Oral aminophylline therapy. Increased dosage requirements in children

Abstract

While monitoring oral aminophylline (theophylline ethylenediamine) therapy [bronchial asthma in children and chronic obstructive lung disease in adults], larger doses (mg/kg) were necessary for children than for adults to achieve similar therapeutic serum levels. The mean apparent theophylline clearance (ATC) determined in 59 children was significantly higher (P < .001) than determined in 114 adults (84.8 vs. 51.4 ml/h per kg). Additionally, the younger children (1-9 yr) eliminated theophylline more rapidly than the older children (10-18 yr) (93.8 vs. 77.3 ml/h per kg). When initiating continuous oral aminophylline therapy, dosage guidelines, based on the mean ATC calculated for each group, were predicted, and trough theophylline serum levels of 10 .mu.g/ml were obtained. The guidelines for aminophylline were 28.0, 23.2 and 15.6 mg/kg per day administered in 4 divided doses for the younger children, older children and adults, respectively. Monitoring of serum levels is suggested to further individualize the patients aminophylline therapy.