Theophylline

Theophylline is a methylxanthine bronchodilator medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

Theophylline 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.

Common side effects of Theophylline 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 Theophylline, 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 Theophylline in pregnancy or breastfeeding strictly under medical supervision.

Store Theophylline 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.