These are naturally occuring substances that are chemically similar to caffeine. They include theophylline (Biophylline, Labophylline, Lasma, Nuelin, Pro-Vent, Sabidal, Slo-Phyllin, Theo-Dur, Uniphyllin Continus), aminophylline (Theodrox, Phyllocontin Continus) and choline theophyllinate (Choledyl). They make the bronchial muscles relax, but affect the heart muscles as well. The dose must be exactly right, as there is only a small difference between the dose that will relax the bronchi and one which will cause irregular heartbeat. Other possible side-effects include headache, nausea, stomach upsets, depression, aching limbs and insomnia. Smoking and drinking will affect the dose needed, as will viral infections or taking other drugs. So it is important that patients taking these drugs have close medical supervision. As long as the dose is correct, they are suitable for long-term use, since there are no serious side-effects.
These drugs are usually taken by mouth. They can also be given as suppositories, inserted before going to bed, for those who suffer from early-morning attacks of asthma. They make the bronchial muscles relax by working inside the cells, whereas the 32 agonists work outside the cell. The two different types of drugs therefore have complementary effects, and using both can be helpful for some patients. Theophylline is combined with a sympathomimetic, ephedrine, in Franol and Tedral.
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