Rational Intravenous Doses of Theophylline

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Abstract
Physiologic responses to intravenously administered theophylline were determined in nine hospitalized asthmatic subjects. In each patient incremental theophylline plasma concentration plateaus were attained at which pulmonary-function changes related to drug administration were examined. Continuous improvement in vital capacity and first-second forced expiratory volume was observed over the plasma range of theophylline concentration of 5 to 20 mg per liter. The improvement varied directly with the logarithm of the plasma concentration. A safe and effective dosage regimen for intravenous theophylline can be based on these observations. After a loading dose of aminophylline, 5.6 mg per kilogram given intravenously, 0.9 mg per kilogram per hour can be given as a maintenance dose. This amount will result in a plasma theophylline concentration of approximately 10 mg per liter for 95 per cent of patients and in recovery from some 30 to 40 per cent of reversible pulmonary-airway obstruction. (N Engl J Med 289:600–603, 1973)