Theophilline levels

Hi,

I've just had my theophilline levels checked and the results came back today as 56 which if I'm right it really high ? I've got an appointment to see my docs on friday but was wondering whether others have had this and if there is anything else that can be used instead of theophilline? I'm not getting any side effects from it except for being quite shaky but I always have been a bit shaky anyway without any asthma meds. I'm a bit worried about stopping it as it made such a difference to me when I was first put on it but obviously don't know whether it still is now or not. I'm still getting a lot of grief from my asthma and don't want to go back onto steroids but I can't think of anything else ? Any advise much appreciated so that I've got some idea before seeing my doc on friday (would rather it was my consultant I was seeing though !)

Cheers,

Fi

9 Replies

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  • HI FrenchFi. It depends on which scale is being used. My local costa uses a different scale where therapeutic is between 55 and 110, whereas other places use the other scale where therapeutic is between 10 and 20.

    Rusty

  • The 55 - 110 scale is in umol/l, and the 10 - 20 scale is in mg/l (or mcg/ml - same thing). All the places I've worked at or been a patient at have given the results as mg/l, but I know there are a few places in this country that use the other scale.

    Using the mg/l scale, 56 would be a *very* high level - I've only seen a level that high with an intentional and large overdose, and the patient was extremely unwell. If you're not getting symptoms its very likely that your result is in umol/l, in which case it is only just therapeutic and not toxic.

    Have you had your theophylline results measured in the past, and what sort of results did you get? Who gave you the result of 56? Usually if you get a level checked and the result is seriously toxic, the lab should phone the doctor that requested the test and tell them, so that they can contact you urgently. A level of 56 on the mg/l scale would certainly generate some doctor action fairly quickly!

    It sounds like your level is alright, but of course if you do get symptoms or are worried, you should contact your GP asap!

    Hope this helps

    Em H

  • Hi Fi,

    I can’t comment on your theo level, because I didn’t know there could be more than one type of measurement, -thanks Rusty and EmH that’s interesting to know. My local chest clinic must use the mg whatever measurement then.

    I’m lucky inasmuch that my theo levels seem to stay constant, despite a regular intake of G and B’s choccy, - ooops - which I know can or could alter absorption rates!

    Like you I’m reliant upon this drug instead of pred. Don’t get the same sort of stability and high pf rates like I did with pred – average pf 250 now instead of 400 – but more importantly control of SOB is much better to the point where I can still run and work and avoid unscheduled hospital visits.

    What sort of inhalers do you use?

    The reason I ask is that when I did stop taking pred the agreement was to increase my combined inhaler – symbicort. 400/12 - to four instead of two puffs per day. That has also made a positive difference, although I still get early morning big dips and symptoms and carefully neb if absolutely necessary.

    It’s got to be worth talking to your doc about other inhaler drugs. Whether combined, separate, - DPI or MDI.

    There is no way I can or will take pred again because of eye related complications.

    But like you I’m very conscious of an ‘iceberg’ situation happening.

    Good luck with your docs appointment.

    Mia

    xxx

    BTW I so sympathise with shaky probs. Couldn't use my stylus pen on smartboard today without 'writing' looking like 'art nouveau' arty sort of effort instead of plain English!

  • Thanks guys,

    I never knew that there was a different scale - only knew the 10-20 one so that's reassured me a bit. It's crazy but I've actually never had my theophilline levels checked before - I've recently moved house and therefore registered with a new Doctor and they requested the check. I found out the results by the receptionist at my GP's phoning me up as soon as a Dr had seen the results saying I needed an appointment so I asked what the level was. I'll find out more tomorrow when I go to my appointment.

    Mia, I'm currently on seretide 250 2 puffs twice a day, get very tight and SOB far too often though although I am currently managing to work full time in the city but only by using my bricanyl too much and resorting to nebs when I need to so would love to find a better way of controlling it. My consultant mentioned referring me to RBH a few months ago but I never heard anymore so I asked the asthma nurse when I saw her last week and she's trying to make sure that goes through now.

    Thanks everyone ! I'll let you know how I get on tomorrow.

    Fi

  • Hi guys,

    So I went to the Dr's this afternoon - and yes, they are using the 55-110 scale so my levels are low. Hopefully now with an increase in my theophilline tablets and regular checks on levels I'll be able to get a bit better control... now the question is why did my consultant never check my levels ???!!! How glad I am to be with a new and very helpful doctors surgery !

    Thanks for your advice.

    love Fi x

  • one thing to say is that theophylline is now thought to work in 2 different ways - on ea t low doses (ie low blood levels) and the other at higher levels. THey therefore use it in lower dose often to avoid side effects but still get clinically useful improvements. It may have been that your consultant was aiming for a lower than the range level previously, although if you are less well it may still be worth increasing it.

  • Theophylline in its many forms have wo ways of working when your levels are higher and theraputic its a broncodilator that opens up your airways and when levels lower its still works as it then has an anti imflamatory effect, so your levels are a more effective in telling if your are toxic as this is highly dangerous, and otherwise its more on syptom control for how effective it is for you.

    Love Andrea xxx

  • Theophylline in its many forms have wo ways of working when your levels are higher and theraputic its a broncodilator that opens up your airways and when levels lower its still works as it then has an anti imflamatory effect, so your levels are a more effective in telling if your are toxic as this is highly dangerous, and otherwise its more on syptom control for how effective it is for you.

    Love Andrea xxx

  • Theophylline in its many forms have wo ways of working when your levels are higher and theraputic its a broncodilator that opens up your airways and when levels lower its still works as it then has an anti imflamatory effect, so your levels are a more effective in telling if your are toxic as this is highly dangerous, and otherwise its more on syptom control for how effective it is for you.

    Love Andrea xxx

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