Evidence supporting the use of: Theophylline
For the health condition: Chronic Obstructive Pulmonary Disorder

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Theophylline is a methylxanthine drug that has been used for decades in the management of Chronic Obstructive Pulmonary Disease (COPD). Its primary mechanism of action is bronchodilation, achieved through non-selective inhibition of phosphodiesterase enzymes, leading to increased intracellular cyclic AMP and subsequent relaxation of bronchial smooth muscle. Additionally, theophylline is thought to have mild anti-inflammatory effects and may improve diaphragmatic contractility. Historically, theophylline was a mainstay in COPD treatment due to its oral administration and availability before the widespread use of inhaled bronchodilators and corticosteroids.

However, the scientific evidence supporting its effectiveness is modest. Systematic reviews and meta-analyses (e.g., Cochrane reviews) indicate that theophylline provides only small improvements in lung function, symptoms, and exercise capacity compared to placebo, and is less effective and less well-tolerated than inhaled long-acting beta-agonists or anticholinergics. The drug’s narrow therapeutic index and significant risk of adverse effects (arrhythmias, seizures, gastrointestinal symptoms) further limit its use. Current clinical guidelines (such as GOLD) recommend theophylline only as an alternative or adjunct therapy when inhaled medications are unavailable or unaffordable. In summary, while there is scientific validation for its bronchodilator and mild anti-inflammatory properties, the evidence base is not strong, and its use is now largely limited due to safety and efficacy concerns.

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Products containing Theophylline

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