Possible harms of theophylline in chronic obstructive pulmonary disease.

Data from large studies show that theophylline is still being prescribed for up to 35% of patients with chronic obstructive pulmonary disease (COPD) (1), although the currently valid guidelines define it as a third-line medication. The role of theophylline in the treatment of asthma and COPD has changed drastically in recent decades, primarily due to the introduction of new classes of substances—the long-acting bronchodilators (beta-2 sympathomimetics and anticholinergics) and inhaled steroids—with high efficacy and a more favorable side effect profile.