Comparison of Once-Daily Evening Versus Morning Sustained-Release Theophylline Dosing For Nocturnal Asthma

Eight diurnally active (∼0730-1100hr) adults (41-61 yr) suffering from nocturnal asthma volunteered for a double-blind, cross-over randomized study of a once-daily dosing (600-900 mg/24hr) of Armophylline® (Rorer s.a., France), a sustained-release theophylline given either at 0800 hr or 2000 hr for 8-day durations. Study variables monitored daily were: (a) self-measured peak expiratory flow (PEF), heart rate, oral temperature and self-rated fatigue checked every 2hr during the waking span as well as upon spontaneous nocturnal awakenings and (b) duration and subjective characteristics of sleep rated every morning. In addition, serum theophylline concentration (STC) plus the variables in (a) were sampled every 2hr during the 24 hr of the eighth day of each timed treatment span. Rxat 0800 hr was associated with a nocturnal dip in PEF of 20 ± 2.8% (X± S.E.M.) from the level achieved at the time of the diurnal crest; Rxat 2000 hr moderated the nocturnal fall; it was only 10 ±2.1% and within the physiologic limits of non-asthmatic persons. The STC peak height (Cmax) was greater (p