Corophyllin , Paladron , Truphylline
Classifications: bronchodilator; (respiratory smooth muscle relaxant); xanthine;
Therapeutic: bronchodilator (respiratory smooth muscle relaxant)

Prototype: Theophylline
Pregnancy Category: C


100 mg, 200 mg tablets; 105 mg/5 mL oral liquid; 25 mg/mL injection; 250 mg, 500 mg suppositories


A xanthine derivative that relaxes smooth muscle in the airways of the lungs and suppresses the response of the airways to stimuli that constrict them.

Therapeutic Effect

It is a respiratory smooth muscle relaxant that results in bronchodilation.


To prevent and relieve symptoms of acute bronchial asthma and treatment of bronchospasm associated with chronic bronchitis and emphysema.

Unlabeled Uses

As a respiratory stimulant in Cheyne-Stokes respiration; for treatment of apnea and bradycardia in premature infants; as cardiac stimulant and diuretic in treatment of CHF.


Hypersensitivity to xanthine derivatives or to ethylenediamine component; cardiac arrhythmias; pregnancy (category C); lactation.

Cautious Use

Severe hypertension, cardiac disease, arrhythmias; impaired hepatic function; diabetes mellitus; hyperthyroidism; glaucoma; prostatic hypertrophy; fibrocystic breast disease; history of peptic ulcer; neonates and young children, patients over 55 y; COPD, acute influenza or patients receiving influenza immunization.

Route & Dosage

Adult: IV Loading Dose 6 mg/kg over 30 min IV Maintenance Dose Nonsmoker, 0.5 mg/kg/h; smoker, 0.8 mg/kg/h; CHF or cirrhosis, 0.1–0.2  mg/kg/h PO Nonsmoker, 0.5 mg/kg/h times 24 h in 4 divided doses; smoker, 0.75 mg/kg/h times 24 h in 4 divided doses; CHF or cirrhosis, 0.25 mg/kg/h times 24 h in 4 divided doses
Child: IV Loading Dose 6 mg/kg IV over 30 min IV Maintenance Dose 1–9 y, 1 mg/kg/h; >9 y, 0.8 mg/kg/h PO 1–9 y, 1 mg/kg/h times 24 h in 4 divided doses; >9 y, 0.75 mg/kg/h times 24 h in 4 divided doses
Infant: PO/IV 6–11 mo, 0.7 g/kg/h; 2–6 mo, 0.5 mg/kg/h

Neonatal Apnea
Neonate: PO/IV Loading Dose 5 mg/kg PO/IV Maintenance Dose 5 mg/kg/d divided q12h
Geriatric Patients: PO 6.25 mg/kg loading dose, then 2.5 mg/kg q8h

Dose on IBW.


  • Note: All doses based on ideal body weight.
  • Give with a full glass of water on an empty stomach (?–1 h before or 2 h after meals) for faster absorption, which is delayed but is not reduced with food.
  • Minimize GI symptoms by taking immediately after a meal or with food.
  • Do not chew or crush extended (controlled) release preparations before swallowing; however, if tablet is scored, it can be broken in half, then swallowed.
  • Do mix contents of extended release capsules with soft, moist food to promote swallowing.
  • Note: Rectal preparations may be ordered when patient must fast or cannot tolerate the drug orally; absorption is enhanced if rectum is empty.
  • Verify correct IV concentration and rate of infusion with physician for neonates, infants, and children.

PREPARE: IV Infusion: ??Dilute loading dose in 100–200 mL NS, D5W, D5/NS, or RL. For continuous or intermittent infusion dilute in 500–1000 mL.??Do not use aminophylline solutions if discolored or if crystals are present. 

ADMINISTER: IV Infusion: Infuse at a rate not to exceed 25 mg/min.  

INCOMPATIBILITIES Solution/additive: Amikacin, bleomycin, cephalosporins, chlorpromazine, ciprofloxacin, clindamycin, dimenhydrinate, dobutamine, doxorubicin, epinephrine, hydralazine, hydroxyzine, insulin, isoproterenol, meperidine, methylprednisolone, morphine, nafcillin, norepinephrine, papaverine, penicillin G, pentazocine, procaine, prochlorperazine, promazine, promethazine, verapamil, vitamin B complex with C, zinc. Y-site: Amiodarone, ciprofloxacin, clarithromycin, dobutamine, fenoldopam, hydralazine, lansoprazole, ondansetron, TPN, vinorelbine, warfarin.

  • Store at 15°–30° C (59°–86° F) in tightly closed containers unless otherwise directed.
  • Follow manufacturer's directions regarding storage of suppositories; some can be stored at room temperature; others must be refrigerated.

Adverse Effects (≥1%)

CNS: Nervousness, restlessness, depression, insomnia, irritability, headache, dizziness, muscle hyperactivity, convulsions. CV: Cardiac arrhythmias, tachycardia (with rapid IV), hyperventilation, chest pain, severe hypotension, cardiac arrest. GI: Nausea, vomiting, anorexia, hematemesis, diarrhea, epigastric pain.


Drug: Increases lithium excretion, lowering lithium levels; cimetidine, high-dose allopurinol (600 mg/d), ciprofloxacin, erythromycin, troleandomycin can significantly increase theophylline levels.


Absorption: Most products are 100% absorbed from GI tract. Peak: IV 30 min; uncoated tablet 1 h; sustained release 4–6 h. Duration: 4–8 h; varies with age, smoking, and liver function. Distribution: Crosses placenta. Metabolism: Extensively in liver; by CYP1A2. Elimination: Parent drug and metabolites excreted by kidneys; excreted in breast milk. Half-Life: 3.7 h (child); 7.7 h (adult).

Nursing Implications

Assessment & Drug Effects

  • Monitor for S&S of toxicity (generally related to theophylline serum levels over 20 mcg/mL). Observe patients receiving parenteral drug closely for signs of hypotension, arrhythmias, and convulsions until serum theophylline stabilizes within the therapeutic range.
  • Note: High incidence of toxicity is associated with rectal suppository use due to erratic rate of absorption.
  • Monitor & record vital signs and I&O. A sudden, sharp, unexplained rise in heart rate may indicate toxicity.
  • Lab tests: Monitor serum theophylline levels.
  • Note: Older adults, acutely ill, and patients with severe respiratory problems, liver dysfunction, or pulmonary edema are at greater risk of toxicity due to reduced drug clearance.
  • Note: Children appear more susceptible to CNS stimulating effects of xanthines (nervousness, restlessness, insomnia, hyperactive reflexes, twitching, convulsions). Dosage reduction may be indicated.

Patient & Family Education

  • Note: Use of tobacco tends to increase elimination of this drug (shortens half-life), necessitating higher dosage or shorter intervals than in nonsmokers.
  • Report excessive nervousness or insomnia. Dosage reduction may be indicated.
  • Note: Dizziness is a relatively common side effect, particularly in older adults; take necessary safety precautions.
  • Do not take OTC remedies for treatment of asthma or cough unless approved by physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

© 2006-2023 Last Updated On: 02/02/2023 (0)
Wait 20 seconds...!!!