). The KAP-relevant note is also that smoking cessation, fluoroquinolone antibiotics (cipro), and fluvoxamine all raise theophylline levels via CYP1A2 — separate concerns from KAP but worth knowing about.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Theo-Dur (Theophylline) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy. Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI. Clinical Pharmacokinetics. 2016. PMID: 27028535
- The characteristics and costs of severe theophylline toxicity in a tertiary critical care unit in Eastern Cape Province, South Africa. Oxley-Oxland JV, Freercks R, Baker D. South African Medical Journal. 2022. PMID: 36420723
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 22, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.