What is the current role of theophylline in asthma?
Theophylline is a very weak bronchodilator. New evidence points to some anti-inflammatory effects of theophylline. Theophylline is mainly considered in its sustained-release formulations for once or twice daily administration in asthma. Being an oral drug, compliance with therapy may be better than with inhaled therapy; however the side-effects are significant, especially when used in high doses. In acute severe asthma, the role of intravenous aminophylline is only secondary now to nebulised b2-agonists. In a patient who fails to respond to both nebulised b2-agonist and ipratropium bromide, an aminophylline infusion may be commenced. Sustained-release oral theophylline has important beneficial effects on diaphragmatic contractility. These effects may be extremely useful in patients with COPD.
