Self-poisoning with Sustained-release Aminophylline: a Mechanism for Observed Secondary Rise in Serum Theophylline

It has been known for some time that after the ingestion of a large quantity of sustained-release aminophylline tablets, a secondary rise in theophylline concentration may occur (Connell et al., 1982). This has, in the past, been ascribed variously to continued absorption from the sustained release formulation (Struthers et al., 1982) or to redistribution of the drug after charcoal haemoperfusion (Connell et al. , 1982). This case demonstrates that Phyllocontin S-R tablets may cause a compacted mass in the stomach, which may become resistant to gastric lavage, and thus become a potential source of a sudden secondary rise in theophylline concentration.