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September 1978

Guide to Oral Theophylline Therapy for the Treatment of Chronic Asthma

Author Affiliations

From the Pediatric Allergy and Pulmonary Division (Drs Weinberger and Wyatt), College of Medicine, and the College of Pharmacy (Dr Hendeles), the University of Iowa, and the Pediatric Allergy Service (Dr Hendeles), the University of Iowa Hospitals and Clinics, Iowa City. Presented in part at the Symposium on Asthma Therapy, the University of Iowa, Iowa City, Sept 9, 1977.

Am J Dis Child. 1978;132(9):876-880. doi:10.1001/archpedi.1978.02120340052010

• Theophylline, when used appropriately, seems to be the most effective noncorticosteroid prophylactic medication for chronic asthma. Dosage, however, requires consideration of the relationship between serum concentration, efficacy, and toxicity, in addition to the variability in rates of elimination. Therapy is initiated with 16 mg/kg/day or 400 mg/day (whichever is less) in divided doses at appropriate intervals depending on the rate of absorption of the product used. If side effects are absent, the dosage is increased at three-day intervals until the age-related mean dosage necessary to produce a therapeutic level, is reached. Final dosage adjustment is generally based on a single determination of serum concentration; dosage requirements generally then remain constant for six to 12 months depending upon the child's growth rate. Dosage adjustment in this manner optimizes benefit, minimizes risk of toxic effect, and avoids excessive numbers of serum theophylline measurements.

(Am J Dis Child 132:876-880, 1978)

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