Theophylline
General
- Type: Bronchodilator
- Dosage Forms: Oral
- Common Trade Names: Elixophyllin, Theo-24, Uniphyl
Adult Dosing
- 300-600mg PO q6-8h (immediate-release) or q12h (ER)
- IV theophylline no longer recommended for use inpatient or in the ED due to lack of added benefit over other treatments and high risk of adverse events[1][2]
Pediatric Dosing
- Apnea in neonate: 4 mg/kg IV load, then 2 mg/kg IV q12h
- Pediatric theophylline doses for asthma are very complicated, and with the narrow therapeutic window, probably not even worth trying it!
Special Populations
- Pregnancy Rating: C
- Lactation: Probably Safe
- Renal Dosing
- Adult: no adjustment
- Pediatric: <3 mo: decrease dose amount not defined; >3 mo: no adjustment
- Hepatic Dosing
- Adult: decrease dose amount not defined
- Pediatric: decrease dose amount not defined
Contraindications
- Allergy to class/drug
- Known allergy to corn or corn products (IV form)
- caution if PUD, active
- caution if seizure disorder
- caution if arrhythmias
- caution if CHF
- caution if pulmonary edema, acute
- caution if cor pulmonale
- caution if hepatic impairment
- caution if hypothyroidism
- caution if febrile
- caution if sepsis with multi-organ failure
- caution if shock
- caution if smoking habit changes
- caution if neonates or infants
- caution in elderly patients
Adverse Reactions
See theophylline toxicity for overdose information
Serious
- seizures
- arrhythmias
- hypotension, shock
- exfoliative dermatitis
Common
- nausea/vomiting, diarrhea
- headache
- insomnia, irritability, restlessness, tremor
- diuresis, transient
Pharmacology
- Half-life: 8h
- Metabolism: liver; CYP450: 1A2, 2E1, 3A3
- Excretion: urine (10% unchanged)
- Mechanism of Action: exact mechanism unknown; increases cAMP; antagonizes adenosine receptors (methylxanthine)
See Also
References
- ↑ National Heart, Lung, and Blood Institute: Expert panel report 3: guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. Bethesda, MD. 2007. http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines
- ↑ Kallstrom TJ. Evidence-based asthma management. Respir Care. 2004;49(7):783-92.