Guide to oral theophylline therapy for the treatment of chronic asthma
L. Hendeles, M. Weinberger and R. Wyatt
Theophylline, when used appropriately, seems to be the most effective
noncorticosteroid prophylactic medication for chronic asthma. Dosage,
however, requires consideration of the relationship between serum
concentration, efficacy, and toxicity, in addition to the variability in
rates of elimination. Therapy is initiated with 16 mg/kg/day or 400 mg/day
(whichever is less) in divided doses at appropriate intervals depending on
the rate of absorption of the product used. If side effects are absent, the
dosage is increased at three-day intervals until the age-related mean
dosage necessary to produce a therapeutic level, is reached. Final dosage
adjustment is generally based on a single determination of serum
concentration; dosage requirements generally then remain constant for six
to 12 months depending upon the child's growth rate. Dosage adjustment in
this manner optimizes benefit, minimizes risk of toxic effect, and avoids
excessive numbers of serum theophylline measurements.