Rectal administration of choline theophyllinate in adult asthmatics on theophylline maintenance therapy

The relief of bronchial obstruction from theophylline administered intravenously and as retention enema was compared in a controlled double-blind cross-over study in 21 adult patients with reversible bronchial obstruction, who were on continuous treatment with an individually adjusted maintenance dose of oral theophylline. In two sessions the patients received in random order a 10 ml aminophylline infusion intravenously (180 mg theophylline) and the equivalent of 400 mg theophylline rectally in the form of choline theophyllinate, followed by serial determinations of ventilatory function and plasma theophylline levels during the next 8 h. Significant improvement of FEV1 within 1 h was recorded with both treatments and the duration of the effect was very similar for the two routes of administration. The patients were in stable state while taking part in the experiment but the similarity in the outcome suggests that choline theophyllinate administered as retention enema, although slower acting, represents a useful alternative to intravenous aminophylline also in the management of acute episodes of bronchial obstruction.