The role of theophyllines in a preventive approach for subjects with both mild and severe asthma.

Theophyllines continue to have a definite place in asthma therapy. With careful attention to therapeutic serum theophylline concentrations they are effective to improve spirometry and prevent symptoms. Theophyllines provide an additional benefit when prescribed with beta 2 agonists, and oral or inhaled steroids. Evening dosing with the once-daily, 24 hour formulation of theophylline 400 mg (Uniphyl) improves early morning function and prevents all or most of the early morning symptom exacerbation. Whereas there has been considerable focus on the potential side effects and theophylline toxicity, if subjects are introduced slowly to theophyllines, particularly in naive patients, and with careful attention to patient tolerance and serum theophylline concentrations, a majority of patients can be satisfactorily introduced to the products. With clinical experience, and when introduced with care, most patients will receive significant therapeutic benefit from theophyllines, with minimal or no side effects. Most patients readily accept the products, particularly the once daily 24 hour formulation.