What is the positioning of Theophylline in asthma management?

Theophylline is positioned as an alternative option in asthma management particularly when there are concerns related to cost or a patient's aversion to inhaled medications. Theophylline, a methylxanthine, acts as a bronchodilator and has anti-inflammatory properties, which can aid in asthma control.

While it is not a first-line treatment due to the availability of more effective and better-tolerated options such as inhaled corticosteroids and long-acting beta-agonists, it can serve as a valuable adjunct therapy. In cases where patients may not prefer inhaled drugs (for reasons such as fear of using inhalers, difficulty with inhaler technique, or other personal preferences) or where economic factors make inhaled therapies less accessible, theophylline can be used as a suitable alternative.

Moreover, it is important to manage the dosing and monitor serum levels due to its narrow therapeutic index, ensuring that efficacy is achieved without reaching toxic levels. Theophylline is not reserved solely for emergencies nor is it considered to have no role in therapy; it still plays a significant role in certain scenarios depending on the individual needs of the patient.