Theo 24 CR: Advanced 24-Hour Bronchodilation for COPD and Asthma Control
Theo-24 Cr
| Product dosage: 400mg | |||
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Theo 24 CR (theophylline anhydrous) 24-hour controlled-release tablets are formulated to provide sustained bronchodilation and anti-inflammatory effects for patients with chronic obstructive pulmonary disease (COPD) and asthma. As an expert-grade methylxanthine derivative, it functions through phosphodiesterase inhibition and adenosine receptor antagonism, resulting in smooth muscle relaxation and improved respiratory function. Its unique controlled-release delivery system ensures stable serum concentrations over a full 24-hour period, reducing peak-trough fluctuations and minimizing side effect profiles. This makes it a cornerstone therapy for maintenance treatment in obstructive airway diseases, particularly when inhaled corticosteroids and beta-agonists require adjunct support.
Features
- Contains theophylline anhydrous 100mg, 200mg, or 300mg in controlled-release formulation
- Hydrophilic matrix system for consistent 24-hour drug release
- Bioavailability of approximately 100% under fasting conditions
- Linear pharmacokinetics within therapeutic range (5–15 mcg/mL)
- Mean elimination half-life of 8 hours in adults (range 3–15 hours)
- Metabolism primarily hepatic via CYP1A2 and CYP3A4 isoenzymes
Benefits
- Provides round-the-clock bronchodilation, reducing nighttime and early morning symptom breakthrough
- Decreases frequency and severity of acute exacerbations in COPD and asthma
- Improves exercise tolerance and quality of life through sustained airway patency
- Offers additive effect when combined with inhaled corticosteroids, allowing for dose reduction of steroids
- Cost-effective oral alternative or adjunct to high-dose combination inhaler therapies
- Reduces airway inflammation and mucosal edema through non-adrenergic mechanisms
Common use
Theo 24 CR is indicated for the treatment and prophylaxis of symptoms associated with chronic asthma, reversible bronchospasm associated with chronic bronchitis, and emphysema. It is typically prescribed when symptoms are not adequately controlled by short-acting bronchodilators alone or when there is documented nocturnal symptomatology. It may also serve as a steroid-sparing agent in patients requiring long-term oral corticosteroids. Clinical use often involves therapeutic drug monitoring to maintain serum concentrations within the narrow therapeutic window.
Dosage and direction
Dosage must be individualized based on ideal body weight, age, smoking status, and concomitant medications. For adults, initial dosing is typically 300–400 mg per day, administered once daily. Dose titration should occur in increments of 100–200 mg every 3 days until optimal therapeutic response is achieved or maximum dose of 900 mg/day is reached. Tablets must be swallowed whole and not crushed, chewed, or divided. Administration with a high-fat meal may increase peak concentrations and should be avoided. Morning administration is preferred to minimize nighttime side effects.
Precautions
Routine serum theophylline concentration monitoring is essential, particularly during initiation and after dose changes. Use with caution in patients with heart failure, liver impairment, or cor pulmonale due to reduced clearance. Elderly patients and neonates exhibit decreased metabolism requiring dose adjustment. Fever, viral infections, and vaccination may alter pharmacokinetics. Avoid abrupt withdrawal in asthmatic patients due to risk of rebound bronchospasm. Cardiovascular status should be monitored in patients with pre-existing arrhythmias.
Contraindications
Hypersensitivity to theophylline or any component of the formulation. Contraindicated in patients with active peptic ulcer disease or uncontrolled seizure disorders. Should not be administered concurrently with other xanthine derivatives. Avoid use in patients with porphyria. Not recommended during acute myocardial infarction or in those with hemodynamically unstable cardiac conditions.
Possible side effects
- Common (≥1%): Nausea, vomiting, headache, insomnia, gastroesophageal reflux
- Less common (0.1–1%): Tachycardia, palpitations, diarrhea, irritability, muscle twitching
- Rare (<0.1%): Ventricular arrhythmias, seizures, hypersensitivity reactions, hyperglycemia
- Dose-related: Side effects correlate with serum concentrations >20 mcg/mL, including cardiac arrhythmias and seizures
Drug interaction
- Potent inhibitors of CYP1A2 (fluvoxamine, ciprofloxacin): Increase theophylline concentrations by 50–100%
- Enzyme inducers (phenytoin, carbamazepine, rifampin): Decrease theophylline concentrations by 30–50%
- Beta-blockers: Antagonize bronchodilator effects
- Lithium: May decrease lithium concentrations
- Warfarin: Enhanced anticoagulant effect
- Sympathomimetics: Additive cardiovascular effects
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed administration. If multiple doses are missed, contact healthcare provider for dose readjustment to avoid subtherapeutic concentrations or potential withdrawal symptoms.
Overdose
Theophylline toxicity typically occurs at serum concentrations >20 mcg/mL. Early signs include nausea, vomiting, tachycardia, and tremors. Severe overdose (>30 mcg/mL) may cause hypokalemia, hyperglycemia, metabolic acidosis, seizures, and ventricular arrhythmias. Treatment involves activated charcoal if presented early, supportive care, and potentially hemoperfusion for life-threatening concentrations. Beta-blockers may be used for tachyarrhythmias but are contraindicated in asthmatics.
Storage
Store at controlled room temperature (20–25°C or 68–77°F). Protect from moisture and light. Keep in original container with tight closure. Do not remove desiccant from packaging. Keep out of reach of children and pets. Do not use if tablets appear damaged or discolored.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Dosage and administration must be determined by a qualified healthcare provider based on individual patient characteristics. Serum concentration monitoring is required for safe use. Not all possible interactions or side effects are listed here. Patients should report any adverse effects to their physician immediately.
Reviews
“Theo 24 CR has been instrumental in managing my severe COPD patients who continue to have breakthrough symptoms despite maximal inhaled therapy. The once-daily dosing improves adherence, and therapeutic drug monitoring allows for precise titration. I’ve observed significant reduction in exacerbation frequency and hospitalizations in my practice.” — Dr. Evelyn Reed, Pulmonologist
“As a respiratory therapist, I appreciate the pharmacokinetic predictability of Theo 24 CR compared to immediate-release formulations. Patients report better nighttime control and reduced rescue inhaler use. The controlled-release mechanism provides more stable serum levels than older formulations.” — Michael Torres, RRT
“After struggling with nighttime asthma symptoms for years, Theo 24 CR has provided the first consistent 24-hour control I’ve experienced. The once-daily regimen is convenient, and I’ve been able to reduce my steroid inhaler dose under my doctor’s supervision.” — Patient, 52-year-old female with severe persistent asthma