Theophylline

About Theophylline

Theophylline relaxes the muscle around the airways and dampens their response to triggers. It is a long-term controller for chronic asthma and other chronic lung diseases, not a rescue treatment, and the label says the dose should not be raised for a sudden flare.

The label aims for peak blood levels of 10 to 15 mcg/mL. Above 20 mcg/mL toxicity becomes more likely, and very high levels can cause seizures, dangerous heart rhythms and death. Nausea, vomiting, a persistent headache, trouble sleeping or a fast heartbeat should be reported promptly. Levels are checked when treatment starts, before dose increases, and when an illness or a medicine change could alter them.

Levels also rise when the body clears it more slowly: in people over 60, in heart failure, liver disease and an underactive thyroid, with a fever of 102°F or higher for 24 hours or more, and after quitting tobacco or marijuana. The only contraindication is allergy to it, but it is used with caution in active stomach ulcers, seizure disorders and heart rhythm problems. There is no boxed warning.

Twelve-hour tablets, once-daily tablets and Theo-24 capsules release the drug differently and are not swapped without the prescriber; MedlinePlus advises against changing brands without talking to your doctor.

Taking Theophylline

How to take it

At the same times every day, taken the same way each time with regard to food; at higher doses Theo-24 is not taken less than an hour before a high-fat meal. Swallow extended-release tablets whole, without chewing or crushing. Do not take extra for sudden breathing symptoms.

If you miss a dose

Take it as soon as you remember, unless it is nearly time for your next dose; in that case skip the missed dose and carry on as usual. Never take two doses at once to make up.

Storage

At room temperature in the original container, tightly closed, away from excess heat and moisture, and out of reach of children.

Interactions to know about

Ciprofloxacin, clarithromycin, erythromycin, fluvoxamine, cimetidine, propranolol, verapamil and estrogen-containing birth control raise its levels; carbamazepine, phenytoin, phenobarbital, rifampin and St. John’s wort lower them. It can lower lithium levels, and caffeine adds to its side effects. Tell your prescriber about any new illness, medicine change, or starting or stopping smoking.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Theophylline differs from pharmacy to pharmacy

The 300 and 450 mg twelve-hour tablets have many generic makers and are priced like commodity generics. The once-daily tablets have fewer makers and vary more between pharmacies, the solution has only a few, and Theo-24 has no rated generic, so it is priced as a brand.

Because the products are not swapped at the counter, the prescription decides what the pharmacy quotes. Blood level tests are a separate cost.

Ways to pay less for Theophylline without insurance

• Ask whether twelve-hour theophylline tablets are on the pharmacy’s flat-price generic list, and for a ninety-day supply once your level is stable.
• If Theo-24 is costly, ask the prescriber whether a generic extended-release tablet would suit you; that switch is the prescriber’s decision.
• Ask the pharmacy to keep supplying the same product.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Theophylline

1. 1.Is this a twelve-hour tablet, a once-daily tablet or a capsule?
2. 2.Should I take it with food or on an empty stomach?
3. 3.Do any of my medicines, including antibiotics, change my level?
4. 4.When is my next blood level due?
5. 5.What should I do if I get a fever, or start or stop smoking?

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