What is theophylline?

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Generic Name: Theophylline Brand Name(s): Generics only. No brands available.

Know the basics

What is theophylline used for?

This medication is used to treat and prevent wheezing and trouble breathing caused by ongoing lung disease (e.g., asthma, emphysema, chronic bronchitis). Theophylline belongs to a class of drugs known as xanthines. It works in the airways by relaxing muscles, opening air passages to improve breathing, and decreasing the lungs’ response to irritants. Controlling symptoms of breathing problems can decrease time lost from work or school.

This medication does not work immediately and should not be used for sudden attacks of breathing trouble. Your doctor should prescribe a quick-relief medicine/inhaler (e.g., albuterol) for sudden attacks of shortness of breath/asthma while you are on this medication. You should always have a quick-relief inhaler with you. Consult your doctor or pharmacist for more details.

How should I take theophylline?

Take this medication by mouth with or without food, usually once or twice daily or as directed by your doctor. If this medication upsets your stomach, you may take it with food. This medicine works best when the amount in your body is kept at a constant level. Therefore, use this drug at evenly spaced intervals. Since different manufacturers have different recommendations, check with your doctor or pharmacist about the best time(s) to take your particular brand of theophylline.

Do not crush or chew this medication. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

If you are taking the capsules, swallow them whole. If you are unable to swallow them, you may open the capsule and sprinkle the contents onto a spoonful of cool, soft food such as applesauce or pudding. Eat the entire mixture immediately without chewing. Then drink a full glass of liquid (8 ounces or 240 milliliters). Do not prepare a supply for future use.

Dosage is based on your medical condition, response to treatment, age, weight, drug blood levels, and other drugs you may be taking. (See also Drug Interactions section.) Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Inform your doctor if your condition persists or worsens.

How do I store theophylline?

Theophylline is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store theophylline in the bathroom or the freezer. There may be different brands of theophylline that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush theophylline down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using theophylline?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of theophylline in children. However, children younger than 1 year of age are more likely to have serious side effects, which may require caution and an adjustment in the dose for patients receiving theophylline.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of theophylline in the elderly. However, elderly patients may be more sensitive to the effects of theophylline than younger adults, and are more likely to have kidney, liver, heart, or lung problems, which may require caution and an adjustment in the dose for patients receiving theophylline.

Is it safe to take theophylline during pregnancy or breast-feeding?

There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.

Know the side effects

What are the side effects of theophylline?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using theophylline and call your doctor at once if you have a serious side effect such as:

  • severe or continued vomiting;
  • rapid or uneven heartbeats;
  • seizure (convulsions);
  • confusion, tremors or shaking;
  • nausea and vomiting, severe headache, rapid heart rate;
  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or
  • high blood sugar (increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss).

Less serious side effects may include:

  • stomach pain, diarrhea, upset stomach;
  • headache;
  • sweating;
  • sleep problems (insomnia); or
  • feeling restless, nervous, or irritable;

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with theophylline?

Theophylline may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Riociguat

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acrivastine
  • Adenosine
  • Blinatumomab
  • Bupropion
  • Ceritinib
  • Cimetidine
  • Ciprofloxacin
  • Cobicistat
  • Deferasirox
  • Desogestrel
  • Dienogest
  • Dihydroartemisinin
  • Drospirenone
  • Enoxacin
  • Erythromycin
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etintidine
  • Etonogestrel
  • Fluconazole
  • Fluvoxamine
  • Fosphenytoin
  • Halothane
  • Idelalisib
  • Idrocilamide
  • Imipenem
  • Levofloxacin
  • Levonorgestrel
  • Medroxyprogesterone Acetate
  • Mestranol
  • Mexiletine
  • Nilotinib
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Pefloxacin
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Phenytoin
  • Pixantrone
  • Regadenoson
  • Rofecoxib
  • Siltuximab
  • Thiabendazole
  • Troleandomycin
  • Vemurafenib
  • Zileuton

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adinazolam
  • Alprazolam
  • Aminoglutethimide
  • Amiodarone
  • Azithromycin
  • Bromazepam
  • Brotizolam
  • Cannabis
  • Carbamazepine
  • Chlordiazepoxide
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Diazepam
  • Disulfiram
  • Estazolam
  • Febuxostat
  • Flunitrazepam
  • Flurazepam
  • Halazepam
  • Interferon Alfa-2a
  • Ipriflavone
  • Isoproterenol
  • Ketazolam
  • Lorazepam
  • Lormetazepam
  • Medazepam
  • Methotrexate
  • Midazolam
  • Nilutamide
  • Nitrazepam
  • Oxazepam
  • Pancuronium
  • Pentoxifylline
  • Phenobarbital
  • Piperine
  • Prazepam
  • Propafenone
  • Quazepam
  • Rifampin
  • Rifapentine
  • Riluzole
  • Ritonavir
  • Secobarbital
  • St John’s Wort
  • Tacrine
  • Tacrolimus
  • Telithromycin
  • Temazepam
  • Ticlopidine
  • Triazolam
  • Viloxazine
  • Zafirlukast

Does food or alcohol interact with theophylline?

Theophylline may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with theophylline?

Theophylline may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Congestive heart failure or
  • Cor pulmonale (heart condition) or
  • Fever of 102 degrees F or higher for 24 hours or more or
  • Hypothyroidism (underactive thyroid) or
  • Infection, severe (e.g., sepsis) or
  • Kidney disease in infants younger than 3 months of age or
  • Liver disease (e.g., cirrhosis, hepatitis) or
  • Pulmonary edema (lung condition) or
  • Shock (serious condition with very little blood flow in the body)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Heart rhythm problems (e.g., arrhythmia) or
  • Seizures, or history of or
  • Stomach ulcer—Use with caution. May make these conditions worse.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of theophylline for an adult?

Usual Adult Dose for Asthma — Acute:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Maintenance dose:

Otherwise Healthy Nonsmoking Adult: 10 mg/kg/day. Do not exceed 900 mg/day.

Otherwise Healthy Adult Smoker: 16 mg/kg/day.

Patient with congestive heart failure or cor pulmonale: 5 mg/kg/day. Do not exceed 400 mg/day.

Usual Adult Dose for Asthma — Maintenance:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Maintenance dose:

Otherwise Healthy Nonsmoking Adult: 10 mg/kg/day. Do not exceed 900 mg/day.

Otherwise Healthy Adult Smoker: 16 mg/kg/day.

Patient with congestive heart failure or cor pulmonale: 5 mg/kg/day. Do not exceed 400 mg/day.

Usual Geriatric Dose for Asthma — Acute:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Otherwise healthy, nonsmokers: 10 mg/kg/day. Do not exceed 900 mg/day

Patient with congestive heart failure, cor pulmonale, and/or liver dysfunction: 5 mg/kg/day. Do not exceed 400 mg/day

Usual Geriatric Dose for Asthma — Maintenance:

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Otherwise healthy, nonsmokers: 10 mg/kg/day. Do not exceed 900 mg/day

Patient with congestive heart failure, cor pulmonale, and/or liver dysfunction: 5 mg/kg/day. Do not exceed 400 mg/day

What is the dose of theophylline for a child?

Loading dose:

If no theophylline has been administered in the previous 24 hours: 5 mg/kg loading dose to achieve a serum concentration of about 10 mcg/mL; loading doses should be given using a rapidly absorbed oral product not a sustained release product).

If theophylline has been administered in the previous 24 hours: 2.5 mg/kg theophylline may be given in emergencies when serum concentrations are not available. A modified loading dose (mg/kg) may be calculated (when the serum level is known) by: [Blood concentration desired – blood concentration measured] divided by 2 (for every 1 mg/kg theophylline given, the blood level will rise by approximately 2 mcg/mL).

Maintenance dose:

less than 42 days: 4 mg/kg/day orally.

42 days to 181 days: 10 mg/kg/day orally. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

6 months less than 12 months: 12 to 18 mg/kg/day. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

1 year to 8 years: 20 to 24 mg/kg/day.

9 years to 11 years: 16 mg/kg/day.

12 years to 15 years: 13 mg/kg/day.

16 years or older: 10 mg/kg/day. Do not exceed 900 mg/day.

How is theophylline available?

Theophylline is available in the following dosage forms and strengths:

Capsule: 100 mg; 200 mg; 300 mg; 400 mg

Elixir: 80 mg/15 mL (473 mL)

Solution 80 mg/ 15 mL

Tablet 100 mg; 200 mg; 300 mg; 450 mg; 600 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of theophylline, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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