a pill bottle on a 90's themed carpet

Old Med That is New to Me

My asthma is in the severe persistent category. I’ve been in this category for almost a decade. I was first diagnosed with asthma when I was eight and it was mild at that time. I only had a rescue inhaler and it wasn’t until I was a teenager that a daily maintenance steroid inhaler was added to my regimen. When I was in my mid-twenties my asthma crossed into the severe category, and by the time I was thirty it was officially classified as "severe persistent."

Finding the right medication combo

I think many asthmatics can relate to the struggle that comes along with finding the right medication(s) that adequately keep our asthma symptoms at bay. We might find one particular inhaler that works well for a while. Then, over time as our asthma changes, it might not work as well anymore and it is back to the drawing board to find a different solution. It becomes a vicious cycle.

Recommendation from my pulmonologist

This past year has been tough for my lungs. The swings in the weather in the Midwest mixed with allergies and triggers around every corner has made for a difficult time breathing more often than I would like.

I am a respiratory therapist and have been one for the past 17 years. I read medical publications often and keep up on the latest treatment options in the asthma world. A few months ago my pulmonologist and I were talking during my regularly scheduled visit and he asked me if I had ever considered trying theophylline. I’ll admit I was pretty surprised he suggested it, as theophylline isn’t a medication that is commonly prescribed anymore; it really hasn’t been widely used since the 1990s. He told me that he only has a handful of people in his entire practice who take it and he felt that we should give it a try because it was one of the only things we hadn’t tried before.

What is theophylline?

Theophylline is a medication that came from methylxanthine which causes smooth muscle relaxation along with bronchodilation. It is naturally present in dry small amounts in cocoa beans and some teas. It is also a diuretic and central nervous system stimulant.1

Theophylline was first synthesized in 1895 and used as a diuretic. In the 1920s, it began being used to treat asthma due to its bronchodilator properties.1 The use of theophylline in the United States has declined as inhaled medications that had less significant side effects became more advanced and available. However, it is still widely used worldwide due to the low cost. In the states and other industrialized countries, theophylline is used as more of a third-line treatment or add-on option for asthma that is difficult to control.2

Side effects of theophylline

The most common side effects of theophylline are nausea, vomiting and headache. Irritability, lightheadedness, dizziness, cardiac arrhythmias and seizures can also occur. It is imperative to have routine blood draws to make sure your theophylline levels are within the therapeutic range and not at toxic levels. There are also some contraindications to taking theophylline, including hypersensitivity to xanthine derivatives.1

Be sure to talk with your doctor if you are curious about if theophylline could help your asthma. Prior to starting theophylline, my pulmonologist talked with my cardiologist (because I have an arrhythmia) to make sure it would be okay.1

I have been taking a low dose of theophylline for two months now and it has made a world of difference in my asthma. I am breathing better than I have in a long time! It took some getting used to as my body adjusted and I have to pay close attention to any potential toxicity symptoms, but I have my blood drawn periodically to check theophylline levels.

I am really glad I decided to give theophylline a try!

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