Theophylline Dosage

This dosage information may not include all the information needed to use Theophylline safely and effectively. See additional information for Theophylline.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Geriatric Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Asthma - Acute

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Maintenance dose:

Otherwise Healthy Nonsmoking Adult: 10 mg/kg/day. Do not exceed 900 mg/day.

Otherwise Healthy Adult Smoker: 16 mg/kg/day.

Patient with congestive heart failure or cor pulmonale: 5 mg/kg/day. Do not exceed 400 mg/day.

Usual Adult Dose for Asthma - Maintenance

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Maintenance dose:

Otherwise Healthy Nonsmoking Adult: 10 mg/kg/day. Do not exceed 900 mg/day.

Otherwise Healthy Adult Smoker: 16 mg/kg/day.

Patient with congestive heart failure or cor pulmonale: 5 mg/kg/day. Do not exceed 400 mg/day.

Usual Geriatric Dose for Asthma - Acute

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Otherwise healthy, nonsmokers: 10 mg/kg/day. Do not exceed 900 mg/day

Patient with congestive heart failure, cor pulmonale, and/or liver dysfunction: 5 mg/kg/day. Do not exceed 400 mg/day

Usual Geriatric Dose for Asthma - Maintenance

Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).

Otherwise healthy, nonsmokers: 10 mg/kg/day. Do not exceed 900 mg/day

Patient with congestive heart failure, cor pulmonale, and/or liver dysfunction: 5 mg/kg/day. Do not exceed 400 mg/day

Usual Pediatric Dose for Asthma - Acute

Loading dose:
If no theophylline has been administered in the previous 24 hours: 5 mg/kg loading dose to achieve a serum concentration of about 10 mcg/mL; loading doses should be given using a rapidly absorbed oral product not a sustained release product).

If theophylline has been administered in the previous 24 hours: 2.5 mg/kg theophylline may be given in emergencies when serum concentrations are not available. A modified loading dose (mg/kg) may be calculated (when the serum level is known) by: [Blood concentration desired - blood concentration measured] divided by 2 (for every 1 mg/kg theophylline given, the blood level will rise by approximately 2 mcg/mL).

Maintenance dose:

less than 42 days: 4 mg/kg/day orally.

42 days to 181 days: 10 mg/kg/day orally. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

6 months less than 12 months: 12 to 18 mg/kg/day. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

1 year to 8 years: 20 to 24 mg/kg/day.

9 years to 11 years: 16 mg/kg/day.

12 years to 15 years: 13 mg/kg/day.

16 years or older: 10 mg/kg/day. Do not exceed 900 mg/day.

Usual Pediatric Dose for Asthma - Maintenance

Loading dose:
If no theophylline has been administered in the previous 24 hours: 5 mg/kg loading dose to achieve a serum concentration of about 10 mcg/mL; loading doses should be given using a rapidly absorbed oral product not a sustained release product).

If theophylline has been administered in the previous 24 hours: 2.5 mg/kg theophylline may be given in emergencies when serum concentrations are not available. A modified loading dose (mg/kg) may be calculated (when the serum level is known) by: [Blood concentration desired - blood concentration measured] divided by 2 (for every 1 mg/kg theophylline given, the blood level will rise by approximately 2 mcg/mL).

Maintenance dose:

less than 42 days: 4 mg/kg/day orally.

42 days to 181 days: 10 mg/kg/day orally. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

6 months less than 12 months: 12 to 18 mg/kg/day. Alternate dosing: [(0.2 x age in weeks) + 5] x kg = 24 hour oral dose in milligrams.

1 year to 8 years: 20 to 24 mg/kg/day.

9 years to 11 years: 16 mg/kg/day.

12 years to 15 years: 13 mg/kg/day.

16 years or older: 10 mg/kg/day. Do not exceed 900 mg/day.

Usual Pediatric Dose for Apnea of Prematurity

Manufacturer recommendations:
Loading dose: 4.6 mg/kg/dose
Maintenance:
Premature neonates: Post natal age less than 24 days: 1 mg/kg/dose every 12 hours
Premature neonates: Post natal age 24 or more days: 1.5 mg/kg/dose every 12 hours
Full term infants: Total daily dose (mg) = [(0.2 x age in weeks) +5] x (weight in kg); divide dose into 3 equal amounts and administer at 8 hour intervals

Alternative dosing:
Loading dose: 5 to 6 mg/kg/dose
Maintenance: 2 to 6 mg/kg/day divided every 8 to 12 hours

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Liver dysfunction:
Loading dose: 5 mg/kg loading dose (patient not receiving theophylline or aminophylline).
Maintenance dose: 5 mg/kg/day. Do not exceed 400 mg/day.

Dose Adjustments

In patients receiving theophylline each 0.5 mg/kg theophylline administered as a loading dose will increase serum theophylline level by 1 mcg/mL. If serum level is too low, (5 to 10 mcg/mL), increase dose by 25% at 3 day intervals. If serum level is too high (20 to 25 mcg/mL), decrease dose by 10% and recheck level in 3 days. If serum level is too high (25 to 30 mcg/mL), skip next dose and decrease by 25%. Recheck level in 3 days. If serum level is too high (greater than 30 mcg/mL), skip next 2 doses and decrease by 50%. Recheck level in 3 days.
Time release capsules may be administered in 1 to 3 doses/day.

Precautions

Higher incidence of toxicity in cirrhosis patients. Cautious dosage adjustments are advised with serum level monitoring.

Dialysis

Theophylline is somewhat removed with hemodialysis. A 50% supplemental dose or administering the dose post dialysis is recommended. A supplemental dose is not needed with peritoneal dialysis.

Other Comments

Calculate doses based on lean body weight. Base dose adjustments on improved clinical response and improvement in pulmonary function with careful monitoring of serum levels. Therapeutic serum level range 10 to 20 mcg/mL.

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