Theo-24 Cr

Theo-24 Cr - medication with an active ingredient called Theophylline. The drug is prescribed for treatment of bronchial asthma, chronic obstructive bronchitis, pulmonary emphysema, pulmonary hypertension, pulmonary heart, edematous renal syndrome (as part of a combination therapy), nocturnal apnea.

Product dosage: 400mg
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Theo 24 Cr (theophylline anhydrous) extended-release capsules represent a cornerstone in maintenance therapy for reversible airway obstruction, including chronic obstructive pulmonary disease (COPD) and asthma. As a methylxanthine derivative, it functions as a bronchodilator and respiratory stimulant, offering sustained therapeutic plasma concentrations over a full 24-hour dosing interval. Its unique delivery system is engineered for once-daily administration, promoting adherence and consistent symptom control. Clinicians value its role in step-up therapy when inhaled corticosteroids and short-acting beta-agonists provide insufficient management, particularly in moderate to severe cases.

Features

• Active ingredient: theophylline anhydrous 100 mg, 200 mg, or 300 mg in extended-release formulation
• Pharmacokinetic profile: zero-order release for consistent 24-hour serum concentrations
• Administration: oral capsule, designed for once-daily dosing to support patient compliance
• Bioavailability: approximately 100% under fasting conditions; absorption may be affected by food
• Half-life: highly variable among individuals (adults: 3–15 hours; influenced by age, smoking, liver function)
• Protein binding: 40%, primarily to albumin
• Metabolism: hepatic, via cytochrome P450 1A2 (CYP1A2); produces active metabolites including 3-methylxanthine
• Excretion: renal (about 10% unchanged theophylline)

Benefits

• Provides round-the-clock bronchodilation, reducing the frequency and severity of bronchospastic episodes
• Decreases the need for rescue inhalers, empowering better long-term disease management
• Improves exercise tolerance and quality of life through sustained airway patency
• May exhibit mild anti-inflammatory and immunomodulatory effects in chronic airway diseases
• Suitable for nocturnal asthma symptoms due to its consistent 24-hour pharmacokinetics
• Cost-effective oral alternative or adjunct to combination inhaler therapies

Common use

Theo 24 Cr is indicated for the treatment and prevention of symptoms associated with reversible airway obstruction. This includes:

• Chronic asthma, especially cases with nocturnal symptoms
• Chronic bronchitis
• Emphysema
• COPD with a reversible component

It is often used when symptoms are not adequately controlled by inhaled corticosteroids and short-acting bronchodilators alone. It may also serve as monotherapy or adjunctive therapy based on individual patient profiles and severity.

Dosage and direction

Dosage must be individualized based on ideal body weight, age, smoking status, and concomitant conditions affecting theophylline metabolism. Serum theophylline concentration monitoring is essential.

Initial dosing (for patients not currently receiving theophylline):

• Adults (non-smoking): 300–400 mg once daily
• Elderly, or patients with cor pulmonale: 200–300 mg once daily
• Smokers: may require higher doses (400–600 mg daily) due to increased clearance

Titration: Increase dose by approximately 25% at 3-day intervals if tolerated and if symptoms persist. The therapeutic range is 5–15 mcg/mL; levels above 20 mcg/mL are associated with toxicity.

Administration: Take at the same time each day, preferably in the morning. Swallow capsule whole; do not crush, chew, or break. Administer on an empty stomach, at least 1 hour before or 2 hours after a meal for consistent absorption.

Precautions

• Narrow therapeutic index: requires careful monitoring of serum concentrations.
• Hepatic impairment: dose reduction necessary; monitor levels closely.
• Congestive heart failure, cor pulmonale: prolonged half-life; use lower doses.
• Elderly patients: increased risk of toxicity due to reduced clearance.
• Fever, acute infections: may alter pharmacokinetics.
• Use with caution in patients with seizure disorders, hyperthyroidism, peptic ulcer disease, or hypertension.
• Avoid abrupt withdrawal; may exacerbate respiratory symptoms.

Contraindications

• Hypersensitivity to theophylline or any component of the formulation
• Underlying seizure disorder not adequately controlled
• Active peptic ulcer disease
• Uncontrolled cardiac arrhythmias

Possible side effects

Common (dose-related):

• Nausea, vomiting, gastroesophageal reflux
• Headache, insomnia, restlessness
• Palpitations, tachycardia

Less common:

• Diarrhea, abdominal discomfort
• Irritability, muscle twitching

Serious (often at serum levels >20 mcg/mL):

• Cardiac arrhythmias (including ventricular tachycardia)
• Seizures
• Hypokalemia
• Hyperglycemia

Drug interaction

Theophylline interacts with numerous medications. Notable examples:

• Inhibitors of CYP1A2 (e.g., ciprofloxacin, fluvoxamine, zileuton): increase theophylline levels.
• Inducers of CYP1A2 (e.g., smoking, phenytoin, rifampin): decrease theophylline levels.
• Beta-blockers: may antagonize bronchodilator effect.
• Lithium: theophylline may increase renal lithium excretion.
• Warfarin: theophylline may potentiate anticoagulant effect.

A thorough medication review is essential before initiation and during therapy.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose. Maintaining a consistent dosing schedule is critical for therapeutic efficacy.

Overdose

Theophylline overdose is a medical emergency. Signs include severe nausea/vomiting, tremors, agitation, tachycardia, hypotension, metabolic acidosis, hypokalemia, hyperglycemia, seizures, and cardiac arrest.

Management:

• Immediate medical attention required.
• Activated charcoal may be administered if ingestion recent.
• Hemodialysis may be indicated for severe cases (serum level >40–60 mcg/mL).
• Supportive care: anticonvulsants for seizures, electrolyte correction, antiarrhythmics.

Storage

Store at controlled room temperature (20–25°C or 68–77°F). Protect from moisture and light. Keep in original container, tightly closed. Do not use if capsules are crushed, damaged, or discolored.

Disclaimer

This information is intended for healthcare professionals. It is not a substitute for clinical judgment or individual patient assessment. Prescribers should refer to the full prescribing information and monitor serum theophylline levels during therapy. Patients should be educated on signs of toxicity and the importance of adherence and follow-up.

Reviews

Dr. Elena Rostova, Pulmonologist: “I’ve used Theo 24 Cr for over a decade in patients with difficult-to-control nocturnal asthma. Its 24-hour profile is unmatched among oral bronchodilators when dosed correctly. Serum monitoring is non-negotiable, but in compliant patients, the results are often transformative.”

Clinical Pharmacist Review: “A classic agent with a modern delivery system. Its interactions are numerous, but in a well-managed setting, it remains a valuable tool—especially in resource-limited environments where inhalers are cost-prohibitive.”

Patient feedback (aggregated): Reports highlight improved nighttime breathing and reduced rescue inhaler use, though some note gastrointestinal discomfort during dose titration.