Symbolic image representing improved breathing capacity in COPD.

Theophylline: Can This Old Drug Help COPD Patients Breathe Easier?

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"A pilot study explores the potential of theophylline to improve exercise capacity in COPD patients already on combination inhaler therapy."

Chronic Obstructive Pulmonary Disease (COPD) significantly limits lung function and exercise capacity, impacting daily life even with modern inhaler treatments. Long-acting bronchodilators, a combination of anticholinergics and beta-agonists, have become the standard, yet many individuals still struggle with breathlessness and fatigue.

Theophylline, a medication used for decades, presents a potential solution. It's known to improve lung function and exercise performance, and because it's affordable and easy to administer, scientists have wondered whether the drug can help COPD patients. However, studies on theophylline's effectiveness have yielded mixed results.

A recent pilot study published in the International Journal of COPD aimed to clarify the role of theophylline. Researchers investigated whether adding theophylline to the existing treatment plans of COPD patients using combination inhalers could further enhance their exercise capacity and overall lung function. This article breaks down the study's findings, explores their implications, and discusses what they mean for people living with COPD.

The Study: Theophylline's Impact on Exercise Capacity

Symbolic image representing improved breathing capacity in COPD.

The study, a randomized, double-blind, placebo-controlled trial, involved 24 COPD patients already using long-acting inhaled beta-agonists and anticholinergic bronchodilators. Participants were divided into two groups: one received theophylline, and the other received a placebo, both over four weeks.

Researchers then assessed lung function and exercise duration using a constant load exercise test – how long participants could cycle at a set intensity. The primary goal was to measure the percentage change in exercise duration between the start and end of the four-week period. Secondary measures included lung function tests, changes in breathlessness, and overall exercise responses.

Exercise Capacity: The theophylline group showed a 26.1% improvement in exercise duration compared to the placebo group. While this indicates a trend, it wasn't statistically significant.
Clinically Meaningful Improvement: Four out of ten patients on theophylline had an improvement exceeding 33% – considered the minimum clinically important difference – compared to only one in the placebo group.
Peak Ventilation: The theophylline group experienced an 11.1% reduction in peak ventilation, which could suggest improved gas exchange efficiency during exercise.
Lung Function & Breathlessness: No significant differences were observed in resting lung function or measures of dyspnea (breathlessness) between the two groups.

The study indicated that theophylline was associated with a trend toward increased exercise duration and improved ventilatory efficiency, but this trend wasn't statistically significant. This means that while the data hints at a benefit, the study couldn't definitively prove theophylline was the direct cause.

The Bottom Line: Is Theophylline Right for You?

While the study didn't yield definitive proof, it does suggest theophylline might offer some benefits for certain COPD patients already using combination inhalers. Specifically, the improvements in exercise capacity were of high interest. Larger trials are necessary to confirm this, as well as assess the likelihood of any adverse effects.

The researchers propose that a larger study, with 45 subjects in each arm, would be needed to detect a significant change in exercise duration. More research would also clarify which COPD patients are most likely to benefit from the medication.

If you're living with COPD and still experiencing limitations despite using inhalers, discuss these findings with your doctor. Theophylline might be a potential add-on therapy, but it's crucial to weigh the potential benefits against the risks and consider your individual circumstances. Don't make any changes to your treatment plan without professional medical advice.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/copd.s29990, Alternate LINK

Title: Effect Of Theophylline On Exercise Capacity In Copd Patients Treated With Combination Long-Acting Bronchodilator Therapy: A Pilot Study

Subject: Public Health, Environmental and Occupational Health

Journal: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Informa UK Limited

Authors: Nha Voduc, Alvarez, Amjadi, Tessier, Sabri, Aaron

Published: 2012-03-01

Everything You Need To Know

What is the purpose of theophylline in the context of COPD treatment?

Theophylline is an older medication that has been investigated for its potential to improve lung function and exercise capacity in Chronic Obstructive Pulmonary Disease (COPD) patients. In this context, it acts as a potential add-on therapy for individuals already using combination inhalers, specifically long-acting bronchodilators like anticholinergics and beta-agonists, which are the standard treatment. The study's focus was on determining if theophylline could further improve exercise capacity and overall lung function for those patients. This is significant because, despite the availability of combination inhalers, many COPD patients still experience breathlessness and limitations in their daily activities.

Why is exercise capacity important for people with COPD?

The significance of exercise capacity in COPD patients is immense. COPD severely restricts lung function, leading to breathlessness and reduced ability to perform physical activities. Combination inhalers, including long-acting bronchodilators (anticholinergics and beta-agonists), aim to alleviate this. However, many patients continue to struggle. Therefore, any treatment that improves exercise capacity, such as theophylline, can significantly enhance a patient's quality of life by allowing them to do more with less breathlessness, and improving their overall physical function and endurance.

What are the implications of the study's findings regarding theophylline?

The study's implications regarding theophylline are multifaceted. Although the results did not achieve statistical significance, they showed a trend toward improved exercise duration with theophylline use. Furthermore, the fact that some patients showed clinically meaningful improvement (over 33% increase in exercise duration) is encouraging. The reduction in peak ventilation in the theophylline group also hints at enhanced gas exchange efficiency. However, it also underscores the need for larger trials. The study suggests that theophylline *might* be beneficial for some COPD patients. However, more definitive data is needed to confirm its effectiveness and assess potential side effects before widespread use.

What were the key differences observed between the theophylline and placebo groups in the study?

The primary difference observed was in exercise duration, where the theophylline group exhibited a 26.1% improvement compared to the placebo group. While this did not reach statistical significance, it indicated a positive trend. Moreover, a notable proportion of patients in the theophylline group experienced a clinically meaningful improvement (exceeding 33%) in exercise capacity, in contrast to the placebo group. Also, the theophylline group experienced a reduction in peak ventilation. The study found no significant differences in resting lung function or breathlessness.

If I have COPD and use combination inhalers, should I consider theophylline?

If you're a COPD patient currently using combination inhalers, theophylline could be a potential consideration. However, it's crucial to understand the study's limitations and the need for more extensive research. The study's findings suggest a possibility of improved exercise capacity, but the results are not definitive. Discuss the potential benefits and risks of theophylline with your doctor, who can assess your specific situation, consider your overall health, and determine if theophylline is appropriate for you. They can also monitor for any adverse effects and discuss any other treatments to manage your COPD.