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Evaluation of a once-a-day theophylline preparation in asthmatic children
1Department of Pediatrics, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Insights
Once-daily Theolan (theophylline) may help nocturnal asthma, but maintaining therapeutic serum levels is challenging in children. Rapid metabolism suggests more frequent dosing may be needed for chronic asthma symptom control.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Asthma management in children requires careful monitoring of medication efficacy and safety.
- Theophylline is a bronchodilator used in asthma treatment, with dosing requiring optimization for pediatric patients.
Purpose of the Study:
- To evaluate serum theophylline concentrations and optimal dosing intervals for Theolan in asthmatic children.
- To compare theophylline levels achieved with once-daily versus twice-daily dosing regimens.
Main Methods:
- Serum theophylline levels were measured in two groups of asthmatic children: one group receiving Theolan once daily and another receiving it twice daily.
- Peak and trough serum theophylline concentrations were analyzed for each dosing group.
Main Results:
- The once-daily group exhibited peak serum theophylline levels exceeding 20 micrograms/ml.
- The twice-daily group generally maintained levels between 10 and 20 micrograms/ml.
- Peak-to-trough fluctuations were more pronounced in the once-daily dosing group.
Conclusions:
- Once-daily evening Theolan may benefit nocturnal asthma symptoms.
- Achieving consistent therapeutic serum theophylline levels with once-daily dosing is difficult in children due to rapid metabolism.
- More frequent dosing intervals might be necessary for effective chronic asthma symptom suppression in pediatric patients.
Abstract:
We conducted a study to evaluate the serum theophylline concentrations and dose interval of Theolan preparation in asthmatic children. A series of serum theophylline levels were measured both in 10 asthmatic children taking Theolan once a day and 9 children twice a day. In the once-a-day group, the peak serum theophylline level was greater than 20 micrograms/ml; whereas, in the twice-a-day group, it was mostly between 10 and 20 micrograms/ml. The difference of the peak-to-trough was more fluctuant in the once-a-day group than in the twice-a-day group. These results suggest that Theolan given once a day in the evening can be useful in the management of nocturnal asthma; however, it was difficult for once-a-day administration of Theolan to sustain rigid therapeutic serum theophylline levels. Because of rapid metabolism in children, they may require a more frequent interval than once-a-day dosing to suppress the symptoms of chronic asthma.