GENERIC NAME: theophylline
DRUG CLASS AND MECHANISM: Theophylline belongs to a class of medications called bronchodilators, used in treating asthma and other airway diseases. Asthma is a breathing problem involving narrowing of the airways. Airways are breathing passages that allow air to move in and out of the lungs. Airways can be narrowed due to accumulation of mucus, spasm of the muscles that surround these airways, or swelling of the lining of the airways. Airway narrowing leads to symptoms of shortness of breath, wheezing, cough and congestion. The narrowed airways can open either spontaneously or from medications. Medications that open airways are called bronchodilators. Theophylline opens airways by relaxing the smooth muscles in the walls of the airways. Theophylline can also be helpful in patients with emphysema and chronic bronchitis when their symptoms are partially related to reversible airway narrowing. Theophylline also strengthens right heart function and diaphragm movement.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Tablets (100mg, 200mg 300mg, 400mg, 450mg), syrups, solutions.

STORAGE: Theophylline should be stored at room temperature in a tightly closed container.

PRESCRIBED FOR: Theophylline is used in the relief and prevention of airway narrowing (bronchospasm) in patients with asthma. Theophylline can also be used in treating patients with emphysema and chronic bronchitis when their symptoms are related to reversible airway narrowing. Theophylline can be administered together with other bronchodilators, such as albuterol (Ventolin, Proventil) for added bronchodilator effect.

DOSING: Theophylline may be taken with or without food, but should not be crushed or chewed. Theophylline is metabolized mainly by the liver and dosages should be reduced in patients with liver dysfunction. On the other hand, theophylline is generally metabolized more rapidly in smokers (both tobacco and marijuana) and higher dosages may be required. High blood theophylline levels can lead to symptoms of toxicity (see below). Therefore, theophylline blood levels are monitored periodically during treatment to assure achievement of optimal and safe levels.

DRUG INTERACTIONS: Certain groups of patients metabolize theophylline slowly, and can develop elevated blood levels and potential toxicity even on usual doses. These patients include those with liver disease, older men with chronic lung diseases, infants, patients with high fever or heart failure, and patients taking other medications that increase blood theophylline levels. Examples of medications that can elevate theophylline blood levels include ephedrine, allopurinol (Zyloprim), cimetidine (Tagamet), ciprofloxacin (Cipro), erythromycin, oral contraceptives, and propranolol (Inderal). Theophylline toxicity can cause nausea, vomiting, insomnia, seizures, agitation and life- threatening heart rhythm abnormalities. Theophylline should be used cautiously in patients with high blood pressure, peptic ulcer disease, seizure disorders, and serious heart disease, especially with heart rhythm problems.

SIDE EFFECTS: Common side effects include nausea, vomiting, diarrhea, headaches, irritability, flushing and palpitations. More serious side effects include seizures and ventricular heart arrhythmias.