Theophylline for Long-Term Control of Asthma
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Theophylline is available as pills, capsules, liquid, and injection.
How It Works
Theophylline is a methylxanthine. Sustained-release methylxanthine medicines are used to control inflammation in the airways in the lungs (bronchial tubes). Short-acting methylxanthine medicines are used to control narrowing of the bronchial tubes. This may reduce asthma symptoms.
Why It Is Used
Theophylline is used in mild-to-moderate persistent asthma. It is usually used with an inhaled corticosteroid. It can be used by itself or with an inhaled corticosteroid to control symptoms at night.
Theophylline is considered an alternative medicine for persistent asthma in adults. Inhaled corticosteroids are preferred. It is also considered an alternative addition to inhaled corticosteroids in moderate persistent asthma in children and adults. Long-acting inhaled beta2-agonists are the preferred addition to inhaled corticosteroids.1
In rare cases, theophylline may be used instead of another asthma medicine:
- In small children who have trouble using an inhaler
- In people who are more likely to take a medicine by mouth than by inhaler
- As added medicine for people whose asthma is not controlled with an inhaled corticosteroid
Different types of medicines are often used together in the treatment of asthma. Treatment for asthma depends on a person's age, his or her type of asthma, and how well the treatment is controlling asthma symptoms.
- Children up to age 4 are usually treated a little differently than those 5 to 11 years old.
- The least amount of medicine that controls the asthma symptoms is used.
- The amount of medicine and number of medicines are increased in steps. So if asthma is not controlled at a low dose of one controller medicine, the dose may be increased. Or another medicine may be added.
- If the asthma has been under control for several months at a certain dose of medicine, the dose may be reduced. This can help find the least amount of medicine that will control the asthma.
- Quick-relief medicine is used to treat asthma attacks. But if you or your child needs to use quick-relief medicine a lot, the amount and number of controller medicines may be changed.
Your doctor will work with you to help find the number and dose of medicines that work best.
How Well It Works
The addition of theophylline to an inhaled corticosteroid can improve lung function in adults with uncontrolled mild-to-moderate persistent asthma.2
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call your doctor right away if you have:
- An extremely rapid heart rate (tachycardia).
- A seizure.
Common side effects of this medicine include:
- Nausea, vomiting, heartburn, and diarrhea.
- Headache and irritability.
- Sleep problems (insomnia).
- Overactivity in children.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Many other medicines (such as antibiotics, medicines to control stomach acid, birth control pills, medicines to calm people, heart medicines, and seizure medicines), alcohol, and some medical conditions can affect the levels of theophylline in the blood. High blood levels of theophylline cause increased side effects.
Because theophylline interacts with many different medicines, tell your doctor about all medicines you are taking. Your doctor also will check the level of theophylline in your blood regularly to make sure it is not too high.
Babies are especially at risk for developing high levels of theophylline in the blood. So they need their blood levels checked regularly. Slow-release theophylline has an even greater risk for causing side effects than the short-acting medicine.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- National Institutes of Health (2007). National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (NIH Publication No. 08–5846). Available online: http://www.nhlbi.nih.gov/guidelines/asthma/index.htm.
- Dennis RJ, Solarte I (2011). Asthma in adults (chronic), search date April 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Last Revised: February 22, 2013
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