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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › Xanthines
theobromine, combinations
R03DA57
Forms & Strengths
- Oral tablets 100 mg
- Syrup 20 mg/mL
- Inhalation solution 5 mg/mL (combined with bronchodilator)
Adult Dosing
- 200‑400 mg/day divided 2‑3 doses (max 600 mg)
- Adjust for renal/hepatic impairment
Pediatric Dosing
- 5‑10 mg/kg/day divided 2‑3 doses (max 300 mg)
- Not recommended <2 years or in severe hepatic disease
Indications
- Adjunct therapy for mild‑moderate asthma
- Relief of bronchospasm in COPD (off‑label)
Mechanism of Action
- Non‑selective phosphodiesterase inhibitor → ↑cAMP → smooth‑muscle relaxation
- Adenosine‑receptor antagonism → bronchodilation
Contraindications
- Hypersensitivity to theobromine or xanthines
- Severe cardiac arrhythmias or recent myocardial infarction
- Uncontrolled seizure disorder
Adverse Reactions
- Nausea, vomiting
- Headache, insomnia
- Tachycardia, palpitations
- Arrhythmias, CNS stimulation
Drug Interactions
- CYP1A2 inhibitors (cimetidine, fluvoxamine) ↑ plasma levels
- CYP1A2 inducers (rifampin, smoking) ↓ levels
- Concurrent theophylline or caffeine ↑ toxicity risk
- Additive CNS stimulants (pseudoephedrine) ↑ side‑effects
- MAO inhibitors may enhance sympathomimetic effects
Curated Content: Needs Vetting Before Put to Clinical Use