The first-line bronchodilator treatment of asthma should be by inhalation of a β-adrenergic agonist. As second-line treatment oral theophylline and oral β2-agonists can be equally effective bronchodilators.1–3 Each drug causes unwanted effects in about 20% of patients but these differ for the two drugs.4 Since the two classes of drug have an additive bronchodilator effect, they can be used together in smaller doses, reducing some side effects but not efficacy. This article discusses the choice of an oral theophylline preparation.
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