Review of the North American experience with evening administration of Uniphyl tablets, a once-daily theophylline preparation, in the treatment of nocturnal asthma.

Increasing awareness of the exaggerated circadian rhythm in bronchomotor tone that causes most asthmatic patients to have increased respiratory symptoms in the early morning has resulted in a search for dosing strategies that will provide maximal bronchodilatory activity at the time of reduced bronchial patency. The purpose of this paper is to review briefly the published data on the North American experience with evening administration of the once-daily theophylline preparation, Uniphyl tablets. An increasing body of data demonstrates that this regimen produces peak concentrations of theophylline in the blood during the early morning hours, the time of maximal benefit for patients with nocturnal asthma. These data also show that once-daily Uniphyl administered in the evening is superior to both a once-daily morning Uniphyl schedule and to a conventional twice-daily sustained-release theophylline preparation in reducing early morning bronchoconstriction and associated symptoms.