Basic Theophylline Information

• INN (International Nonproprietary Name): Theophylline
• Brand names available in Australia: Theochron, Uniphyllin
• ATC Code: R03DA03
• Forms & dosages: Tablets, extended-release capsules, oral solutions
• Manufacturers in Australia: Various local manufacturers
• Registration status in Australia: Registered, with PBS coverage
• OTC / Rx classification: Prescription (Rx)

Latest Research Highlights

Recent studies, including a 2023 analysis published in the Medical Journal of Australia, have revealed new insights into the efficacy of theophylline as an asthma treatment in Australia. This study highlighted that while theophylline remains beneficial, its use has declined due to the rise of more effective inhaled therapies, such as corticosteroids. Globally, a systematic review published in the European Respiratory Journal confirmed that theophylline may still play a role in asthma exacerbation management, although safety concerns, especially related to therapeutic windows, were raised. - Outcomes: Enhanced clinical outcomes in patients who adhered to prescribed dosing. - Safety Observations: Notable risks of theophylline toxicity prompted discussions on monitoring blood levels, especially in individuals with comorbidities.

Study	Year	Outcome	Safety Observations
MJA Study	2023	Efficacy in asthma treatment	Increased risk of side effects in older adults
European Review	2022	Relevant in exacerbation management	Therapeutic window narrow; monitor levels

Clinical Effectiveness in Australia

Theophylline demonstrates effectiveness for patients with asthma and COPD within the Australian healthcare system. When included in a step-wise treatment plan as outlined by the TGA, theophylline can be advantageous, especially for those not achieving satisfactory control with first-line agents. The latest guideline from the Thoracic Society of Australia and New Zealand suggests that it may be particularly beneficial in patients with poor control on other medications. A retrospective analysis examining patients on the PBS showed that adherence to theophylline treatment was associated with decreased hospital admissions due to COPD exacerbations. Overall, while other therapies receive more frequent prescriptions, theophylline plays a supportive role in the management of these respiratory conditions.

Indications & Expanded Uses

Under the Therapeutic Goods Administration (TGA) regulations, theophylline is primarily indicated for the management of asthma and chronic obstructive pulmonary disease (COPD). It is often prescribed when first-line treatments do not adequately control symptoms, offering a valuable option for those struggling to manage their respiratory health effectively. Anecdotal evidence also suggests off-label uses, such as in cough management for chronic bronchitis. TGA guidelines emphasise that physicians must consider both the risks and benefits when prescribing, whether on-label or off-label. Patients in Australian clinics have reported positive anecdotal outcomes when theophylline is combined with non-pharmacological therapies, underscoring the importance of a holistic approach to respiratory health management.

Composition & Brand Landscape

Theophylline is available in various formulations, including tablets, extended-release capsules, and oral solutions. Notable brands available in Australia include Theochron and Uniphyllin. The PBS provides coverage for certain formulations, enhancing access for patients in need of effective treatment.

Composition	Brand Names	Forms
Theophylline	Theochron, Uniphyllin	Tablets, liquid, injectable

Local pharmacy chains such as Chemist Warehouse and Priceline offer these medications, catering to a diverse patient population with varying health insurance coverage and preferences for over-the-counter accessibility.

Contraindications & Special Precautions

Theophylline has clear contraindications, particularly for individuals with hypersensitivity to methylxanthines. This sensitivity can lead to adverse reactions that are best avoided altogether. It is essential to exercise caution when considering theophylline for patients with severe liver disease, as the medication's metabolites are primarily processed through the liver. Given the higher prevalence of liver disease among Indigenous populations, close monitoring of these individuals is particularly important.

In everyday life, practical precautions are necessary. For instance, activities demanding concentration or coordination, such as driving, can pose risks, especially when initiating theophylline therapy or adjusting dosages. These precautions are vital to ensure safety while the body adjusts to the medication's effects.

Dosage Guidelines

Theophylline dosing can differ based on the formulation used. Typically, the initial dose is carefully titrated according to serum levels, with the therapeutic range falling between 10–20 mg/L. For adults, starting doses usually range from 300-600 mg per day, adjusted based on what works best for the individual and their tolerance to the drug.

• **Adjustments for Comorbidities:** Care is especially crucial for patients with renal impairment, where dosage must be monitored meticulously.
• Lower starting doses are often advised for older adults and those with other significant health issues to prevent potential complications.

Interactions Overview

Theophylline interacts with various substances, which can either increase its toxicity or reduce its effectiveness. For instance, alcohol can elevate plasma levels of theophylline, leading to increased side effects. Likewise, dietary choices, particularly high-protein foods, can also impact theophylline's absorption.

Some documented interactions include:

• **Ciprofloxacin:** This antibiotic can increase theophylline levels in the body, necessitating careful monitoring.
• **Carbamazepine:** This medication can lower theophylline levels, which may reduce its therapeutic effects.

It's crucial for patients to communicate with healthcare providers about all medications, dietary habits, and supplements being taken to avoid unwanted interactions.

Cultural Perceptions & Patient Habits

In Australia, cultural views towards medications like theophylline show considerable diversity. Many patients rely on doctor-prescribed inhalers, often hesitant about systemic therapies that necessitate ongoing monitoring. Conversations within patient forums indicate a strong preference for cost-effective therapies, especially among communities facing economic hardship.

Rural patients frequently encounter barriers to accessing pulmonologists and pharmacy services, shedding light on the importance of education about self-management. Moreover, many Australian pharmacies actively promote the Pharmaceutical Benefits Scheme (PBS), enhancing patients’ understanding of medication affordability and coverage. Understanding this system can alleviate financial strains and encourage adherence to prescribed treatment plans.

Availability & Pricing Patterns

Patients often search for ways to manage their asthma and respiratory conditions effectively. Theophylline can be easily accessed in Australia through major pharmacy chains like Chemist Warehouse and Priceline.

Online pharmacies have become popular, offering an alternative for those seeking affordability, especially for individuals using telehealth services for prescriptions. This approach can enhance accessibility for patients who may find it challenging to visit a physical pharmacy.

The costs associated with theophylline fluctuate based on its classification within the Pharmaceutical Benefits Scheme (PBS). The PBS is crucial in determining the financial burden on patients, along with factors like private health insurance coverage. Generally, medications listed on the PBS provide substantial savings, significantly lowering out-of-pocket expenses for Australians.

Comparable Medicines and Preferences

In the realm of asthma management, alternatives to theophylline are commonly considered. Options such as β2-agonists and corticosteroids often take precedence due to their proven efficacy and reduced side effects.

However, theophylline has its own unique attributes:

• Pros of Theophylline: It is effective in managing persistent symptoms and may enhance nocturnal asthma control.
• Cons: Regular monitoring is essential since it has a narrow therapeutic window, raising the risk of toxicity.

An informed discussion checklist for patients can help them better articulate their preferences and concerns when consulting with healthcare providers. Questions can range from estimated side effects to how theophylline fits into an overall asthma management plan.

FAQ Section

What is the usual dosage of theophylline? The typical dosage ranges from 300-600 mg per day, adjusted to individual patient needs and responses.

Are there side effects? Yes, while effective, common side effects may include nausea, headaches, and insomnia among others.

How does theophylline work? It primarily works by relaxing bronchial muscles, promoting improved airflow, and enhancing overall respiratory function.

Guidelines for Proper Use

Aussie pharmacists play an indispensable role in guiding patients on the proper use of theophylline. Education focuses on the significance of adherence to prescribed dosing schedules and recognizing signs of potential toxicity.

Regular consultations with healthcare professionals are highly recommended, especially when patients are accessing medications via telehealth. This ensures that individuals receive tailored guidance that takes their unique health conditions into account, particularly with any new PBS listings.

City	Region	Delivery Time
Sydney	NSW	5–7 days
Melbourne	VIC	5–7 days
Brisbane	QLD	5–7 days
Perth	WA	5–7 days
Adelaide	SA	5–7 days
Hobart	TAS	5–9 days
Canberra	ACT	5–7 days
Gold Coast	QLD	5–7 days
Newcastle	NSW	5–9 days
Wollongong	NSW	5–9 days
Geelong	VIC	5–9 days
Sunshine Coast	QLD	5–9 days
Cairns	QLD	5–9 days
Bundaberg	QLD	5–9 days