Theophylline tablets plus a steroid inhaler to prevent symptoms
Do they work?
They may help. If you are using steroids from an inhaler but are still having asthma symptoms, taking theophylline tablets may help you breathe more easily. But it doesn't seem to have any other effects.
Theophylline tablets don't seem to work any better alongside a steroid inhaler than drugs called leukotriene antagonists and long-acting beta-2 agonists.
What are they?
Theophylline is a drug that helps your airways open up so you can breathe more easily in the morning and evening. It's known as a long-acting bronchodilator. That's because it works for a long time, and it makes the bronchial tubes (airways) dilate (open up). It seems to work by relaxing the muscles in your airways.
Theophylline starts working very slowly, so it should not be used for quick relief.
You can take theophylline as a tablet or as syrup. It can also be injected. There are a lot of brand names for this kind of drug. Here are some of them:
- Nuelin SA
- Slo-Phyllin
- Uniphyllin Continus.
How can they help?
Taking theophylline tablets as well as steroids from an inhaler may improve your breathing.[1] But it may not make any difference to your other symptoms or how likely you are to have a bad asthma attack.
Taking theophylline tablets as well as steroids from an inhaler doesn't seem to be any better than taking:[2] [3]
- A leukotriene antagonist and steroids from an inhaler
- A long-acting beta-2 agonist (a long-acting inhaler) and steroids from an inhaler
- Beta-2 agonist tablets and steroids from an inhaler.
Why should they work?
The main purpose of theophylline is to help keep the air passages in your lungs open. This makes it easier for air to get into your lungs. Experts are not sure exactly how theophylline works. But it seems to keep muscles relaxed.
Theophylline also seems to help calm down irritation in the airways and stop them getting swollen. But it isn't as good at doing this as other drugs.
Can they be harmful?
Theophylline tablets may make you feel sick and give you a headache. Theophylline can make you irritable, too. It can also cause seizures and abnormal heart rhythms. All of these side effects are more likely to happen if you are taking a dose that is too high for you.
A disadvantage of theophylline is that it is difficult to get the dose right.[4] There isn't much difference between the dose of theophylline that may help you breathe better and the dose that may cause side effects.
To reduce side effects, your doctor will need to adjust your dose of theophylline very carefully. This usually means having blood tests to see how much of the drug is in your body.
Elderly people are especially at risk of side effects.[5] That's because an older person's liver doesn't get rid of theophylline as well as a younger person's liver does.
Theophylline can also cause problems if you take it at the same time as some other drugs.
References
- Lim S, Jatakanon A, Gordon D, et al. Comparison of high dose inhaled steroids, low dose inhaled steroids plus low dose theophylline, and low dose inhaled steroids alone in chronic asthma in general practice. Thorax. 2000; 55: 837-841.
- Yurdakul AS, Calisir HC, Tunctan B, et al. Comparison of second controller medications in addition to inhaled corticosteroid in patients with moderate asthma. Respiratory Medicine. 2002; 96: 322-329.
- Xuejun G, Huanying W, Qingyun L. Treatment of chronic moderate asthma by corticosteroid inhalation with controlled released theophylline or beta2 agonist. Chinese Journal of Practical Internal Medicine. 2001; 21: 141-142.
- British National Formulary. Theophylline. Section 3.1.3. September 2007. BNF 54. British Medical Association and Royal Pharmaceutical Society of Great Britain. Also available at http://bnf.org (accessed on 12 October 2007).
- Ramsdell J. Use of theophylline in the treatment of COPD. Chest. 1995; 107 (supplement): 206S-209S.
Glossary
- seizure
- A seizure (or fit) is when there is too much electrical activity in your brain, which results in muscle twitching and other symptoms.
- liver
- Your liver is on the right side of your body, just below your ribcage. Your liver does several things in your body, including processing and storing nutrients from food, and breaking down chemicals, such as alcohol.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
