THEOPHYLLINE

Theophylline is a week bronchodilator that relaxes the smooth muscle around the bronchial tubes allowing for more air to move freely though the tubes.  Theophylline is metabolized by the liver and excreted by the kidneys.  It can be measured in the blood.  Occasional blood tests need to be done to maintain therapeutic levels. Theophylline has been used to treat asthma for over fifty years.  There are now new forms of theophylline that are long acting and only need to be taken once or twice daily.  There are now better alternatives to this medication.

Brand Names
Xanthines (Bronchodilators)

Theophylline

Aerolate – TD capsules, liquid

Quibron- T- Tablets, SA tablets

Respid – SR tablets

Slo-bid – ER capsules

T-Phyl – CR tablets

Theo-24 – ER capsules

Theo-Dur Sprinkle – SA capsules

Theo-X – Tablets

Uniphyl – CR tablets

Unidur

Dyphylline ( similar to theophylline, but rarely used anymore)

Lufyllin – Tablets, injection, syrup

Oxytriphylline ( this is a choline salt of theophylline and 400 mg is equivalent to 254 mg of theophylline)

Choledyl – DR tablets, SA tablets

Drug Action
Theophylline relaxes bronchial smooth muscles.  Theophylline can also improve ciliary activity and diaphragmatic contractibility.

 Side Effects
Theophylline is well tolerated by most people.  Side effects may occur when theophylline is first introduced into your system.   Theophylline can increase urination, increase acid in the stomach, increase the heart rate, stimulate the nervous system and worsen gastric reflux.  These side effects can cause the following symptoms:

nausea
heartburn
restlessness
insomnia
tremors
frequent urination
muscle
muscle spasms
anxiety
irritability
headache

Toxic Side Effects
These side effects may occur if the amount of medicine in the blood reaches toxic levels. T his can occur if you have a viral infection or a drug incompatibility.  Notify your doctor if you have symptoms of nausea and vomiting or severe headaches.  Seizures can occur with very high levels of theophylline.  Never take an extra dose of theophylline without your doctor’s permission.

Available Forms
Theophylline preparations come in liquids, tablets or capsules. Liquids are short-acting and take 30 to 60 minutes to begin working.  Tablets can be short-acting or long-acting.  Long-acting tablets take 1 to 1/5 hours to begin working.  Some once-a-day preparations don’t begin to work fully for 4 to 6 hours.  Capsules can be swallowed or opened and the beads sprinkled onto foods.  It is important not to chew the beads as this will cause faster absorption.  Capsules are long-acting. Intravenous aminophylline or theophylline can be given during hospitalization.

Additional Comments
Theophylline should be taken in a regularly scheduled basis.  If a dose is missed, the blood levels may decrease which may cause an increase in asthma symptoms.  If an extra dose is taken the blood level may increase, causing side effects.

Uniphyl and Unidur are long-acting bronchodilators that work well for those individuals who have nighttime symptoms.  They are best taken between 7 and 8 PM. This will allow the peak effect to occur when it is most necessary.