Abstract
Methylxanthines are widely used in the treatment of asthma. Being one of the few drugs that can be administered orally, they are especially helpful in resource restricted settings. Theophylline, the commonly used methylxanthine drug is associated with a wide range of adverse effects accounting for the poor compliance and high drop-out rates. Moreover, a narrow therapeutic index warrants routine monitoring of its levels in the blood. Doxofylline, a new methylxanthine derivative, is shown to have similar efficacy with significantly less side effects in both animal studies as well as human adults. However, there is a paucity of studies in children with asthma. Retrospective data suggest that 11% patients experienced some side effects, but only 5% reported moderate side effects. Available evidence suggests that it improves spirometric parameters in children with asthma as compared to placebo. Extrapolating data from adult patients, it may be used in place of theophylline as an add on therapy in step 3 and step 4 in children with asthma. Dosage recommended for children >6 yrs of age is 6 mg/Kg/dose BID. Doxofylline produces stable serum concentrations, hence plasma monitoring is required only in patients with hepatic insufficiency and intolerance to xanthine drugs.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Global initiative for asthma (GINA). Global strategy for asthma management and prevention. Revised 2006. www.ginasthma.org.
Guglani L, Lodha R, Kabra SK. Epidemiology, Risk Factors and Natural History of Asthma. In Kabra SK, Lodha R, eds. Essential Pediatric Pulmonology. 1st ed. Delhi; Noble Vision 2006; 123–143.
Barnes PJ, Pauwels RA. Theophylline in the management of asthma: time for reappraisal? Eur Respir J 1994; 7: 579–591
Weinberger M, Hendeles L. Theophylline in asthma. N Engl J Med 1996; 334: 1380–1388.
Bierman CW, William PV. Therapeutic monitoring of theophylline: rationale and current status. Clin Pharmacokinet 1989; 17: 377–384.
Franzone JS, Cirillo R, Barone D. Doxofylline and theophylline are xanthines with partly different mechanisms of action in animals. Drug Exp Clin Res 1988; 14: 479–489
Bagnato G, Fodale P, Bottari M. Clinical evaluation of doxofylline sachets in a pediatric population. Riv Eur Sci Med Farmacol 1989; 11: 359–363.
Bagnato GF. Tolerability of doxofylline in the maintenance therapy of pediatric patients with bronchial asthma. Eur Rev Med Pharmacol Sci 1999; 3: 255–260.
Melillo G et al. Treatment of reversible chronic airways obstruction with doxofylline compared with slow-release theophylline: a double-blind, randomized, multicentre trial. Int J Clin Pharmacol Res 1989; 9: 397–405.
Goldstein MF, Chervinsky P. Efficacy and safety of doxofylline compared to theophylline in chronic reversible asthma — a double-blind randomised placebo-controlled multicentre clinical trial. Med Sci Monit 2002; 8: 297–304
Dini, FL Cogo R. Doxofylline: A new generation xanthine brochodilator devoid of major cardiovascular adverse effects. Curr Med Res Opin 2001; 16: 258–268.
Poggi R, Brandolese R, Bernasconi M et al. Doxofylline and respiratory mechanics. Short-term effects in mechanically ventilated patients with airflow obstruction and respiratory failure. Chest 1989; 96: 772–778.
Bologna E, Laganà A, Terracino D, Bolignari P, Biffignandi P. Oral and intravenous pharmacokinetic profiles of doxofylline in patients with chronic bronchitis. J Int Med Res 1990; 18: 282–288.
Dolcetti A, Osella D, De Filippis G, Carnuccio C, Grossi E. Comparison of intravenously administered doxofylline and placebo for the treatment of severe acute airways obstruction. J Int Med Res 1988; 16: 264–269.
Lazzaroni M, Grossi E, Banchi PG. The effect of intravenous doxofylline or aminophylline on gastric secretion in duodenal ulcer patients. Aliment Pharmacol Therapy 1990; 4: 643–649.
Cipri A, Pozzar F, Dini FL. Heart rhythm changes in patients with chronic obstructive bronchopneumopathies: effects of different methylxanthine drugs. Minerva Cardioangiol 1992; 40: 31–39.
Sacco C, Braghiroli A, Grossi E et al. The effects of doxofylline versus theophylline on sleep architecture in COPD patients. Monaldi Arch Chest Dis 1995; 50: 98–103
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sankar, J., Lodha, R. & Kabra, S.K. Doxofylline: The next generation methylxanthine. Indian J Pediatr 75, 251–254 (2008). https://doi.org/10.1007/s12098-008-0054-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-008-0054-1