Theophylline: Basics, Side Effects & Reviews


Basics, Side Effects, Reviews & More

Theophylline is a long-term medication that helps you breathe easier when you have asthma or COPD, but it is not a first-choice medication for these problems.


Theo-24, Elixophyllin, Theochron


PDE inhibitor, nonselective


Not a controlled medication


Lower-cost generic available


Prescription only

Reviewed by:

Aileen Chu, PharmD, BCPS

Michelle Nguyen, PharmD

Last reviewed on:

August 2, 2020


What is theophylline?

How theophylline works

Theophylline is a bronchodilator, which means that it relaxes the muscles in your airways so that air passes through easier. It also blocks your body's tendency to tighten the airways when they get irritated, and helps strengthen breathing muscles.

What is theophylline used for?

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)

Theophylline dosage forms

capsule icon
ml of oral solution icon
ml of oral solution

Typical dosing for theophylline

Children who weigh less than 45 kg (99 lbs) typically start with 12 to 14 mg/kg per day, but no more than 300 mg in a day. Their dose can be as high as 20 mg/kg per day, but no more than 600 mg in a day.

Adults and children who weigh over 45 kg typically start with 300 to 400 mg per day. Some people may need more than 600 mg per day if their theophylline lab levels tend to run low.

Frequently asked questions about theophylline

Pros and cons of theophylline


Thumbs UpCan help you breathe easier when other medications do not work well enough

Thumbs UpAvailable as a 24-hour pill form that can be taken once a day

Thumbs UpBoth the pill and liquid forms are available in cheaper generic versions


Thumbs DownDoes not work quickly and will not help if you are currently having an asthma or COPD attack

Thumbs DownRequires regular blood tests to check theophylline lab levels

Thumbs DownCan interact with with other medications or supplements

Thumbs DownFood affects absorption, so you have to be consistent with how you take theophylline

Pharmacist tips for theophylline

Capsule IconDo not use theophylline when you are having an asthma or COPD attack because it is not fast or strong enough to help your breathing. For these instances, make sure to keep your rescue inhaler with you at all times.

Capsule IconIt is important to take this medication consistently. You can choose to always take it with food or on an empty stomach. Take your dose around the same time everyday. If you are taking the capsule form, take it in the daytime for best effect, and avoid taking it less than 1 hour before a fatty meal since that might make the levels go too high.

Capsule IconSwallow theophylline pills whole. Do not crush or chew it, since this can release the drug into the body too quickly. If your tablet has a line in the middle, you can break it in half.

Capsule IconIf you're taking the tablet version, you might see the tablet shell in your stool, which is normal.

Capsule IconMake sure to limit your intake of caffeine because theophylline causes similar side effects like headache, feeling jittery, or trouble sleeping.

Prices for theophylline start at just $30.12 with a GoodRx coupon. They’re fast, easy-to-use and free!

View Coupon Prices

What are the side effects of theophylline?

With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

Caution Small The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

Common side effects

  • Feeling like you had too much caffeine (nausea, vomiting, headache, inability to sleep)

Other side effects

  • Abdominal pain or stomach irritation
  • Feeling anxious, irritable, or restless
  • Severe allergic reaction
  • Abnormal heart rhythm or fast heart rate
  • Diarrhea
  • Dizziness
  • Muscle tremors
  • High uric acid levels
  • Itchiness, rash, or hives
  • Urinating more, or not being able to urinate

Source: DailyMed

The following side effects have also been reported:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Chest pain or discomfort



fast, slow, or irregular heartbeat

increase in urine volume


persistent vomiting

pounding or rapid pulse



Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Abdominal or stomach pain

blurred vision


confusion about identity, place, and time

dark-colored urine

decrease in frequency of urination

decreased urine


difficulty in passing urine (dribbling)

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

dry mouth

fast, pounding, or irregular heartbeat or pulse


increased thirst

irregular heartbeat

loss of appetite

mood changes

muscle cramps or spasms

muscle pain or stiffness

nausea or vomiting


numbness or tingling in the hands, feet, or lips

pain or discomfort in the arms, jaw, back, or neck

painful urination

shakiness in the legs, arms, hands, or feet

shortness of breath


unusual tiredness or weakness

vomiting of blood or material that looks like coffee grounds

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known





trouble sleeping

unable to sleep

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What are the risks and warnings for theophylline?

Theophylline can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options


  • Risk factors: Stomach ulcers | Seizure problems | Heart rhythm problems

If you have stomach ulcers, seizure problems, or heart rhythm problems, they can become worse when you take theophylline. Let your provider know if you have any of these conditions.

theophylline TOXICITY

  • Risk factors: Children under 1 year old | Age 60 and older | Fluid buildup in the lungs (pulmonary edema) | Heart failure | Fever for over a day | Low thyroid hormones (hypothyroidism) | Liver problems | Kidney problems | Severe infection | Stopping smoking

Many things can cause theophylline to accumulate in your body. Very high levels of theophylline can be life-threatening. It's important to get your blood levels checked regularly so that your provider can make sure they are in the normal range. You might need to take a lower dose as you get older, if you have have certain diseases, or if you recently stopped smoking cigarettes or marijuana. Nausea, vomiting, or headache that doesn't go away might mean that there is too much theophylline in your body. If you notice these symptoms, let your provider know right away and do not take any more theophylline until they tell you it is safe to do so.


  • Risk factors: Taking other medications

Many medications can affect the level of theophylline in your body. High levels can be life-threatening, while low levels will cause the drug not to work effectively. If you are taking theophylline, talk with your provider or pharmacist before you start a new medication, including supplements. Also check with your provider before you stop other medications or supplements, since you may need to change the dose of theophylline.

Interactions between theophylline and other medications

Theophylline may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with theophylline. Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Riociguat
  • Viloxazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

How much does theophylline cost?

Theophylline is available as a generic medication and may be significantly cheaper compared to the brand version. Unless there is a specific reason you need the brand, the generic medication will be a better value. For even more savings, use a GoodRx coupon and pay just a fraction of the retail price.

Lowest GoodRx Price
Theo-24, Elixophyllin, Theochron (brand)


Lowest GoodRx Price
theophylline (generic)


View Prices & Coupons

Pricing based on most commonly-filled versions: 473 ml 80mg/15ml of theophylline oral solution

What are alternatives to theophylline?

There are a number of medications that your doctor can prescribe in place of theophylline. Compare a few possible alternatives below.

Drug Class:PDE inhibitor, nonselective


lowest GoodRx price

View Prices
Advair (fluticasone / salmeterol)
Drug Class:ICS / LABA combo


lowest GoodRx price

View Prices
Qvar (beclomethasone)
Drug Class:Inhaled corticosteroid (ICS)


lowest GoodRx price

View Prices

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