Generic Theophylline

Introduction

Theophylline is a bronchodilator used primarily to manage obstructive air‑way diseases such as asthma and chronic obstructive pulmonary disease (COPD). The medication contains the active compound Theophylline and belongs to the asthma medication group. In the United Kingdom it is prescribed when inhaled therapies alone are insufficient to control symptoms. Theophylline’s anti‑inflammatory and smooth‑muscle‑relaxing properties make it a useful adjunct in the long‑term treatment of reactive airway conditions.

What is Theophylline?

Theophylline is a xanthine derivative that has been employed in respiratory medicine since the 195s. It is classified as a methylxanthine bronchodilator and is manufactured by several licensed producers worldwide.

Theophylline is the generic version of the original brand Theo‑Dur, containing the same active compound Theophylline. Our online pharmacy provides this generic alternative as a cost‑effective treatment option. Other recognised brand names include Theochrol and Theosine, which may still be referenced in older clinical literature.

How Theophylline Works

Theophylline exerts its therapeutic effect by inhibiting the enzyme phosphodiesterase (PDE), predominantly the PDE‑3 and PDE‑4 isoforms. Inhibition raises intracellular cyclic adenosine monophosphate (cAMP) levels in bronchial smooth‑muscle cells, leading to relaxation of the air‑way smooth muscle and bronchodilation.

Elevated cAMP also dampens the release of pro‑inflammatory mediators from mast cells and eosinophils, providing a modest anti‑inflammatory benefit. The drug’s onset of action after oral administration is usually within 1–2 hours, while the elimination half‑life ranges from 6 to 12 hours in healthy adults; clearance is largely mediated by hepatic cytochrome P450 1A2 (CYP1A2).

Conditions Treated with Theophylline

• Asthma (moderate to severe) – Theophylline improves symptom control when inhaled corticosteroids and long‑acting β₂‑agonists are insufficient.
• Chronic obstructive pulmonary disease (COPD) – Used as add‑on therapy to reduce exacerbation frequency in patients with persistent airflow limitation.
• Bronchiectasis – May enhance mucociliary clearance and alleviate chronic cough.

In the UK, the prevalence of asthma (≈5 % of the adult population) and COPD (≈2.5 % of adults) creates a substantial clinical need for adjunctive agents like theophylline, especially in patients who experience poor inhaler technique or limited response to inhaled regimens.

Suitable Candidates for Theophylline Therapy

Theophylline is most appropriate for adult patients who:

• Have confirmed asthma or COPD despite optimal inhaled therapy.
• Demonstrate reliable adherence to a regular oral dosing schedule.
• Do not have contraindications such as active cardiac arrhythmias, uncontrolled seizure disorders, or recent use of strong CYP1A2 inhibitors (e.g., ciprofloxacin, erythromycin).

Patients with significant liver disease, uncontrolled hypertension, or a history of hypersensitivity to methylxanthines may be unsuitable for Theophylline and should be evaluated for alternative treatments.

Risks, Side Effects, and Interactions

Common adverse events

• Nausea, vomiting, or abdominal discomfort.
• Headache.
• Insomnia or central nervous system stimulation (tremor, restlessness).

Rare adverse events

• Cutaneous rash or pruritus.
• Mild arrhythmias (e.g., premature atrial or ventricular beats).

Serious adverse events

• Life‑threatening ventricular tachycardia or fibrillation.
• Severe seizures, especially at high plasma concentrations.
• Hypotension unresponsive to conventional fluid therapy.

Clinically relevant drug–drug interactions

• CYP1A2 inhibitors (ciprofloxacin, enoxacin, enzalutamide, fluvoxamine, allopurinol) → increase plasma Theophylline, raising toxicity risk.
• CYP1A2 inducers (rifampicin, carbamazepine, phenobarbital, smoking) → lower concentrations, potentially reducing efficacy.
• Macrolide antibiotics (erythromycin, clarithromycin) → may double Theophylline levels.
• β‑blockers (propranolol) and theophylline → additive cardiac stimulation.

Patients should inform their healthcare professional of all concomitant medicines, including over‑the‑counter products and herbal supplements.

Practical Use: Dosing, Missed Dose, Overdose

Standard adult dosing (general information only):

• Loading dose: 5 mg kg⁻¹ divided every 6 hours for 24 hours (used only in acute exacerbations).
• Maintenance dose: 200–400 mg total per day, usually administered as 100 mg twice daily or 200 mg once daily, adjusted to maintain a therapeutic plasma concentration of 10–20 µg mL⁻¹.

Missed dose:

• If a dose is forgotten and the next scheduled dose is more than 6 hours away, take the missed dose as soon as remembered.
• If less than 6 hours remain before the next dose, skip the missed tablet and continue the regular schedule; contact a pharmacist or doctor for clarification.

Overdose:

• Early signs include nausea, vomiting, agitation, arrhythmias, and seizures.
• Immediate medical attention is required; if available, administer activated charcoal and monitor cardiac rhythm and plasma concentration.
• In severe cases, intravenous sodium bicarbonate or beta‑adrenergic antagonists may be employed under specialist supervision.

Practical precautions

• Take tablets at the same time(s) each day to maintain steady plasma levels.
• Avoid grapefruit juice and large quantities of caffeine, both of which can increase Theophylline concentrations.
• Alcohol may potentiate central nervous system toxicity; limit intake.
• Renal or hepatic impairment, advanced age, and pregnancy all warrant dose adjustment and close monitoring.

Buying Theophylline from Our Online Pharmacy

Theophylline can be purchased safely from our online pharmacy in the UK. Our service offers:

• Affordable pricing – generic tablets are priced close to the manufacturer’s international cost, providing a cost‑effective alternative to brand‑name products.
• Verified quality – all supplies are sourced from licensed overseas manufacturers who comply with European Medicines Agency (EMA) and UK Medicines and Healthcare products Regulatory Agency (MHRA) standards.
• Guaranteed delivery – discreet, tracked shipping with express options (typically 7 working days) or regular airmail (approximately 3 weeks).
• Pharmacy‑broker model – we work with overseas licensed pharmacies, enabling a private, confidential supply chain that respects patient anonymity while meeting UK import regulations.

Our online pharmacy is a suitable option for patients who have limited access to local pharmacy stock, encounter insurance restrictions, or seek a reliable generic formulation of Theophylline.

FAQ

• Is Theophylline available in both brand‑name and generic forms in the UK?
  Yes, Theophylline is marketed under several historic brand names such as Theo‑Dur and Theochrol, while generic tablets contain the identical active molecule and are usually cheaper.

• What storage conditions are recommended for Theophylline tablets?
  Store at a temperature between 15 °C and 30 °C, in a dry place protected from direct sunlight and humidity. Keep the container tightly closed to avoid moisture ingress.

• Can Theophylline be safely imported for personal use in the UK?
  Personal import of a licensed medication is permitted provided the product is for your own use, the quantity is within the 90‑day supply limit, and you retain a copy of the prescription from a UK‑registered prescriber.

• Does smoking affect Theophylline levels?
  Yes. Tobacco smoke induces CYP1A2, which can increase the metabolism of Theophylline, lowering plasma concentrations and potentially reducing therapeutic effect.

• Are there specific warnings for Asian patients taking Theophylline?
  Some studies suggest higher susceptibility to Theophylline toxicity in East Asian populations due to genetic variations in CYP1A2; dose titration and close monitoring of plasma levels are advisable.

• How does Theophylline differ from inhaled β₂‑agonists?
  Theophylline works systemically by increasing cAMP through PDE inhibition, whereas inhaled β₂‑agonists directly stimulate β₂‑receptors in the airway. Theophylline therefore provides a broader anti‑inflammatory effect but carries a higher risk of systemic side effects.

• What tablet strengths of Theophylline are commonly supplied?
  In the UK, generic tablets are typically marketed in 100 mg, 200 mg, and 300 mg strengths, allowing flexible dosing regimens.

• Is there a pediatric formulation of Theophylline available?
  For children, a liquid syrup formulation (1 mg mL⁻¹) is used in some countries, but it is not routinely licensed for routine asthma management in the UK; pediatric use is limited to specialist settings.

• What are the implications of Theophylline on drug testing for employment?
  Therapeutic levels of Theophylline do not constitute a prohibited substance in standard employment drug screens; however, unusually high concentrations may be flagged as a stimulant.

• Can Theophylline be taken together with herbal supplements?
  Certain herbal products, particularly those containing St. John’s wort (hyperforin), inhibit CYP1A2 and may raise Theophylline concentrations, increasing toxicity risk.

Glossary

Phosphodiesterase (PDE)

An enzyme that breaks down cyclic adenosine monophosphate (cAMP); inhibition by Theophylline raises cAMP levels, leading to bronchodilation.

Therapeutic window

The plasma concentration range within which a drug is effective without causing unacceptable side effects; for Theophylline this is 10–20 µg mL⁻¹.

CYP1A2

A liver enzyme responsible for metabolising Theophylline; its activity can be increased by smoking or certain medications, affecting drug levels.

Bronchoconstriction

The narrowing of the airways due to smooth‑muscle contraction, a hallmark of asthma and COPD; Theophylline helps to relax this muscle tone.

Disclaimer

The information provided about Theophylline is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Theophylline for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.