Theophylline ER (Extended‑Release) 200 mg – Quick Reference
| Topic | Key Points |
|-------|------------|
| What it is | Theophylline is a bronchodilator that relaxes the smooth muscles in the lungs. The ER formulation releases the drug gradually over 12–18 hours, so it’s usually taken twice daily. |
| Common uses | • Asthma (maintenance therapy)
• Chronic obstructive pulmonary disease (COPD)
• Other chronic obstructive airway diseases |
| Typical dosing | • Adults: 200 mg once or twice daily (often 100 mg BID is a starting point, titrated to 200 mg).
• Pediatrics: 5–10 mg/kg/day in divided doses (not typically 200 mg).
• Adjust based on trough blood levels (desired range 5–10 µg/mL). |
| How to take it | • Take with food to reduce GI upset.
• Do not crush or chew the tablet; it’s designed for slow release.
• Stick to the same time each day. |
| Common side effects | • Nausea, vomiting, abdominal pain, diarrhea
• Headache, tremor, insomnia
• Rare: arrhythmias, seizures at high blood levels |
| Serious risks | • Narrow therapeutic window – blood levels must be monitored.
• Overdose can cause cardiac arrhythmias, seizures, and even death. |
| Drug interactions | • Increased levels: cimetidine, fluvoxamine, ciprofloxacin, erythromycin, macrolides, anti‑epileptics, steroids, SSRIs, etc.
• Decreased levels: smoking, rifampin, phenobarbital, carbamazepine, phenytoin, allopurinol, etc. |
| Monitoring | • Blood levels every 3–5 days after dose adjustment
• Check electrolytes (especially potassium, magnesium)
• Watch for signs of toxicity (nausea, dizziness, palpitations, seizures) |
| When to seek help | • Symptoms of toxicity: vomiting, severe abdominal pain, irregular heartbeat, seizures.
• If you miss a dose, don’t double up. |
| Lifestyle tips | • Stop smoking or reduce intake; smoking induces metabolism, requiring higher doses.
• Avoid alcohol – it can increase risk of GI upset. |
| Special notes | • Pregnancy: Use only if benefit outweighs risk; monitor levels closely.
• Children under 2 years old should not receive theophylline. |
| Patient FAQ | • “Will it help my asthma?” – Yes, it helps prevent wheezing and improves breathing, but it’s not a rescue inhaler.
• “Can I take it with my other meds?” – Talk to your provider, especially if you’re on antibiotics, antidepressants, or anti‑seizure meds.
• “What if I’m on a steroid inhaler?” – Theophylline can be used together; steroids mainly control inflammation. |
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Quick Take‑Away
- Theophylline ER 200 mg is a long‑acting bronchodilator used for chronic asthma/COPD.
- Because of its narrow therapeutic window, blood levels must be checked regularly.
- Be vigilant about drug interactions and lifestyle factors (e.g., smoking, alcohol).
- If you experience nausea, vomiting, or any sign of toxicity, contact your healthcare provider immediately.
Feel free to ask if you need more detail on dosing schedules, how to handle missed doses, or anything else!