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{{Short description|Drug used to treat respiratory diseases}}

factoids

| MedlinePlus = a681006| pregnancy_AU = Adate=April 2015}}| pregnancy_US = C| pregnancy_category = | legal_AU = S4| legal_CA = Rx-only| legal_UK = P| legal_US = Rx-only| legal_status = Oral administration>oral, Intravenous therapy, Rectal administration>rectalOral administration>oral)| protein_bound = 40% (primarily to albumin)Liver>Hepatic: CYP1A2, CYP2E1, CYP3A4| metabolites = • 1,3-Dimethyluric acid • 1-Methyixanthine • 3-Methylxanthine| elimination_half-life = 5–8 hourscorrect|??}}| CAS_number = 58-55-9| ATC_prefix = R03| ATC_suffix = DA04| ATC_supplemental = R03DB04correct|EBI}}| ChEBI = 28177| PubChem = 2153| IUPHAR_ligand = 413correct|drugbank}}| DrugBank = DB00277correct|chemspider}}| ChemSpiderID = 2068correct|FDA}}| UNII = 0I55128JYKcorrect|kegg}}| KEGG = D00371correct|EBI}}| ChEMBL = 190| C = 7| H = 8| N = 4| O = 2| smiles = Cn1c2c(c(=O)n(c1=O)C)[nH]cn2correct|chemspider}}| StdInChI = 1S/C7H8N4O2/c1-10-5-4(8-3-9-5)6(12)11(2)7(10)13/h3H,1-2H3,(H,8,9)correct|chemspider}}| StdInChIKey = ZFXYFBGIUFBOJW-UHFFFAOYSA-N| drug_name = | alt = | caption = | type = | licence_EU = | licence_US = }}(File:Cylmin 100mg by Tsuruhara.jpg|thumb|right|upright|Theophylline extended-release tablets in Japan)Theophylline, also known as 1,3-dimethylxanthine, is a drug that inhibits phosphodiesterase and blocks adenosine receptors.WEB, Theophylline,pubchem.ncbi.nlm.nih.gov/compound/2153, PubChem, US National Library of Medicine, 2 September 2023, 26 August 2023, It is used to treat chronic obstructive pulmonary disease (COPD) and asthma.JOURNAL, Barnes PJ, Theophylline, American Journal of Respiratory and Critical Care Medicine, 188, 8, 901–906, October 2013, 23672674, 10.1164/rccm.201302-0388PP,www.atsjournals.org/doi/10.1164/rccm.201302-0388PP, Its pharmacology is similar to other methylxanthine drugs (e.g., theobromine and caffeine). Trace amounts of theophylline are naturally present in tea, coffee, chocolate, yerba maté, guarana, and kola nut.JOURNAL, ((IARC Working Group on the Evaluation of Carcinogenic Risks to Humans)), Coffee, Tea, Mate, Methylxanthines and Methylglyoxal., IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, 51, 391–419, 1991, 2033791, 7681294,www.ncbi.nlm.nih.gov/books/NBK507021/#:~:text=Theophylline%20is%20found%20in%20black,used%20principally%20in%20pharmaceutical%20preparations., International Agency for Research on Cancer, The name ‘theophylline’ derives from “Thea“—the former genus name for tea + Legacy Greek φύλλον (phúllon, “leaf“) + -ine.

Medical uses

The main actions of theophylline involve:

• relaxing bronchial smooth muscle
• increasing heart muscle contractility and efficiency (positive inotrope)
• increasing heart rate (positive chronotropic)
• increasing blood pressure
• increasing renal blood flow
• anti-inflammatory effects
• central nervous system stimulatory effect, mainly on the medullary respiratory centerJOURNAL, Eldridge FL, Millhorn DE, Kiley JP, Antagonism by theophylline of respiratory inhibition induced by adenosine, Journal of Applied Physiology, 59, 5, 1428–1433, November 1985, 4066573, 10.1152/jappl.1985.59.5.1428,

The main therapeutic uses of theophylline are for treating:

• Chronic obstructive pulmonary disease (COPD)JOURNAL, Mahemuti G, Zhang H, Li J, Tieliwaerdi N, Ren L, Efficacy and side effects of intravenous theophylline in acute asthma: a systematic review and meta-analysis, Drug Design, Development and Therapy, 12, 99–120, 10 January 2018, 29391776, 5768195, 10.2147/DDDT.S156509, free,
• Asthma
• infant apneaJOURNAL, Miao Y, Zhou Y, Zhao S, Liu W, Wang A, Zhang Y, Li Y, Jiang H, 3, Comparative efficacy and safety of caffeine citrate and aminophylline in treating apnea of prematurity: A systematic review and meta-analysis, PLOS ONE, 17, 9, e0274882, 19 September 2022, 36121807, 9484669, 10.1371/journal.pone.0274882, free, 2022PLoSO..1774882M,
• Blocks the action of adenosine; an inhibitory neurotransmitter that induces sleep, contracts the smooth muscles and relaxes the cardiac muscle.
• Treatment of post-dural puncture headache.JOURNAL, Hung KC, Ho CN, Chen IW, Hung IY, Lin MC, Lin CM, Wang LK, Chen JY, Sun CK, 6, The impact of aminophylline on incidence and severity of post-dural puncture headache: A meta-analysis of randomised controlled trials, Anaesthesia, Critical Care & Pain Medicine, 40, 4, 100920, August 2021, 34186265, 10.1016/j.accpm.2021.100920, 235686558, JOURNAL, Barati-Boldaji R, Shojaei-Zarghani S, Mehrabi M, Amini A, Safarpour AR, Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis, Anesthesia and Pain Medicine, 18, 2, 177–189, April 2023, 37183286, 10.17085/apm.22247, 10183611,

Performance enhancement in sports

Theophylline and other methylxanthines are often used for their performance-enhancing effects in sports, as these drugs increase alertness, bronchodilation, and increase the rate and force of heart contraction.JOURNAL, Watson CJ, Stone GL, Overbeek DL, Chiba T, Burns MM, Performance-enhancing drugs and the Olympics, Journal of Internal Medicine, 291, 2, 181–196, February 2022, 35007384, 10.1111/joim.13431, 245855348, There is conflicting information about the value of theophylline and other methylxanthines as prophylaxis against exercise-induced asthma.JOURNAL, Pigakis KM, Stavrou VT, Pantazopoulos I, Daniil Z, Kontopodi AK, Gourgoulianis K, Exercise-Induced Bronchospasm in Elite Athletes, Cureus, 14, 1, e20898, January 2022, 35145802, 10.7759/cureus.20898, free, 8807463,

Adverse effects

The use of theophylline is complicated by its interaction with various drugs and by the fact that it has a narrow therapeutic window (