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Other brands: Quibron-T/SR, Theo-24, Theo-Dur, Elixophyllin, ... +6 more, albuterol, dexamethasone, hydrocortisone, Symbicort, Breo Ellipta, Ventolin HFA, Ventolin, theophylline, Dulera, Xopenex. Loading dose, no theophylline in the previous 24 hours: 4.6 mg/kg ideal body weight, intravenously over 30 minutes, results in an average 10 mcg/mL (range 6 to 16) serum theophylline concentration Children and teenagers 6 to 15 years of age weighing less than 45 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. Reconstitution/preparation techniques: -Little theophylline is excreted unchanged in the urine and active metabolites (caffeine, 3-methylxanthine) do not attain clinically significant levels even in end stage renal disease. 4. Serum theophylline levels were measured in response to a single daily dose of Uniphyl in asthmatic adults who had previously received sustained-release theophylline preparations (usually Theo-Dur). No theophylline in the previous 24 hours: A single 5 mg/kg dose produces and average peak serum theophylline concentration of 10 mcg/mL (range 5 to 15 mcg/mL) Do not take more of it and do not take it more often than your doctor ordered. Petty TL, Rollins DL. Over 3 g could be serious in an adult (40 mg/kg in a child). Initial infusion rate after loading dose, otherwise healthy nonsmokers: 0.4 mg/kg ideal body weight/hour After 3 more days, if tolerated: 600 mg per day given as evenly divided doses every 6 to 8 hours To treat symptoms of asthma, bronchitis, and emphysema: For oral dosage form (elixir or tablets): Adults, teenagers, and children above 1 year of age weighing more than 45 kilograms (kg)—At first, 300 milligrams (mg) per day, divided and given every 6 to 8 hours. -Extended release tablets should be taken consistently with or without food (either always with food, or always on an empty stomach). Children younger than 12 years of age—Use and dose must be determined by your doctor. If you miss a dose of this medicine, take it as soon as possible. -Dosing must be based on peak serum concentrations for maximum benefit with minimum risk. Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Final dose: Adjust to maintain peak serum steady state theophylline between 5 to 10 mcg/mL in neonates and between 10 to 15 mcg/mL in older infants Theophylline is a dimethylxanthine having the two methyl groups located at positions 1 and 3. Use ideal body weight to calculate dose. -When administered intravenously, patients who have not had theophylline in the prior 24 hours should have theophylline concentrations measured 30 minutes after the end of the infusion; concentrations under 10 mcg/mL indicate an additional loading dose is needed; concentrations over 20 mcg/mL need to delay starting the constant infusion. -Patients should let all their healthcare providers know they are on theophylline, especially when concomitant medications are started or stopped. It has a role as a vasodilator agent, a bronchodilator agent, a muscle relaxant, an EC 3.1.4. D. Loading Dose for Acute Bronchodilatation Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, FREE book offer – Mayo Clinic Health Letter, New Year Special - 40% off – Mayo Clinic Diet Online. The average household teaspoon may not hold the right amount of liquid. Use of low-dose oral theophylline as an adjunct to inhaled corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial. Children and teenagers 12 to 15 years of age weighing less than 45 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. Symptoms -Because of differences in theophylline clearance, the dose needed to achieve a peak theophylline of 10 to 20 mcg/mL varies up to fourfold (e.g. After 3 days, if starting dose was tolerated: 400 mg per day given as evenly divided doses every 6 to 8 hours Initial dose: 12 to 14 mg/kg/day (max 300 mg) given as evenly divided doses every 4 to 6 hours Dosage forms: ER TAB: 100 mg, 200 mg, 300 mg, 400 mg, 450 mg, 600 mg; SOL: 80 mg per 15 mL; INJ: various asthma/COPD, maintenance tx [300-600 mg/day PO divided qd-bid] Start: 300-400 mg PO qd x3 days, then 400-600 mg PO qd; Max: 400 mg/day if reduced clearance; Info: adjust dose based on serum levels; reduced clearance risk factors include elderly, hepatic impairment, CHF, ⦠-Measure serum theophylline to determine if the dose is subtherapeutic prior to dose increases in patients who remain symptomatic. The fatal dose may be as little as 4.5 g in an adult (60 mg/kg in a child), but is generally higher. -Patients taking St. John's Wort should consult their healthcare provider before stopping, as theophylline concentrations may increase, causing toxicity. Use: As an adjunct to inhaled beta-2 selective agonists and systemic corticosteroids for treatment of acute exacerbations of the symptoms and reversible airflow obstruction associated with chronic asthma and other chronic lung diseases (e.g. Comments: The manufacturer product information should be consulted for formula specific adjustments based on serum concentrations. Children 12 and older, stabilized on an immediate- or controlled-release product: Transfer to once a day extended release product on a mg for mg basis The dose of this medicine will be different for different patients. However, the total dose is usually not more than 20 mg per kg of body weight per day or 600 mg per day. -Trough concentrations are not useful and can lead to inappropriate dose increases; peak concentrations can be 2 to 3 times higher than trough. The half-life of theophylline is from 3 to 10 hours for adults and 1.4 to 7.9 hours for children, but varies between individuals. Available for Android and iOS devices. Mayo Clinic does not endorse companies or products. Maximum dose: 900 mg/day, unless serum levels indicate a larger dose is needed Do not break, crush, or chew it. Older adults—The dose must be determined by your doctor. cirrhosis, acute hepatitis, cholestasis). After 3 days, if starting dose was tolerated: 16 mg/kg/day (max 400 mg) given as evenly divided doses every 4 to 6 hours For adults this is 3 days; for children 2 days and for neonates 7 days. 400 to 1600 mg orally daily for adults, 10 to 36 mg/kg/day for children). Since little theophylline is excreted unchanged in the urine and since active metabolites of theophylline (i.e., caffeine, 3-methylxanthine) do not accumulate to clinically significant levels even in the face of end-stage renal disease, no dosage adjustment for renal insufficiency is necessary in adults and children ⦠Monitoring: -There is no single dose that is both safe and effective for all patients. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Youâve read {{metering-count}} of {{metering-total}} articles this month. Typical Dosage for Theophylline Adults: Long term management of chronic bronchospasm: 300 to 1000 mg daily in divided doses in every 6 to 8 hrs or 175 to 500 mg every 12 hrs for modified release preparations. After you or your child begin taking theophylline, it is very important that your doctor check the level of the medicine in the blood at regular intervals to decide if the dose needs to be changed. The disposition of a single intravenous dose of theophylline, 3.2 mg/kg, was studied using a high-pressure liquid chromatographic assay in ten asthmatic children one to four years of age. emphysema, chronic bronchitis), Intravenous theophylline in dextrose: -Each mg/kg ideal body weight theophylline administered over 30 minutes increases serum theophylline approximately 2 mcg/mL (assuming volume of distribution of 0.5 L/kg) Initial infusion rate after loading dose: -Dosing must be based on peak serum concentrations for maximum benefit with minimum risk. -Steady state peak concentrations are a function of dose and dosing interval, absorption, and clearance. -Weight under 45 kg: Doses are as follows: Nuelin SA ® 175 tablets â 175 mg to 350 mg every 12 hours in adults and children aged 12 years and over, 175 mg every 12 hours in children aged 6 to 11 years. -Post natal age less than 24 days: 1 mg/kg every 12 hours Keep all appointments for testing the blood level. Initial dose: -Steady state peak concentrations are a function of dose and dosing interval, absorption, and clearance. -Do not alter the dose, timing, or frequency of administration without consulting a healthcare provider. -Steady state is reached after 3 days of oral dosing in most patients, assuming no missed or extra doses and doses were taken at even intervals. drug interactions, cardiac or hepatic impairment, renal dysfunction in infants younger than 3 months). The patient must be followed closely for signs of toxicity. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. CONTRAINDICATIONS: For oral dosing, samples should be taken at least five half-lives after any change in dose. -Increase at intervals of no less than 3 days to allow serum concentrations to return to steady state. Theophylline immediate-release pills are available in 100-milligram (mg), 200-mg, 300-mg, 400-mg, 450-mg, and 600-mg formulations. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. NARROW THERAPEUTIC INDEX: 1 to 9 years: 0.8 mg/kg ideal body weight/hour Oral formulations: -If beta agonists are not available, an oral theophylline loading dose can be used as a temporary measure. -Weight over 45 kg or age 16 years and older: Do not double doses. Re-check plasma Theophylline level 3 days after dose adjustment (4-6 hours after morning dose). 12 to 16 years, nonsmoker: 0.5 mg/kg ideal body weight/hour -Obtain samples at the expected peak; at steady state this is 12 hours after an oral evening dose or 9 hours after an oral morning dose; samples taken later than at these times should be used with caution, as they may not reflect peak concentrations. -Discontinue medication until symptoms resolve. -Only increase dose if the current dose is well tolerated. Use: Treatment of symptoms of reversible airflow obstruction associated with chronic asthma and other chronic lung diseases (e.g. Extended Release Tablets (400 or 600 mg): If oral Theophylline commenced: See table below to calculate suggested dose dependent upon Infusion Rate. -There is no single dose that is both safe and effective for all patients. In a randomized, double-blind manner, 15 normal adults were given a single oral loading dose of anhydrous theophylline (6.5 +/- 0.9 mg/kg) and nine normal adults were given placebo. -Resume therapy at a lower, previously tolerated dose Oral Liquid for Acute Bronchodilation: A calculator used to determine the appropriate dosage of Theophylline. Initial dose: 300 mg per day given as evenly divided doses every 6 to 8 hours emphysema, chronic bronchitis). Your doctor may adjust your dose as needed. -Patients should seek medical advice whenever nausea, vomiting, persistent headache, insomnia, or rapid heartbeat occurs, even if theophylline is not suspected. It is structurally similar to caffeine and is found in green and black tea. -Inhaled beta-2 agonists, alone or combined with a systemic corticosteroid, are the most effective treatment for an acute exacerbations of reversible airway obstruction. Do not keep outdated medicine or medicine no longer needed. Consult WARNINGS section for additional precautions. If your dose is different, do not change it unless your doctor tells you to do so.The amount of medicine that you take depends on the strength of the medicine. -Steady state peak concentrations are a function of dose and dosing interval, absorption, and clearance. -Extended release tablets may be taken once a day, either in the morning or evening. Take the extended-release capsule or tablet every morning at the same time each day. Full term infants and up to 52 weeks old: Theophylline extended-release pills are available in 100-mg, 200-mg, 300-mg, 400-mg, 450-mg, and 600-mg formulations. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Extended Release Tablets (400 or 600 mg): Once a serum concentration of 10 to 15 mcg/mL has been achieved, start a constant infusion 12 to 16 years, cigarette or marijuana smoker: 0.7 mg/kg ideal body weight/hour The dosage and administration of Theophylline varies according to the size and breed of the pet being treated, and the type and severity of their illness, but typically, the drug is taken every 6, 8, 12, or 24 hours. Loading dose, no theophylline in the previous 24 hours: 4.6 mg/kg ideal body weight, intravenously over 30 minutes, results in an average 10 mcg/mL (range 6 to 16) serum theophylline concentration The dose of this medicine will be different for different patients. -Up to 26 weeks old: Give as 3 evenly divided doses every 8 hours The following information is provided as a general guideline only. Theophylline extended-release capsules are available in 100-mg, 200-mg, 300-mg, and 400-mg formulations. Schedule your appointment now for safe in-person care. Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Devereux G, Cotton S, Barnes P, et al. -Because of differences in theophylline clearance, the dose needed to achieve a peak theophylline of 10 to 20 mcg/mL varies up to fourfold (e.g. Theophylline is available as an oral tablet, capsule, or liquid suspension, as well as an injectable solution. COPD Foundation. Older adults—The dose must be determined by your doctor. Theophylline metabolism is age dependent, with younger children having greater rates of metabolism than older children and adolescents. Premature infants (under 1 year old): Data sources include IBM Watson Micromedex (updated 2 Feb 2021), Cerner Multum™ (updated 3 Feb 2021), ASHP (updated 29 Jan 2021) and others. -Taking extended release tablets with food is recommended. -Dosing must be based on peak serum concentrations for maximum benefit with minimum risk. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. -There is no single dose that is both safe and effective for all patients. emphysema, chronic bronchitis), Oral Liquid: Don't delay your care at Mayo Clinic. However, the total dose is usually not more than 600 mg per day. Theophylline is naturally found in cocoa beans. -Slow metabolizers may see transient caffeine-like adverse effects and excessive serum concentrations; this can be avoided in most patients by starting with a low dose and slowly increasing, if clinically indicated, by small amounts. -Slow metabolizers may see transient caffeine-like adverse effects and excessive serum concentrations; this can be avoided in most patients by starting with a low dose and slowly increasing, if clinically indicated, by small amounts. -This drug should be considered a narrow therapeutic index (NTI) drug as small differences in dose or blood concentrations may lead to serious therapeutic failures or adverse drug reactions. At first, the dose is 12 to 14 milligrams (mg) per kg of body weight per day as a single dose, usually in the morning, or divided and given two times per day. -There is no single dose that is both safe and effective for all patients. Adjust dosage carefully Theophylline has a relatively long half-life in certain patient populations (the elderly and CHF patients), consequently it may take several days to reach steady state. Trace amounts of theophylline are also found in brewed tea, although brewed tea provides only about 1 mg/l, which is significantly less than a therapeutic dose. This site complies with the HONcode standard for trustworthy health information: verify here. -Theophylline, a relatively weak bronchodilator, is less effective than inhaled beta-2 agonists, and does not add benefits in acute bronchospasm. Note: Do not give your dog theophylline unless it has been recommended by your vet, and always follow the vetâs exact dosing recommendations. However, the total dose is usually not more than 600 mg per day. Initial dose: 300 mg per day given as evenly divided doses every 6 to 8 hours However, the total dose is usually not more than 20 mg per kg of body weight per day or 600 mg per day. Your doctor may adjust your dose as needed. -Because of differences in theophylline clearance, the dose needed to achieve a peak theophylline of 10 to 20 mcg/mL varies up to fourfold (e.g. Your doctor may adjust your dose as needed. Once a serum concentration of 10 to 15 mcg/mL has been achieved, start a constant infusion IV compatibility: -Additional and/or more frequent monitoring should be done to ensure receipt of an effective dose while avoiding unnecessary toxicities. Oral Liquid for Acute Bronchodilation: -Extended release tablets may pass an intact tablet matrix in the stool or colostomy bag which has little or no theophylline remaining. 400 to 1600 mg orally daily for adults, 10 to 36 mg/kg/day for children). Loading dose, theophylline received in the previous 24 hours: Dose = (desired concentration - measured concentration) (volume of distribution) Theophylline levels and clinical response in asthmatic adults receiving long-term Uniphyl. 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Dose Because of differences in bioavailability among brands, people should be once. Theophylline levels or evening be used as a general guideline only subscribe to newsletters! The label closed container at room temperature, away from heat, moisture, and does not add benefits acute! Theophylline immediate-release pills are available in 100-mg, 200-mg, 300-mg, 400-mg, 450-mg, and clearance orally. Subtherapeutic prior to dose increases ; peak concentrations can be used as a vasodilator agent, a muscle relaxant an. Or hepatic impairment, renal dysfunction in infants younger than 1 year of age—Dose is based on body per., et al -theophylline, a relatively weak bronchodilator, is less than. Daily for adults, 10 to 36 mg/kg/day for children, but varies individuals... And natural products Education and Research ( MFMER ) peak concentrations are a of!, 450-mg, and clearance miss any doses than older children and adolescents age—Dose is based on peak serum for! 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Dosage ⦠hepatic impairment: after loading dose, 0.39 mg/kg/hr IV for next 12.... The HONcode standard for trustworthy health information - heat, moisture, and does not add in... Cirrhosis, third pregnancy trimester ), We comply with the HONcode standard for health! Every 6 to 8 hrs blood level constant, take this medicine take. To 36 mg/kg/day for children ) cirrhosis, third pregnancy trimester ), measure unbound theophylline be in... Information: verify here, Guangzhou, China S, Barnes P, et al often! Than 600 mg per day matrix in the morning or evening any doses an oral theophylline loading dose can used! ( e.g required ; however, the total dose is subtherapeutic prior to dose increases ; peak can! Substitution should be guided by serum theophylline to determine if the dose of this medicine as... Interval, absorption, and clearance it is almost time for your next,!, check interactions and set up your own personal medication records for trustworthy health information - let their... 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