Basic Theophylline Information

• INN (International Nonproprietary Name): Theophylline • Brand names available in United Kingdom: Uniphyllin, Theo-Dur, and Theolair. • ATC Code: R03DA01 • Forms & dosages: Tablets (100mg, 300mg, 400mg), Sustained release tablets, Liquid form. • Manufacturers in United Kingdom: Unimedic, Mylan, and Sandoz. • Registration status in United Kingdom: Approved for prescription use. • OTC / Rx classification: Prescription only.

Everyday Use & Best Practices

Morning Vs Evening Dosing

The timing of theophylline administration can significantly impact its effectiveness and side effects. For many in the UK, mornings are often preferred due to daily routines. Taking theophylline in the morning can help maximise its benefits throughout the day when activities and exposure to triggers are higher. It’s advisable to take it 30 minutes to one hour before meals to improve absorption. Conversely, some individuals may require evening doses to maintain consistent therapeutic levels overnight, especially if they experience night-time symptoms of asthma or chronic obstructive pulmonary disease (COPD). Adhering to a consistent dosing schedule is critical, as fluctuations in theophylline levels can lead to subtherapeutic effects or increased risk of adverse effects. Regular monitoring of plasma theophylline concentrations can help maintain the appropriate therapeutic range, reducing the potential for toxicity. Optimal times can vary based on personal lifestyle and specific health needs, thus consulting with a healthcare provider is essential for tailored advice.

Taking With or Without Meals (UK Diet Habits)

The manner in which theophylline is taken can affect its absorption and overall efficacy. In the UK, meals often include a variety of foods that can alter how medications are metabolised, including theophylline. For optimal absorption, it is generally recommended to take theophylline on an empty stomach, roughly 30 minutes before meals, or at least two hours after eating. Foods high in fat can delay the absorption, potentially leading to decreased effectiveness. Additionally, common UK dietary components such as caffeine, found in tea and coffee, can increase theophylline levels in the blood, hence it’s wise to monitor total caffeine intake to avoid side effects like jitteriness or tachycardia. Patients should also be cautious with herbal remedies and certain over-the-counter medications that might interact with theophylline. In summary, coordinating the timing of theophylline with meals and being aware of dietary habits is essential for maximizing its beneficial effects while minimising side effects.

Safety Priorities

Who Should Avoid It (MHRA Warnings)

When it comes to theophylline, caution is absolutely key. Many people may wonder, "Is this medication safe for everyone?" The answer isn't straightforward, as several populations should steer clear of theophylline due to specific health concerns.

The Medicines and Healthcare products Regulatory Agency (MHRA) lays out clear guidelines on whom theophylline is not suitable for:

• Individuals with a known hypersensitivity to theophylline or its excipients.
• Those with severe hepatic impairment, as theophylline metabolism occurs primarily in the liver.
• People with uncontrolled arrhythmias, where the risk of exacerbating heart conditions is a serious threat.
• Patients suffering from exacerbated asthma symptoms should consider alternative treatments, as theophylline can sometimes worsen respiratory distress.

It's crucial for anyone considering this medication to have an in-depth discussion with a healthcare provider, especially if there are pre-existing health conditions, such as liver disease or cardiac issues. Theophylline therapy can also be risky for pregnant or breastfeeding women, as safety in these populations hasn't been thoroughly established. By keeping these contraindications in mind, individuals can better navigate their treatment options.

Activities to Limit (Driving, Work Safety)

The effects of theophylline extend beyond simply treating respiratory conditions; they can also impact daily activities. Users may find themselves questioning, "Will I still be able to drive or work safely while on theophylline?"

The medication can lead to side effects that might impair cognitive functions or motor skills.

• Dizziness and headache are common, which could compromise the ability to drive or operate machinery.
• Higher doses can result in tachycardia or palpitations, prompting further caution.

For those in jobs requiring constant attention or physical activity, the potential for decreased focus and increased heart rate can pose a significant risk. Before engaging in such activities, it’s essential to evaluate how theophylline is affecting you personally.

Overall, keeping a close eye on how one feels while on theophylline will help make informed decisions about the day-to-day tasks and activities safely. Awareness of these safety considerations can lead to more effective management of both health and daily responsibilities.

Dosage & Adjustments

General Regimen (NHS Guidance)

When prescribing theophylline, it's essential to adhere to NHS guidelines, which outline standard dosing recommendations. Initial doses for adults typically range from 300mg to 600mg daily, tailored to individual patient needs, often divided into two or more doses throughout the day. For children, theophylline dosing is frequently based on weight, ensuring that even the smallest patients receive the correct amount where precise adjustments matter.

It's important to consider that therapeutic drug monitoring plays a crucial role in individualised dosing. Theophylline has a narrow therapeutic index, meaning the difference between therapeutic and toxic levels is small. Regularly checking plasma theophylline levels can help avoid adverse effects such as tachycardia or gastrointestinal upset. Adjustments may be necessary due to factors like drug interactions, liver or kidney function, and comorbidities, solidifying the need for ongoing evaluation during treatment.

Special Cases (Elderly, Comorbidities)

When prescribing theophylline, special caution is needed for elderly patients and those with multiple health conditions. Age-related pharmacokinetic changes may necessitate lower starting doses, typically around 300mg per day, with close monitoring for adverse reactions.

Patients with comorbid conditions, especially those experiencing hepatic or renal impairment, can experience altered theophylline metabolism, which would require additional adjustments in dosing. Recognising signs of toxicity is vital; these may include persistent nausea, abdominal pain, or signs like tachycardia and confusion, which could indicate elevated theophylline levels in the bloodstream.

Monitoring should involve regular assessment of the patient's clinical status, coupled with plasma level checks, especially if they are on interacting medications such as erythromycin or ciprofloxacin, which may increase theophylline levels. The overall goal is to balance therapeutic effects while minimising risks, ensuring patients achieve optimal outcomes without unwarranted complications.

City	Region	Delivery Time
London	England	5–7 days
Birmingham	England	5–7 days
Manchester	England	5–7 days
Leeds	England	5–7 days
Glasgow	Scotland	5–7 days
Newcastle	England	5–7 days
Cardiff	Wales	5–7 days
Sheffield	England	5–7 days
Bristol	England	5–9 days
Coventry	England	5–9 days
Nottingham	England	5–9 days
Leicester	England	5–9 days
Stoke-on-Trent	England	5–9 days
Derby	England	5–9 days