What dose of theophylline is in 2ml of Deriphylline (theophylline) IV for an adult patient with asthma or COPD?

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Deriphylline IV 2ml Dose Information

Deriphylline IV 2ml typically contains 200mg of theophylline (aminophylline equivalent), as most standard IV formulations are concentrated at 100mg/ml, though you must verify the specific concentration on your product label as formulations vary by manufacturer.

Standard IV Theophylline Concentrations

  • Most IV theophylline/aminophylline preparations are formulated at 25mg/ml (aminophylline) or 100mg/ml (theophylline), meaning 2ml would contain either 50mg or 200mg depending on the specific product 1, 2
  • You must check your specific vial concentration before administration - this is critical given theophylline's narrow therapeutic window and risk of toxicity at levels >15 μg/L 1, 2

Target Therapeutic Levels

  • The therapeutic serum concentration target for theophylline is 5-15 μg/L (equivalent to 5-15 mg/L) for both asthma and COPD management 1, 2
  • Doses must be individualized based on serum concentration monitoring to maintain this narrow therapeutic window 1, 2, 3

IV Dosing Context for Acute Situations

  • For acute severe asthma in adults not currently on oral theophyllines, a typical loading dose of aminophylline is 250mg IV over 20 minutes 2
  • Never administer bolus aminophylline (250mg IV) to patients already taking oral theophyllines due to severe toxicity risk 2
  • IV magnesium sulfate 2g over 20 minutes is preferred over theophylline for severe refractory asthma in emergency settings 4

Critical Safety Considerations

  • Theophylline has significant toxicity risks including cardiac arrhythmias and seizures at supratherapeutic levels >15 μg/L 1, 3
  • Common side effects even at therapeutic levels include nausea (1.05-10.9% incidence), vomiting, gastroesophageal reflux, and headache 4, 1, 3
  • Hepatic metabolism via cytochrome P450 creates numerous drug interactions that can dramatically alter serum levels 4, 3

Clinical Positioning

  • Theophylline is reserved as add-on therapy for patients with severe COPD or asthma not controlled by optimal inhaled bronchodilator and corticosteroid therapy 1, 2, 5
  • Inhaled β2-agonists are strongly preferred over IV theophylline for acute bronchospasm, as there is no evidence of improved outcomes with IV theophylline compared to selective inhaled β-agonists 4

References

Guideline

Theophylline Dosing Guidelines for Asthma and COPD

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Theophylline Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Theophylline.

American journal of respiratory and critical care medicine, 2013

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

COPD Management Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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