Methylxanthine bronchodilator
Theophylline
Brand names: Uniphyllin Continus, Slo-Phyllin
Adult dose
Dose: MR: 200–400mg PO BD; titrate to plasma level
Route: PO/IV
Frequency: BD
Dose adjustments
Renal
Reduce if hepatic impairment / HF
Clinical pearls
- Asthma/COPD (3rd-line); narrow TI (10–20 mg/L)
- Brand-specific MR — do not switch
Contraindications
- Active peptic ulcer
- Uncontrolled arrhythmias
- Severe hypertension
- Hypersensitivity
- Acute porphyria
Side effects
- Tachycardia
- Arrhythmias
- Tremor
- GI upset
- Seizures (toxicity)
- Hypokalaemia
Interactions
- Many — narrow therapeutic index
- Macrolides
- Quinolones
- Cimetidine
- Smoking (induces — dose change on cessation)
Monitoring
- Plasma levels
- K+
- HR
Reference: BNF; NICE NG80/NG115; BTS/SIGN; https://bnf.nice.org.uk/drugs/theophylline/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
Same specialty
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA