Covers methylxanthines for COPD. Looks at medicines that help relax airways, improve breathing, and help get mucus out of the lungs. Lists generic and brand names such as theophylline (Theo-24). Includes how well they work and side effects.
Methylxanthines for Chronic Obstructive Pulmonary Disease (COPD)
These medicines are available in pill, liquid, injection,
or suppository form. One medicine may be available in multiple forms. Your
doctor will help you decide which type is best for you.
How It Works
The actions of methylxanthines are not
Still have major difficulty breathing despite
using both an inhaled beta2-agonist and an inhaled
Have persistent nighttime
Have frequent, rapid, and sometimes sudden
increase in shortness of breath (COPD exacerbation).
How Well It Works
A few studies have noted that,
compared to a
placebo, theophylline provides a small improvement in
lung function as measured by tests (spirometry) in
people who have stable COPD.1
In a COPD
exacerbation, methylxanthines, compared to a placebo, provide a small
improvement in lung function as measured by spirometry.2
In general, research shows that the small
improvement in lung function does not justify the severe side effects for most
people who have COPD. In most cases, newer and safer medicines
have replaced methylxanthines for treatment of people who have COPD.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Usually the benefits of the medicine are more important than any minor side effects.
Side effects may go away after you take the medicine for a while.
If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call your doctor right away if you have:
Irregular heartbeat (arrhythmia).
Common side effects of methylxanthines include:
upset and heartburn. The heartburn may make breathing
more difficult, especially for people with
Rapid heart rate (tachycardia).
People taking the medicine may be able to reduce these side
effects by avoiding caffeine.
The difference between a dose of theophylline that helps
improve symptoms and a dangerous dose (one that causes serious side effects) is
small. Theophylline also has significant interactions with other prescribed
medicines, which can make it less effective and potentially life-threatening.
See Drug Reference for a
full list of side effects. (Drug Reference is not available in all
What To Think About
Other medicines may be a better
choice than methylxanthines for treating COPD, because the dose needed to
improve symptoms is so close to a dose that causes serious side effects.
Theophylline interacts with many different types of medicines,
such as antibiotics, antacids, birth control pills, and those used for
seizures. Ask your doctor or pharmacist if a new
medicine will affect how much theophylline you take.
brands of theophylline get into the bloodstream at different rates. So always use the same generic or brand-name medicine.
Medicines and illnesses can affect how quickly theophylline is cleared from the
body. So the amount of theophylline in the blood must be measured regularly to be
sure it stays at a safe level.
Smoking increases how quickly
theophylline is cleared from the body. So a person with COPD who continues to
smoke may need larger doses of the medicine.
theophylline should avoid caffeine-containing beverages. These may make
theophylline's side effects worse, especially jittery nerves and
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
McIvor RA, et al. (2011). COPD, search date April 2010. Online version of BMJ Clinical Evidence: http://www.clinical
Barr RG, et al. (2003). Methylxanthines for
exacerbations of chronic obstructive pulmonary disease: Meta-analysis of
randomised trials. BMJ, 327: 643–648.
How this information was developed to help you make better health decisions.