A comparative study of efficacy and tolerability of doxofylline over other methylxanthenes in mild to moderate persistent bronchial asthma patients in a tertiary care hospital

Satyendra K. Alladi, Imran Khan


Background: Studies have shown that doxofylline is endowed with a remarkable bronchodilator activity with less extra respiratory effects than other methylxanthines. To compare the efficacy and tolerability of doxofylline over other methylxanthines in mild to moderate persistent bronchial Asthma patients.

Methods: It is a comparative study conducted in patients of mild to moderate persistent bronchial Asthma in the outpatient department of regional chest hospital. The subjects were randomly assigned into 2 groups, one group treated with oral doxofylline and the other with theophylline oral or Deriphylline. Efficacy was measured objectively using spirometric parameters like FEV1 (Forced Expiratory Volume at the end of 1 second), FVC (Forced Vital Capacity), FEV1/FVC and PEFR (Peak Expiratory flow Rate), Subjectively by the Asthma control test questionnaire, subjective rating of Asthma control and the need for use of rescue medications like β2 agonists in the previous four weeks. Tolerability were done at base line and at the end of study.

Results: Doxofylline compared to other methylxanthines groups was statistically better with respect to subjective parameters like Asthma control tests questionnaire, subjective rating of Asthma control. Doxofylline had equal efficacy with spirometric parameters compared to other methylxanthines. Doxofylline was significantly better tolerated with adverse drug reactions noted in 10% compared to 28% in other methylxanthins group.

Conclusions: Doxofylline with better tolerability profile and equivalent efficacy seemed to be a good alternative to other methylxanthines in the treatment of bronchial Asthma.


Bronchial asthma, Doxofylline, Efficacy, Methylxanthines, Tolerability

Full Text:



Global strategy for asthma management and prevention, global initiative for asthma (GINA) revised asthma guidelines; May 2014. Available at: Accessed 2nd July 2015

Rai SP, Patil AP, Vardhan V, Marwah V, Pethe M. Pandey IM Best Treatment Guidelines for bronchial asthma MJAFI. 2007:63:264-8.

Goodman and gilman’s the Pharmacological basis of therapeutics 12th Ed; Mc graw hill Newyork; 2011:031-1067.

Bar ne PJ. Pauwels RA. Theophylline in the management of asthma, time for appraisal? Eur Respir J. 1994:7:579-91.

Aggarwal AN, Chaudhry K, Chhabra SK, D Souza GA, Gupta D, Jindal SK, et al. Prevalence and risk factors for bronchial asthma in Indian adults: a multicentre study. Indian Journal of Chest Diseases and Allied Sciences. 2006 Jan 18;48(1):13.

Patel YA, Patel P, Bavadia H, Dave J, Tripathi CB. A randomized, open labeled comparative study to assess the efficacy and safety of controller medications as add on to inhaled corticosteroid and long - acting β2 agonist in the treatment of moderate - to - severe persistent asthma. J Postgradu Med. October-December 2010:56:270-4.

Lai CK, Ko FW, Bhome A, De Guia TS, Wong GW, Zainudin BM, et al. Relationship between asthma control status, the Asthma Control Test™ and urgent health‐care utilization in Asia. Respirology. 2011 May;16(4):688-97.

Dolcetti A, Osella D, de Fillippis G. Comparison of intravenously administered doxofylline and placebo for the treatment of severe acute airways obstruction. J Int Med Res. 1988:16:264-9.

Melillo G, Balzano G, Jodice F. Treatment of reversible chronic airways obstruction with doxofylline compared with slow - release theophylline. A double blind randomized multicentre trail, Int J clin Pharm Res. 1989:9;397-405.

Bossi R, Berni F. A double - blind multi center trail on efficacy and tolerability of doxofylline vs aminophylline in patients with chronic airway obstruction and reversible broncospasm. Ital J Che Disea. 1989:43:355-60.

Dini FL, Chronotropic and arrhythmogenic effects of two methylxanthine bronchodilators, doxofylline and theophylline, evaluated by Holter Monitoring Curr Ther Res. 1991:49:978-84.

Lazzaroni M, Grossi E, Porro GB. The effect of intravenous doxofylline or aminophylline on gastric secretion in duodenal ulcer patients. Alimentary pharmacology & therapeutics. 1990 Dec;4(6):643-9.

Sacco C, Braghiroli A, GrossiE, Donner CF. The effects of doxofylline versus theophylline on sleep architecture in COPD pts. Monaldi Arch chest Dis. 1995;50;98-103.