Theo-24 CR is an oral medication used to treat asthma and chronic bronchitis. It works by relaxing muscles in the lungs and decreasing bronchospasm. The active ingredient of the drug is theophylline 400 mg.
How does it work?
This drug belongs to the group of anti-asthma pharmaceuticals that are used to treat obstructive respiratory diseases.
Theophylline is similar in structure and pharmacological properties to theobromine and caffeine.
The drug is able to bind adenosine receptors, block phosphodiesterase, reduce the concentration of calcium in cells. It has a pronounced antispasmodic, vasodilating, bronchodilating, anti-asthma, cardiotonic effect. It causes muscle relaxation in the bronchi, a decrease in the level of mediators of hypersensitivity in the blood, an increase in the tone of the muscles of the respiratory system, especially in the diaphragm and between the ribs.
The drug expands pulmonary blood vessels expand, reduces the risk of blood clots, and normalizes microcirculation in blood vessels.
Indications for use
- Bronchial obstructive syndrome of various origins: bronchial asthma, COPD (chronic obstructive bronchitis, pulmonary emphysema);
- Pulmonary hypertension, pulmonary heart, edematous syndrome of renal origin (as part of combination therapy), night apnea.
Dosage and instructions for use
Doses of Theo-24 CR are determined individually. Since theophylline is not distributed in adipose tissue, the dose is calculated based on ideal body weight. The dose of the drug depends on the clinical course of the disease, the patient’s body weight, age, and metabolic characteristics. Usually, the pills are taken 2 times a day. Doses of the drug are selected individually.
Treatment begins with lower doses, which are gradually increased until the desired therapeutic effect is obtained. After 3-4 days, with insufficient effectiveness, the dose is increased, with poor tolerance – reduced.
- Adults: 200-300 mg 2 times a day.
- Children over 6 years: 100-200 mg 2 times a day.
Capsules should be taken without chewing, with a sufficient amount of liquid.
The total dose for adults should not exceed 900 mg/day.
Theo-24 CR can cause the following adverse reactions:
- CNS: dizziness, headache, insomnia, agitation, anxiety, irritability, tremor;
- cardiovascular system: palpitations, tachycardia (including the fetus when taken in the third trimester), arrhythmias, decreased blood pressure, cardialgia, increased frequency of angina attacks;
- digestive system: gastralgia, nausea, vomiting, gastroesophageal reflux, heartburn, exacerbation of peptic ulcer, diarrhea, with prolonged use – decreased appetite;
- allergic reactions: skin rash, itching, fever;
- other: chest pain, tachypnea, flushing, albuminuria, hematuria, hypoglycemia, increased urine output, increased sweating. Side effects decrease with a lower dose.
Theo-24 CR is contraindicated for use in the presence of the following conditions/diseases:
- gastric and duodenal ulcer in the acute phase;
- gastritis with increased acidity;
- recent gastrointestinal bleeding;
- severe arterial hyper- or hypotension;
- severe tachyarrhythmias;
- hemorrhagic stroke;
- retinal hemorrhage;
- children’s age (up to 3 years, for prolonged oral forms – up to 12 years);
- hypersensitivity to theophylline and other xanthine derivatives (caffeine, pentoxifylline, theobromine).
- It’s recommended to reduce a dose of theophylline if you are currently taking cimetidine, allopurinol, corticosteroids, furosemide, isoprenaline, oral contraceptives, thiabendazole, ciprofloxacin, erythromycin, and other macrolide antibiotics, the calcium channel blocker (diltiazem and verapamil), nizatidine, norfloxacin, isoniazid, fluconazole, carbimazole, mexiletine, propafenone, disulfiram, viloxazine, interferon alfa and influenza vaccines since they can increase theophylline plasma concentrations;
- Phenytoin, carbamazepine, barbiturates, rifampicin, sulfinpyrazone, ritonavir, primidone and aminoglutethimide may decrease theophylline concentration in blood plasma and, therefore, an increase in theophylline dose may be required;
- Theophylline may increase lithium excretion;
- The simultaneous administration of theophylline and fluvoxamine should be avoided. In cases where this combination is necessary, the dose of theophylline should be halved, it is necessary to carefully monitor the plasma concentrations of theophylline;
- Plasma concentrations of theophylline can be reduced when taken together with drugs containing St. John’s wort perforated;
- Co-administration with β-blockers prevents bronchodilation;
- Combining ketamine and theophylline leads to lowering the seizure threshold;
- Co-administration with doxapram increases CNS stimulation.
Overdose of Theo-24 CR can cause the following side effects:
- dyspeptic phenomena;
- hypokalemia, hyperglycemia, hypomagnesemia;
- jumps in blood pressure, arrhythmia, tachycardia;
- lactic acidosis, metabolic acidosis;
- tremor, cramps, coma.
In case of an overdose, treatment should be symptomatic.
The use of barbiturates is contraindicated.
Taking enterosorbents can improve the patient’s condition.
Pregnancy and breastfeeding
Theophylline crosses the placental barrier and excretes in breast milk.
During pregnancy, the medicine is used only if the intended benefit to the mother outweighs the possible risk to the fetus.
If it is necessary to use this medicine during lactation, you should take into account that theophylline is excreted in breast milk.
In severe liver diseases, the dose of Theo-24 CR should be reduced.
For smoking patients, an increase in the daily dose may be required. Children and smokers may also need unequal doses — a higher dose in the evening and lower in the morning.
Theophylline can cause irritation, fatigue, muscle twitching, clonic and tonic generalized cramps and affect the ability to drive a car and work with moving mechanisms.
The drug should be used with caution, only in case of emergency: heart diseases, impaired renal and hepatic function, severe arterial hypertension, severe arteriosclerosis, sepsis, hyperthyroidism, patients with a history of gastrointestinal ulcer, patients over 60 years of age.
Restrictions on the use of this drug in gastroesophageal reflux are associated with the effect on the smooth muscle of the cardio esophageal sphincter, which can worsen the patient’s condition, increasing reflux.
Smoking and drinking alcohol can lead to increased clearance of theophylline and, accordingly, to a decrease in its therapeutic effect and the need for higher doses.
It is necessary to control theophylline level in blood plasma and carry out clinical observation in the treatment of patients with heart failure, chronic alcoholism, impaired liver function (especially cirrhosis), with elevated body temperature, pneumonia or viral infections since due to a possible decrease in clearance of theophylline dose reduction required.
Patients with a history of convulsive conditions should avoid using theophylline and apply the alternative treatment.
Hypokalemia that occurs with hypoxia, therapy with β2-adrenergic agonists, steroids, diuretics can be enhanced with the use of xanthines. In these cases, it is recommended to control the level of potassium in the blood plasma.
Increased attention requires the use of the drug in older men with an increase in the history of the prostate due to the risk of urinary retention.
The drug contains sucrose, so it should not be used in patients with rare congenital fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase deficiency.