Theophylline

Theophylline is a type of medicine called a long-acting bronchodilator. This means it helps to keep your airways open and can make breathing easier.

It can help some people with long-term lung conditions, like asthma or chronic obstructive pulmonary disease (COPD, to manage and improve their breathlessness.

Theophylline is not a common medicine for asthma or COPD. Your doctor will only prescribe it if your symptoms cannot be controlled well with other treatments, or if you find it hard to use your inhaler. This is because it has more side effects compared to other medications.

You’ll usually take theophylline as a tablet or capsule that you swallow. If your symptoms are severe, it can also be given directly into your vein (intravenously) in emergency situations. This form of the medicine is commonly called aminophylline and you’ll be given this treatment by a healthcare professional in hospital.
 

Theophylline is not a steroid medicine and does not work like a reliever inhaler

Theophylline is a long-acting medicine. This means it lasts for about 12 hours. This can also mean theophylline may take longer to start working, so it’s not useful for quickly relieving symptoms during an asthma attack or a COPD flare-up.

Can anyone with asthma or COPD take theophylline?

Although theophylline works well for some people with asthma or COPD, it’s not suitable for everyone. For example, if:

• you’re older, because theophylline takes longer to clear from your blood, so it may be difficult to keep the medicine at a safe level.
• you’re a child, unless a specialist doctor prescribes it because of limited research about the use of theophylline in children.
• you have other health conditions, including high blood pressure, heart problems, stomach ulcers, liver problems, epilepsy, cystic fibrosis, or thyroid problems.
• you take other medicines, including some antibiotics, betablockers, and oral contraceptives.

Go for regular blood tests 

It’s important to go for regular blood tests to make sure that theophylline stays at a safe level in your blood.

Your doctor or specialist nurse should arrange for you to have a blood test five days after you first start taking theophylline and at least three days after any change in the amount you’re prescribed.

Depending on the results, they will change your dose as needed.

Take theophylline exactly as prescribed

It’s important to take theophylline exactly as prescribed. Accidentally taking the wrong amount can be harmful.

Never take a double dose to make up for a dose you’ve missed. If you forget to take a dose, or are not sure how often to take it, speak to your doctor, specialist nurse, or ask a pharmacist as soon as possible.

Theophylline is usually taken every 12 hours, but this may not always be the case. Always check how often you should take it with your doctor when they’re prescribing it to you. Ask them to write it down in your asthma action plan or COPD self-management plan. 

Swallow tablets or capsules whole

If you’re taking theophylline tablets or capsules, always swallow them whole with a glass of water.

It can be dangerous to crush or chew the tablets or capsules. This is because your body will absorb the medicine too quickly. In serious cases, this could lead to an overdose.

If you’re worried you may have accidentally chewed or crushed your theophylline tablets, you can call 111 for advice.

Take the same brand

Make sure you get the same brand of theophylline each time you pick up a new prescription.

This is because the amount of theophylline absorbed by your body varies between brands. If you start taking a different brand to the one you normally have, you may be getting too much or too little of the medicine.

If your doctor changes your prescription or brand, they should always schedule blood tests to make sure the new drug works well for you. This follow up test should be within 12 weeks of any changes.

If you’re worried about medicine shortages, call your pharmacy beforehand to check they have your medication in stock. They should also be able to tell you which other pharmacies have it.

Go for regular health checks

It’s always important to go for regular reviews with your doctor or specialist nurse. This means you can make sure theophylline is still working well for you, especially if you’re also taking other medicines.

Your doctor or nurse can discuss other treatments with you if:

• theophylline is making you feel unwell or is not helping your symptoms.
• you’ve been taking theophylline for at least eight weeks and your symptoms have not improved. This means it’s probably not the right medicine for you.
   

Theophylline if you’re pregnant

If you’re pregnant, planning to get pregnant, or breast feeding, speak to your GP or specialist about your medicines. If you’re already taking theophylline or any other medication, it’s important to keep taking these as prescribed and review them regularly.

We have more information about asthma and pregnancy.

It’s important to take theophylline at the right dose for you. 

It can be toxic if levels build up in the blood, but taking the right dose will lower your risk of side effects.

Always read the patient information leaflet that comes with your medication

It’s helpful to be aware of the possible side effects of theophylline. This means you understand the symptoms to look out for and when to follow up with your doctor, nurse, or call 111. 

Ask your doctor, nurse, or pharmacist to explain the possible side effects to you too.

Side effects of theophylline can include:

• headache
• cough
• nausea, stomach upset, or vomiting
• not sleeping well
• faster heart rate or suddenly noticeable heartbeats
• skin rash
• seizures
• trembling, particularly in the hands
• muscle cramps
• a dry mouth.

If you experience any of these side effects, speak to your doctor or nurse as soon as possible, or call 111.

Your doctor or nurse can arrange for you to have a blood test and may change your dose of theophylline.

They can also talk to you about other treatments that could work better for you.

Other things to watch out for

Even after you’ve started theophylline, remember to tell your doctor, nurse, or pharmacist you’re taking it because it could affect other medicines they prescribe. It’s also important to mention if you’re having surgery or have recently had, or are planning to have, a flu jab.

Theophylline can also interact with things like caffeine, over-the-counter drugs, herbal remedies, smoking and alcohol. This can affect how the medicine works for you and whether it’s still safe for you to take it.

If you started, or stopped, smoking during treatment, you should ask for a blood test to check that the dose is still correct for you.

Your healthcare professional may also ask you if you smoke, drink, or use recreational drugs. It’s important to be honest with them about this, as it’s to make sure the medication is safe for you to take.

Talk to your doctor, nurse, or pharmacist if you have any concerns about your medicines.