Variable | Weight-adjusted and maximal dose | Comments | Adjustment to dose |
Initial dose | ~10 mg/kg of body weight/day; maximum, 300 mg/day | If initial dose is tolerated, increase the dose no sooner than 3 days later to the first dose increase. | |
First dose increase | ~13 mg/kg/day; maximum 450 mg/day | If the first dose increase is tolerated, increase the dose no sooner than 3 days later to the second dose increase. | |
Second dose increase | ~16 mg/kg/day; maximum 600 mg/day | Measure the peak serum concentration after at least 3 days at the highest tolerated dose¶. | |
Serum theophylline concentration (µg/mL) | |
<10 | | | Increase approximately 25 percent. |
10 to 15 | | | Maintain dose if tolerated. |
15.1 to 19.9 | | | Consider a reduction of approximately 10 percent. |
20 to 25 | | | Withhold next dose, then resume treatment with next lower dose level. |
>25 | | | Withhold next 2 doses, then resume treatment with initial dose or lower dose. |