Theophylline

Brand Name:Apo-Theo La, Novo-Theophyl SR, Quibron-T/SR, Theolair, Uniphyl

Prescription needed: Yes

What is this drug used for?

Theophylline is used to prevent and treat breathing problems associated with asthma, chronic bronchitis, and emphysema. It works by relaxing the muscles in the airways of the lungs, making breathing easier, and prevents wheeziness or shortness of breath.

This medicine may be used for other medical conditions. Talk to your doctor.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to theophylline or aminophylline. Tell your doctor if you smoke. Also tell your doctor if you have or have ever had:

  • angina (chest pain)
  • high blood pressure (hypertension)
  • irregular heartbeat
  • heart failure
  • liver problems
  • epilepsy (seizures)
  • migraine headaches
  • overactive thyroid (hyperthyroidism)
  • porphyria
  • stomach ulcers

What about possible side effects?

Some common side effects are:

  • headache
  • nausea and vomiting

Other less common side effects include:

  • diarrhea
  • faster heartbeat
  • unable to sleep
  • tremor

These side effects are usually related to dose and/or the use of other medications and other factors (e.g. older age, other medical conditions). As well, some of these side effects are similar to a caffeine-like effect. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects. Contact your doctor if these symptoms continue or become worse.

Other less common and potentially serious side effects:

Call your doctor immediately if you experience any of the following side effects

  • severe, persistent vomiting, heartburn
  • severe diarrhea
  • stomach pains, black stools or blood in the stools
  • palpitations or chest pain
  • severe tremor or muscle twitching
  • seizures
  • ringing in the ears, vision changes
  • flushing, extreme thirst
  • unusual increase or decrease in urination

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Theophylline can affect or be affected by other medications in many different ways. Many of these medications need special monitoring and/or have significant side effects. Therefore, it is extremely important that you let all healthcare providers know that you are taking this medication.

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking:

  • allopurinol, birth control pills, calcium channel blockers (diltiazem, verapamil), cimetidine, certain antibiotics (such as ciprofloxacin, erythromycin), influenza vaccine, ticlopidine – may increase the amount of theophylline in the blood which increases the chances of side effects
  • certain seizures medications (such as carbamazepine, phenytoin), rifampin, St. John’s Wort – may decrease the effectiveness of theophylline
  • lithium amount in the blood may decrease
  • tacrolimus - amount in the blood may increase, increasing the chance of tacrolimus side effects
  • Benzodiazepines (such as alprazolam, lorazepam) may not work as well
  • phenylephrine, pseudoephedrine (which may be present in non-prescription cough or cold medicines) – may increase side effects such as nausea, nervousness or unable to sleep

Since these drugs will either increase or decrease the effects of theophylline, your doctor may need to make changes or monitor you more closely. If in doubt ask your doctor or pharmacist to review your list of medications.

Other information:

Lab test: Before you have myocardial perfusion studies (a medical test that shows how well blood is flowing to your heart), tell the doctor in charge that you are taking theophylline, since the results of the test may be affected by this medicine.

Because the dose of theophylline that works is different for each individual, follow your doctor’s instructions on how to take this medication. Do not increase your dose without first talking to your doctor. Your doctor will likely send you for blood tests from time to time to determine the dose and effect of this medication for you.

How to take: Theophylline is available in tablets, liquid and by injection. There are different oral forms of theophylline. The number of doses you take each day and the time between doses also depend on whether you are taking a short-acting or long-acting form of theophylline.

  • If you are taking the regular tablet (not including the once-a-day tablet) or the liquid form of this medicine, it usually works best when taken with a glass of water on an empty stomach (either 30 minutes to 1 hour before meals or 2 hours after meals).
  • If you are taking the once-a-day tablet form of this medicine, some products are to be taken each morning after fasting overnight and at least 1 hour before eating. However, other products are to be taken regardless of food. Be sure you understand exactly how to take the medicine prescribed for you. Do not crush or chew.
  • If you have any questions about how you should be taking this medicine, check with your doctor or pharmacist.
  • Do not change brands or dosage forms of this medicine without first checking with your doctor. Different products may not work the same way. If you refill your medicine and it looks different, check with your pharmacist.

Some lifestyle choices may also affect how theophylline works in your body:

Smoking - Tell your doctor if you smoke. Cigarette or marijuana smoking may decrease the amount of theophylline in the blood, making theophylline not work as well.

Caffeine - Avoid eating or drinking large amounts of foods and beverages that contain caffeine (e.g. more than 6 cups of coffee) because both theophylline and caffeine stimulate the central nervous system and may increase chances of side effects such as irritability and confusion. Also try to keep your caffeine intake (e.g. chocolate, tea, cola, and coffee) consistent. Talk to your doctor.

Alcohol - Alcohol can increase the risk of theophylline side effects such as nausea, vomiting, headache and irritability.

Food - The effect of food on theophylline medications can vary widely. High-fat meals may increase the amount of theophylline in the body, while diets with low carbohydrate and high protein may decrease it. It is important to let your doctor know if you make significant changes to your diet.

It is also important to check with your pharmacist about the specific form you are taking because food can also have different effects depending on the dose form (e.g., regular release, sustained release).

Children: The proper dosage depends on the child’s age and weight. In all cases, it will likely be lower than that prescribed for adults.

Seniors: May be more sensitive to effects. Lower dose may be necessary.

Pregnant women: Risks and benefits should be discussed with your doctor.

Women who are nursing: Passes into breast milk. Talk to your doctor.

People who drive or operate machinery: No specific recommendations.

Alcohol: Alcohol can increase the risk of side effects such as nausea, vomiting, headache and irritability.

Overdose: If you experience any unusual reactions, especially chest pains, seizures, severe nausea or vomiting, or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: Do not stop taking this drug without first talking to your healthcare provider as the underlying condition may worsen.

Missed dose: You should take this drug at the same time each day. Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Never take a double dose. If you are unsure, please ask your doctor or pharmacist

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.

Dietary precautions: Avoid large amounts of beverages or foods high in caffeine, like coffee, tea, cocoa, and chocolate, which may increase the side effects caused by theophylline. Let your doctor know if you make significant changes to your diet or if you have lots of charcoal-broiled meats, since your doctor may need to adjust your theophylline dose.