Theophylline is a bronchodilator that is used to treat respiratory conditions such as asthma, emphysema, and chronic bronchitis. It also serves to relax the muscles within the lungs, allowing the airways to dilate. This action helps relieve symptoms of breathing problems, such as coughing, wheezing, and shortness of breath.

What is theophylline for?

Theophylline for its bronchodilator effect is used to control a series of conditions related to the respiratory tract:

  • Theophylline works for coughs

Controls a dry and prolonged cough caused by chronic bronchitis.

  • Theophylline works for asthma

Theophylline dilates the bronchial tubes, managing to calm asthma attacks that prevent proper breathing, caused by chronic bronchitis or emphysema.

  • Theophylline is used to treat huffing

The uncomfortable wheezing or shortness of breath usually disappears during theophylline use.

How to take theophylline?

Theophylline prolonged release is taken once a day, usually at night and with food or failing that, within 2 hours after a meal, this to ensure adequate absorption of the drug by the body.

The tablets should be swallowed whole with 120 ml to 180 ml of water. This ensures that the medicine enters the stomach quickly.

The tablets can be used in half according to the doctor’s instructions, in any case, they should always be taken whole, avoid crushing and chewing, or dissolving them in the mouth. Theophylline extended-release tablets that are not swallowed in their entirety release the drug too quickly and can cause significant adverse reactions.

Theophylline takes too long to work, therefore, in the event of a sudden event of shortness of breath, take this into account, as it will not relieve symptoms immediately.

Mechanism of action of theophylline

Theophylline is a xanthine base that exerts a bronchodilator action by relaxing the bronchial smooth muscles.

In addition, it has an effect on the relaxation of the smooth muscles of the urinary and biliary tract and the lower esophageal sphincter; an action on central stimulation, respiratory analeptic, psychostimulant, convulsive agent in high doses; coronary vasodilation, cardiac stimulation with increased oxygen needs; and finally a diuretic action.

Presentation of theophylline

Theophylline comes as an oral solution, tablet (generic) and extended-release capsule, and intravenously.

Generic drugs are generally available at a lower price than brand-name drugs, but the effectiveness of their components does not vary. The versions in which the tablets and capsules are presented are as follows:

Form: extended-release tablet and capsule

Fortalezas: 100 mg, 200 mg, 300 mg, 400 mg, 450 mg, 600 mg

Inactive Ingredients: Hypromellose, Lactose Monohydrate, Magnesium Stearate, and Povidone.

What is the dose of theophylline

The theophylline dose varies depending on the age, health condition and tolerance of the patient:

Theophylline dosage for adults (ages 18-59 years)

The usual starting dose is 300 to 400 mg per day. After 3 days the dose can be increased to 400-600 mg per day, if there are no side effects. After 3 days again, it can be adjusted based on the level of theophylline in the blood.

Theophylline dose for children (ages 1 to 17 years weighing over 45 kg)

For this group of patients, a dose of 300 to 400 mg per day is recommended, with possible increases of 400-600 mg per day.

Theophylline dose for children (1 to 15 years weighing less than 45 kg)

The starting dose is 12-14 mg / kg per day up to 300 mg per day. After 3 days, this dose can be increased to 16 mg / kg daily up to a maximum of 400 mg per day. This medicine is given in divided doses every 4-6 hours.

Theophylline dosage for infants (up to 12 months of age)

The pediatrician will calculate the baby’s dose based on his age and body weight, but generally this calculation is based on:

Babies 0-25 weeks: the total daily dose should be divided into 3 equal doses taken by mouth every 8 hours.

Babies 26 weeks of age and older: The total daily dose should be divided into 4 equal doses taken by mouth every 6 hours.

Theophylline dosage for infants (preterm less than 12 months of age)

Babies under 24 days: 1 mg / kg body weight

Babies 24 days and older: 1.5 mg / kg of body weight

Theophylline dosage for over 60s

The decreased functioning of the kidneys in this group of people is not able to process theophylline correctly, so its components can remain in the body for longer, which greatly increases the risk of side effects. The maximum dose per day should not exceed 400 mg.

Contraindications of theophylline

The use of theophylline is limited by the risk of toxicity whose toxic concentrations approach therapeutic levels. Theophylline metabolism varies according to the subjects, age and certain associated drugs. Additionally, some health conditions or habits such as smoking, or drinking alcohol, may be contraindicated with the use of theophylline.

Theophylline use and seizures

Theophylline use may cause an increase in the number or duration of seizures in people with this history or with a history of epilepsy or medical conditions that increase this risk.

Theophylline use and cystic fibrosis

People with cystic fibrosis metabolize theophylline faster than others. In the event that the patient has this disease, it is important to know from the doctor, the strict way of how to ingest this medicine.

Theophylline use and liver problems

If the patient has liver disease or reduced liver function, the body can cause a buildup of the drug, resulting in other more prominent side effects.

Theophylline use and kidney problems

People with kidney disease or decreased kidney function, who are taking theophylline, may accumulate the components of this medicine in their body and suffer some more severe side effects.

Use of theophylline in heart patients

Theophylline can build up in the body of patients with certain types of heart disease, such as congestive heart failure, leading to more pronounced adverse reactions. Additionally, it can cause irregularities in the heartbeat in patients with a history of arrhythmia.

Theophylline use and thyroid disease

A patient with hypothyroidism is more likely to accumulate theophylline in his body and experience adverse reactions. In the case of an overactive thyroid gland, theophylline is metabolized too quickly and may not be effective.

Theophylline use in pregnant women

Pregnant or breastfeeding women can take theophylline, only if the doctor has indicated it.

Use of theophylline in smokers

Smoking causes an acceleration in the metabolism of theophylline. Therefore, the doctor must be aware to adjust the corresponding dose.

Side effects of theophylline

Theophylline side effects, like other medications, are an undesirable response of the body to the components. Even taking the indicated dose, some of these effects can manifest only in some people, in a mild, severe, temporary or permanent way.

  • Agitation
  • Itch
  • Stomach ache
  • Eruption
  • Headaches
  • Irritability
  • Loss of appetite
  • Sickness
  • Tremors

Other side effects may also occur, but are less likely.

  • Fast and very pounding heartbeat.
  • Irregular heartbeat
  • Vomiting
Samantha Robson
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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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