Theophylline Tablet: Uses, Dosage & Side Effects in Pakistan

Theophylline Tablet Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info

2. What is Theophylline?

Theophylline is a xanthine bronchodilator that opens the airways of the lungs, making breathing easier. It is available in Pakistan under the brand names Theo-Dur and Phyllocontin.

Important note: Theophylline has a very narrow therapeutic index — the difference between a therapeutic dose and a toxic dose is very small. Serum theophylline levels must therefore be monitored. Modern inhalers (ICS/LABA) have largely replaced it for asthma, but it is still used in COPD and resource-limited settings.

3. Uses

• Asthma — maintenance therapy (second/third-line; largely replaced by ICS/LABA)
• COPD — adjunct bronchodilator when inhaler therapy is insufficient
• Neonatal apnoea — IV aminophylline in hospital settings

4. How It Works

Theophylline is a non-selective phosphodiesterase (PDE) inhibitor. It raises intracellular cAMP/cGMP → bronchial smooth muscle relaxes → airways open (bronchodilation). Adenosine receptor antagonism also occurs. It has mild anti-inflammatory properties at low doses and also mildly stimulates the diaphragm.

5. Who Should Take

• COPD patients who have not achieved adequate control with inhaler therapy
• Asthma patients where ICS/LABA is not accessible or is insufficient
• Hospital patients: neonatal apnoea (IV aminophylline — specialist only)

6. When NOT to Take

• Active seizure disorder (uncontrolled epilepsy)
• Serious cardiac arrhythmias
• Hypersensitivity to theophylline or xanthines
• Acute porphyria
• Without serum level monitoring capability

7. Dosage

Adult Dose

• As prescribed — dose individualized based on serum theophylline levels
• Target therapeutic range: 10–20 mg/L (some guidelines recommend lower 5–15 mg/L)
• SR (sustained-release) preparations preferred — twice daily dosing
• Do NOT crush or chew SR tablets — swallow whole

Child Dose

• Weight-based dose — specialist guidance is required
• Neonates: hospital-only IV aminophylline (specialist only)

Missed Dose

• Take it as soon as you remember. If the next dose is close, skip the missed dose. Never take a double dose.

Overdose

• Contact emergency services immediately — theophylline toxicity is serious and can be life-threatening.

8. How to Take

• Swallow SR tablets whole — do not crush, chew, or break them
• Generally twice daily (SR preparation) — follow your doctor's instructions
• Same time every day

9. With Food or Empty Stomach

• SR tablets can be taken with or without food — however, a high-fat meal may alter absorption; follow your doctor's specific instructions

10. Narrow Therapeutic Index — Critical Warning

Factors that INCREASE levels (toxicity risk): ciprofloxacin, clarithromycin, erythromycin, cimetidine, fluvoxamine, oral contraceptives, flu/fever, liver disease, heart failure, elderly age, stopping smoking.

Factors that DECREASE levels (reduced efficacy): rifampicin, carbamazepine, phenytoin, phenobarbitone, smoking (active).

Critical smoking note: If a patient stops smoking, theophylline levels rise significantly — dose reduction or level re-checking is necessary.

11. Warnings

• Serum level monitoring should be done after any illness, drug change, or smoking status change
• Toxicity risk is higher in elderly patients
• Fever reduces theophylline clearance — levels may rise during illness
• Cardiac disease: arrhythmia risk is increased
• Never crush SR tablets

12. Side Effects

Common

• Nausea, vomiting
• Headache
• Insomnia
• Rapid heartbeat / palpitations (tachycardia)
• Tremor
• Mild diuresis (frequent urination)

Serious (see a doctor immediately)

• Severe nausea/vomiting
• Irregular or rapid heartbeat (arrhythmia — cardiac toxicity)
• Seizures (severe toxicity — EMERGENCY)
• Agitation, confusion, hallucinations (neurological toxicity)
• Hypotension (low blood pressure)

13. Drug Interactions

Before starting or stopping any new medicine, always inform your doctor about theophylline.

14. When to See Doctor

• Severe nausea/vomiting (early toxicity — get levels checked)
• Irregular or rapid heartbeat (arrhythmia — toxicity)
• Fits / convulsions
• Persistent tremors or agitation/confusion
• Planning to stop smoking — consult your doctor first
• Starting any new medicine — especially antibiotics (ciprofloxacin, erythromycin)

15. Alternatives

16. Price in Pakistan

17. FAQs

Q: What is Theophylline used for?

A: Theophylline is a bronchodilator. It relaxes the airways and is used for COPD and asthma. However, modern inhalers have replaced it in most cases.

Q: What are the side effects of Theophylline?

A: Common effects: nausea, vomiting, headache, rapid heartbeat. Serious: arrhythmias, seizures (toxicity) — see a doctor immediately.

Q: Why is a blood test required for Theophylline?

A: The therapeutic range is narrow (10–20 mg/L). Without level monitoring there is a serious risk of toxicity.

Q: What is the price of Theophylline in Pakistan?

A: Local brands (Phyllocontin, Theo-Dur) are available — confirm the exact price at your pharmacy.

Q: Why is Theophylline used less than modern inhalers?

A: ICS/LABA inhalers are safer, more effective, and easy to use. Theophylline's narrow index and drug interactions make it a last-resort or resource-limited option.

18. Medical Review

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.