3.1.3 Theophylline

Brand name prescribing is recommended for oral formulations due to variations in bioavailability.

Interactions

There are significant drug interactions with theophylline / aminophylline. Consult the BNF, manufacturer's Summary of Product Characteristics (SPC) and specialist textbooks for further information.

Monitoring plasma levels

Therapeutic levels of plasma-theophylline are usually between 10–20 mg/litre (55–110 micromol/litre), although lower concentrations may be effective in order to achieve satisfactory bronchodilation. Adverse effects can occur within the range 10–20 mg/litre and both the frequency and severity increase at concentrations above 20 mg/litre.

  1. Oral: Plasma-theophylline concentration is measured 5 days after starting oral treatment and at least 3 days after any dose adjustment. A blood sample should usually be taken 4–6 hours after an oral dose of a modified-release preparation (sampling times may vary—consult local guidelines).
  2. Parenteral: If aminophylline is given intravenously, a blood sample should be taken 4–6 hours after starting infusion.
Uniphyllin Continus®

(Theophylline)

  • Prolonged release tablets 200mg, 300mg, 400mg (£2.96 = 200mg twice daily)

Indications

Dose

  • Refer to product literature
Phyllocontin Continus®

(Aminophylline)

  • Prolonged release tablets 225mg (£2.40 = one twice daily)
  • Prolonged release Forte tablets 350mg (£4.22 = one twice daily)

Indications

Dose

  • Refer to product literature
Slo-phyllin®

(Theophylline)

  • Prolonged release capsules 60mg, 125mg, 250mg (£4.34 = 250mg twice daily)

Indications

Dose

  • Refer to product literature
Aminophylline
  • Injection 25mg in 1ml

Notes

  1. Particular care needs to be exercised on initiation of therapy. Prescribers who are unfamiliar with the prescribing of this drug are strongly advised to read the Manufacturer's Summary of Product Characteristics (SPC) and the Medusa - the injectable medicines guide

 

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