Theo 24 CR: Advanced 24-Hour Bronchodilation for COPD and Asthma Control
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Theo 24 CR (Theophylline Extended-Release Tablets, 24 Hour) is a methylxanthine bronchodilator formulated to provide sustained, around-the-clock relief for patients with reversible airway obstruction. Its unique extended-release delivery system ensures stable serum concentrations, minimizing peak-trough fluctuations and supporting consistent pulmonary function. This product is indicated for the symptomatic management of chronic asthma and for bronchospasm associated with chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. By maintaining therapeutic theophylline levels over a full 24-hour period, Theo 24 CR supports improved respiratory outcomes and enhanced quality of life for patients requiring long-term bronchodilator therapy.
Features
- Contains theophylline anhydrous in a 24-hour controlled-release formulation
- Available in 100 mg, 200 mg, 300 mg, and 400 mg tablet strengths
- Utilizes a proprietary extended-release matrix for consistent drug delivery
- Designed for once-daily dosing to support adherence
- Bioavailability approximately 100% under fasting conditions
- Serum half-life ranges from 6 to 12 hours in adults, depending on metabolic factors
Benefits
- Provides continuous bronchodilation for full 24-hour coverage, reducing breakthrough symptoms
- Minimizes peak-to-trough serum concentration variations, lowering risk of adverse effects
- Supports improved exercise tolerance and reduced dyspnea in obstructive airway diseases
- Once-daily dosing enhances patient compliance compared to multiple-daily regimens
- May reduce frequency and severity of nocturnal asthma symptoms
- Can be used as maintenance therapy alongside inhaled corticosteroids for additive effect
Common use
Theo 24 CR is primarily prescribed for the long-term management of chronic respiratory conditions characterized by reversible airway obstruction. It is commonly used in adult patients with persistent asthma who require maintenance bronchodilator therapy beyond inhaled beta-agonists. In COPD management, it serves as an additional bronchodilator option for patients who continue to experience symptoms despite maximal inhaled therapy. The medication may also be utilized in certain cases of chronic bronchitis and emphysema where sustained bronchodilation is clinically indicated. Healthcare providers often prescribe Theo 24 CR when around-the-clock bronchodilation is necessary to control symptoms that demonstrate circadian variation.
Dosage and direction
Dosage must be individualized based on patient characteristics including age, weight, smoking status, and concomitant medications that affect theophylline metabolism. The recommended starting dose for adults is 300-400 mg once daily, preferably taken in the morning. Dose titration should proceed gradually, increasing by approximately 100 mg every 3 days until optimal therapeutic response is achieved or maximum recommended dose is reached. The maximum recommended daily dose is 900 mg for adults. Tablets should be swallowed whole and not crushed, chewed, or broken. Administration with a high-fat meal may significantly increase peak serum levels and should be avoided. Consistent timing of administration is crucial for maintaining stable serum concentrations.
Precautions
Theophylline has a narrow therapeutic index (10-20 mcg/mL), requiring careful monitoring of serum concentrations. Patients should be advised that many factors can alter theophylline clearance, including fever, viral infections, changes in diet, and addition or discontinuation of concomitant medications. Use with caution in patients with cardiac arrhythmias, congestive heart failure, liver disease, hypertension, hyperthyroidism, peptic ulcer disease, or seizure disorders. Elderly patients and those with cor pulmonale may have reduced clearance and require lower doses. Smoking tobacco or marijuana may increase theophylline clearance, potentially necessitating higher doses. Patients should avoid excessive caffeine consumption while taking theophylline.
Contraindications
Theo 24 CR is contraindicated in patients with known hypersensitivity to theophylline or any component of the formulation. It should not be used in individuals with active peptic ulcer disease or uncontrolled seizure disorders. Concurrent administration with other xanthine derivatives is contraindicated. The medication is contraindicated in patients with certain cardiac arrhythmias, particularly those that may be exacerbated by tachycardia. Use is contraindicated in patients who have demonstrated allergic reactions to ethylenediamine, as cross-sensitivity may occur.
Possible side effects
The most common adverse reactions are related to theophylline’s pharmacological effects and typically occur at serum concentrations above 20 mcg/mL. Gastrointestinal effects include nausea, vomiting, epigastric pain, and diarrhea. Central nervous system effects may include headache, insomnia, irritability, and muscle twitching. Cardiovascular effects can include sinus tachycardia, palpitations, and extrasystoles. At higher concentrations, more serious effects may occur including hypotension, cardiac arrhythmias, seizures, and metabolic acidosis. Hypersensitivity reactions including urticaria and exfoliative dermatitis have been reported. Diuresis may occur, particularly during initial therapy.
Drug interaction
Theophylline interacts with numerous medications through effects on cytochrome P450 metabolism. Drugs that increase theophylline concentrations include cimetidine, erythromycin, clarithromycin, fluoroquinolones, allopurinol, propranolol, and oral contraceptives. Drugs that decrease theophylline concentrations include phenytoin, carbamazepine, rifampin, and barbiturates. Theophylline may potentiate the effects of sympathomimetics and may antagonize the effects of beta-blockers and lithium. Concurrent use with other xanthine derivatives may increase the risk of adverse effects. Theophylline may interfere with laboratory tests including uric acid and plasma catecholamines.
Missed dose
If a dose is missed, it should be taken as soon as possible on the same day. However, if it is near the time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed dose, as this may significantly increase serum concentrations and risk of toxicity. Consistency in dosing time is important for maintaining therapeutic levels. Patients should be educated about the importance of regular dosing and advised to contact their healthcare provider if multiple doses are missed.
Overdose
Theophylline overdose represents a medical emergency that can be fatal. Serum concentrations above 25 mcg/mL may cause serious toxicity, with concentrations above 40 mcg/mL potentially life-threatening. Early signs of overdose include nausea, vomiting, tachycardia, and tremors. Severe overdose may cause cardiac arrhythmias, hypotension, seizures, metabolic acidosis, hypokalemia, hyperglycemia, and rhabdomyolysis. Treatment involves immediate medical attention, prevention of further absorption, supportive care, and enhancement of elimination. Multiple-dose activated charcoal enhances theophylline clearance. Hemodialysis or hemoperfusion may be necessary in severe cases. Serum concentrations should be monitored frequently until stable.
Storage
Store at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container with the lid tightly closed. Do not store in bathroom or other humid areas. Keep out of reach of children and pets. Do not use if the seal is broken or tablets show signs of deterioration. Properly discard any unused medication after the expiration date or when no longer needed.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. The prescribing physician should be consulted for specific medical guidance. Dosage must be individualized based on clinical assessment and therapeutic drug monitoring. Theophylline therapy requires careful medical supervision due to its narrow therapeutic index and potential for serious adverse effects. Patients should not initiate, adjust, or discontinue therapy without physician guidance. The information presented reflects current medical knowledge but may not encompass all possible uses, directions, precautions, or interactions.
Reviews
Clinical studies demonstrate that properly dosed theophylline provides effective bronchodilation and symptom control in obstructive airway diseases. Many pulmonologists report satisfactory outcomes with Theo 24 CR when serum concentrations are maintained within the therapeutic range. Patients often appreciate the convenience of once-daily dosing compared to multiple-daily regimens. Some reviews note that individual response varies considerably, emphasizing the importance of therapeutic drug monitoring. The medication receives mixed evaluations regarding side effect profile, with gastrointestinal effects being the most commonly reported concern. Overall, when appropriately prescribed and monitored, Theo 24 CR represents a valuable option in the management of chronic respiratory conditions.