theophylline

Adult Dosing .

Dosage forms:  ER TAB: 100 mg, 200 mg, 300 mg, 400 mg, 450 mg, 600 mg; SOL: 80 mg per 15 mL; INJ: various

asthma/COPD, maintenance tx

[300-600 mg/day PO divided qd-bid]

Start: 300-400 mg PO qd x3 days, then 400-600 mg PO qd; Max: 400 mg/day if reduced clearance; Info: adjust dose based on serum levels; reduced clearance risk factors include elderly, hepatic impairment, CHF, fever, sepsis w/ multi-organ failure, shock, and hypothyroidism; ER tab may be cut in half, but do not crush/chew

acute bronchospasm, adjunct tx

[healthy nonsmoker]

Dose: 0.4 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[smoker]

Dose: 0.7 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[elderly]

Dose: 0.3 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[pt w/ reduced clearance]

Dose: 0.2 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels; reduced clearance risk factors include hepatic impairment, CHF, fever, sepsis w/ multi-organ failure, shock, and hypothyroidism

renal dosing

[see below]

renal impairment: no adjustment

HD/PD: not defined

hepatic dosing

[adjust dose amount]

hepatic impairment: decr. usual dose, amount not defined

Peds Dosing .

Dosage forms:  SOL: 80 mg per 15 mL; INJ: various

asthma, maintenance tx

[premature neonates, <24 days old]

Start: 1 mg/kg/dose PO q12h; Info: adjust dose based on serum levels

[premature neonates, 24 days old and older]

Start: 1.5 mg/kg/dose PO q12h; Info: adjust dose based on serum levels

[full term up to 26 wk old]

Start: ((0.2 x age [wk]) + 5) x wt [kg] = mg/day PO divided q8h; Info: adjust dose based on serum levels

[26-52 wk old]

Start: ((0.2 x age [wk]) + 5) x wt [kg] = mg/day PO divided q6h; Info: adjust dose based on serum levels

[1-15 yo, <45 kg]

Start: 12-14 mg/kg/day up to 300 mg PO divided q6-8h x3 days, then 16 mg/kg/day up to 400 mg PO divided q6-8h x3 days, then 20 mg/kg/day up to 600 mg PO divided q6-8h; Max: 16 mg/kg/day up to 400 mg/day if reduced clearance; Info: adjust dose based on serum levels; reduced clearance risk factors include hepatic impairment, CHF, fever, sepsis w/ multi-organ failure, shock, and hypothyroidism; ER tab may be cut in half, but do not crush/chew

[1-15 yo, >45 kg]

see Adult Dosing

acute bronchospasm, adjunct tx

[<24 days old]

Dose: 1 mg/kg/dose IV q12h; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[24 days old and older]

Dose: 1.5 mg/kg/dose IV q12h; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[6-52 wk old]

Dose: ((0.008 x age [wk]) + 0.21) mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[1-9 yo]

Dose: 0.8 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[9-12 yo or young smoker]

Dose: 0.7 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

[12-16 yo]

Dose: 0.5 mg/kg/h IV; Start: load 5 mg/kg/dose IV x1 if no theophylline w/in 24h; Info: not recommended per NIH guidelines; adjust dose based on serum levels

apnea of prematurity (off-label)

[3-6 mg/kg/day PO divided q6-8h]

Start: 5 mg/kg/dose PO x1; Info: adjust dose based on serum levels

renal dosing

[0-3 mo]

renal impairment: decr. usual dose, amount not defined

HD/PD: not defined

[>3 mo]

renal impairment: no adjustment

HD/PD: not defined

hepatic dosing

[adjust dose amount]

hepatic impairment: decr. usual dose, amount not defined