Summary
The efficacy and side-effects of individually adjusted doses of controlled-release theophylline given once daily in the evening (average dose 650 mg) were compared with those of standard treatment with controlled-release terbutaline 7.5 mg b.d. Thirty-six asthmatics with regular morning obstruction (“morning dipping”) were studied over two treatment periods each of two weeks, according to a crossover, randomized, double blind design.
Morning peak expiratory flow (PEF) was slightly but significantly higher with theophylline (363 l·min−1) than terbutaline (342 l·min−1). Feelings of dyspnoea on waking in the morning were also less pronounced with theophylline. There were no other differences between the treatment periods during the day or night, with respect to dyspnoea or any the other symptoms. Side-effects were mild and were reported with similar frequencies during both treatments.
It is concluded than an individually adjusted dose of once-daily theophylline administered in the evening is at least as effective as conventional therapy with controlled-release terbutaline in preventing nocturnal and early morning asthma, when both drugs are added to regular medication with inhaled sympathomimetics and steroids.
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References
Turner-Warwick M (1977) On observing patterns of airflow obstruction in chronic asthma. Br J Dis Chest 71: 73–86
Bateman JRM, Clarke SW (1979) Sudden death in asthma. Thorax 34: 40–44
Turner-Warwick M (1988) The management of chronic asthma. In: Barnes PJ, Rodger IW, Thomson NS (eds) Asthma. Basic mechanisms and clinical management. Academic Press. London, pp 721–732
Nyberg L, Kennedy BM (1984) Pharmacokinetics of terbutaline given in slow-release tablets. Eur J Respir Dis 65 [Suppl 134]: 119–139
Karttunen P, Tukiainen H, Nykänen S, Saano V (1985) Night-time pharmacokinetics of once a day theophylline: a steady state comparison of three preparations. Int J Clin Pharmacol Ther Toxicol 23: 161–165
Mordelet-Dambrine M, Baglin J-Y, Roux A, Dusser D, Flouvat B, Huchon G (1986) Comparison between theophylline analysis by nephelometric inhibition immunoassay and high performance liquid chromatography. Ther Drug Monit 8: 106
Weinberger M (1986) Clinical and pharmacokinetic concerns of 24-hour dosing with theophylline. Ann Allergy 56: 2–12
Barnes PJ, Greening AP, Neville L, Timmers J, Poole GW (1982) Single-dose slow-release aminophylline at night prevents nocturnal asthma. Lancet I: 299–301
Thompson PJ, Beckett AH, Turner-Warwick M (1984) Prospects for once-a-day theophylline medication. Am Rev Respir Dis 129: A 45
Lamont H, Pauwels R, van der Streaten M (1987) The effect of dosing time and pharmacokinetics and pharmacodynamics of a “once-a-day” sustained release theophylline preparation. Br J Clin Pharmacol 24: 735–742
Davies DS (1984) Pharmacokinetics of terbutaline after oral administration. Eur J Respir Dis 65 [Suppl 134]: 111–117
Roberts JR, Desai HI, Gillespie CA, Simons ER (1986) Sustained-release terbutaline vs sustained-release theophylline in young patients with asthma. Am J Dis Child 140: 650–654
Laursen LC, Taudorf E, Gnosspelius Y, Gymose E, Weeke B (1985) Long-term oral therapy of asthma with terbutaline and theophylline, alone and combined. Eur J Respir Dis 66: 82–90
Heins M, Kurtin L, Ollerich M, Maes R, Sybrecht GW (1988) Nocturnal asthma: slow-release terbutaline versus slow-release theophylline therapy. Eur Respir J 1: 306–310
van der Vet APH, Kreukniet J, van Drost RH, Maes RAA, Fokkens JK, Hamelink MJ (1987) Combination therapy of theophylline and terbutaline as sustained-release preparations in patients with asthmatic bronchitis. Int J Clin Pharmacol Ther Toxicol 25: 558–564
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Vilkka, V., Brander, P., Hakulinen, A. et al. Once-daily theophylline in the treatment of nocturnal asthma. Eur J Clin Pharmacol 39, 241–243 (1990). https://doi.org/10.1007/BF00315103
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DOI: https://doi.org/10.1007/BF00315103