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Theophylline kinetics in a geriatric group.

R W Fox, S Samaan, S C Bukantz

    Clinical Pharmacology and Therapeutics
    |July 1, 1983
    PubMed
    Summary
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    Geriatric patients exhibit altered theophylline pharmacokinetics, with faster elimination and greater clearance. However, dose reduction is not always necessary for the elderly, as sustained-release theophylline effectively reaches therapeutic levels.

    Area of Science:

    • Pharmacology
    • Geriatric Medicine
    • Drug Metabolism

    Background:

    • Theophylline is a medication used for respiratory conditions.
    • Understanding how age affects drug disposition is crucial for safe and effective treatment.
    • Previous studies have suggested potential age-related differences in theophylline pharmacokinetics.

    Purpose of the Study:

    • To investigate the influence of age, sex, and smoking on theophylline disposition in healthy adults.
    • To compare the pharmacokinetic parameters of theophylline in young versus geriatric subjects.
    • To determine if dose adjustments are necessary for geriatric patients receiving sustained-release theophylline.

    Main Methods:

    • A crossover study design was employed with 38 healthy subjects (26-81 years old).

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  • Subjects received a single dose of theophylline elixir followed by a sustained-release (SR) theophylline tablet.
  • Serum theophylline concentrations were measured using High-Performance Liquid Chromatography (HPLC).

    • Main Results:

    • Theophylline elimination half-life was shorter in the geriatric group (6.93-8.14 hr).
    • Total body theophylline clearance was greater in geriatric subjects (44.39-32.97 ml/kg/hr).
    • Apparent volume of distribution was also larger in the geriatric group (26.29-22.97 L).
    • Neither sex nor smoking status significantly affected theophylline pharmacokinetic parameters.
    • 93% of geriatric subjects achieved therapeutic serum theophylline levels (8-20 µg/mL) with the SR tablet.

    Conclusions:

    • Age significantly influences theophylline pharmacokinetics, leading to faster elimination and increased clearance in geriatric individuals.
    • Despite pharmacokinetic differences, sustained-release theophylline formulations can achieve therapeutic concentrations in the elderly.
    • Arbitrary dose reduction of theophylline based solely on age may not be consistently indicated.