Theophylline for treatment of asthma

Theophylline has become useful not just as an acute bronchodilator, but also as a major prophylactic agent for the suppression of symptoms of chronic asthma. Efficacy and toxicity both relate closely to serum concentration. Variable elimination rates for the drug among individuals require careful individualization of dosage guided by measurement of serum theophylline concentration to maintain safe and effective serum theophylline concentrations. Fixed-dose combinations with ephedrine are more likely to add toxicity than benefit compared with theophylline alone if the latter is used in an adequate dose. Choices among the vase array of products available can be further simplified by considering cost and convenience of the various formulations. When used appropriately, theophylline has been successful in the essential elimination of asthmatic symptoms in over 70% of asthmatic children seen at a tertiary care referral center.