Frezma 120 mg/5 ml Syrup

Frezma 120 mg/5 ml syrup by Beximco Pharmaceuticals Ltd. contains Theophylline, a methylxanthine bronchodilator. It is used in asthma and chronic obstructive pulmonary disease (COPD) to keep the airways open, reduce wheezing and breathlessness, and improve breathing — usually as an add-on when inhalers alone are not enough. Many preparations are sustained-release, giving a steady effect over the day or night.

Theophylline relaxes the smooth muscles that wrap around the breathing tubes, so the airways widen and air flows more easily. It also mildly reduces airway inflammation and strengthens the breathing muscles. Importantly, Theophylline has a narrow safety margin — the gap between a helpful dose and a harmful one is small — so the dose must be carefully set and monitored by a doctor.

Frezma is prescribed for:

• Bronchial asthma — as maintenance (add-on) therapy to reduce wheeze and night-time symptoms
• COPD (chronic bronchitis and emphysema) — to ease chronic breathlessness
• Reversible airway obstruction of other causes, as judged by the physician

It is a controller-type medicine taken regularly; it is not suitable for the rapid relief of a sudden severe attack, for which fast-acting inhalers and emergency care are needed.

Adults: doses of Frezma vary widely between individuals. Sustained-release preparations are commonly given as 200–400 mg once or twice daily, but the right dose depends on body weight, age, smoking habit, liver function and other medicines — the doctor sets and adjusts it, sometimes guided by blood-level tests.

Children: only under a doctor's direction, with doses calculated by weight.

Swallow sustained-release tablets whole; do not crush or chew them. Take Frezma at the same times daily, consistently with or without food as advised. Never increase the dose yourself — toxicity can develop quickly because of the narrow safety margin.

Common side effects of Frezma include:

• Nausea, vomiting, stomach upset or heartburn
• Headache, restlessness, difficulty sleeping
• Fast heartbeat or palpitations
• Increased urination, shakiness

Warning signs of toxicity — persistent vomiting, severe palpitations or irregular heartbeat, confusion, agitation, or seizures (fits). These mean the blood level may be too high: stop the medicine and seek emergency care immediately. Fever, some antibiotics or a recent illness can push levels up even on your usual dose.

• Theophylline has a narrow therapeutic margin — take exactly the prescribed dose and never double up after a missed dose.
• Limit tea, coffee, cola and energy drinks — their caffeine is a related compound and adds to side effects such as palpitations and sleeplessness.
• Tell your doctor if you have liver disease, heart failure, thyroid problems, peptic ulcer, epilepsy or prolonged fever — doses often need lowering.
• Smoking changes theophylline levels; inform your doctor if you start or stop smoking.
• Tell every doctor you visit that you take Frezma, since many common antibiotics interact with it.
• Periodic blood-level checks may be advised — do not skip them.

Theophylline interacts with many medicines; always show your full list to the doctor. Important examples:

• Ciprofloxacin, erythromycin, clarithromycin — raise theophylline levels and can cause toxicity.
• Cimetidine, some antifungals, oral contraceptives — also increase levels.
• Rifampicin, phenytoin, carbamazepine, smoking — lower levels and reduce effect.
• Caffeine (tea, coffee, cola) — additive stimulant side effects.
• Salbutamol/levosalbutamol and diuretics — combined use can lower blood potassium.
• Lithium — theophylline can reduce its effect.

• Known hypersensitivity to Theophylline or other xanthines (caffeine, theobromine)
• Active peptic ulcer disease and uncontrolled seizure disorders — use only if the doctor decides it is essential
• Severe uncontrolled heart rhythm disorders
• Caution in severe liver disease, heart failure and in the elderly — lower doses and monitoring are required

Theophylline crosses the placenta. It is used in pregnancy only when the doctor judges that controlling the mother's asthma outweighs the risk, often at adjusted doses with closer monitoring. It passes into breast milk and may make the baby irritable or disturb sleep; feeding just before a dose can reduce exposure. Use Frezma in pregnancy or breastfeeding strictly under medical supervision.

Store Frezma below 30°C in a dry place, protected from light and moisture. Keep in the original container, tightly closed, and out of the reach of children. Do not use after the expiry date.