The effect of adding slow release nifedipine to oral theophylline has been studied in eight patients with stable but symptomatic asthma, a double blind placebo controlled crossover protocol being used. No change in asthma control occurred during the nifedipine treatment period as assessed by serial peak flow measurements and symptom scores. Serum theophylline concentrations were significantly lower after nifedipine than after placebo (6-8 v 9-7 g/ml) and in three patients were well below the therapeutic range ( < 4 jg/ml).Although calcium antagonists reduce bronchoconstriction induced by exercise, histamine, and antigen, resting airway calibre is not altered to any great extent.' They may, however, have a beneficial effect when combined with other treatment for asthma. Nifedipine potentiates the bronchodilator effect of inhaled salbutamol2 and intravenous terbutaline3 in acute studies in asthmatic subjects and it enhances the airways smooth muscle relaxation induced by theophylline4 in isolated guinea pig trachea. We have studied asthma control in a group of patients with stable but symptomatic asthma when nifedipine was added for two weeks to their usual asthma treatment, which included theophylline.Several drugs are known to influence theophylline pharmacokinetics' and these are important clinically in view of the narrow therapeutic range of theophylline. Nifedipine is widely used to treat angina and hypertension in asthmatic patients, in whom / adrenoceptor antagonists are contraindicated. We have therefore evaluated the effect of nifedipine on serum theophylline concentrations.
MethodsWe recruited 10 patients (six male, four female), with a mean age of 56 (range 49-70) years and with stable but symptomatic asthma. All gave informed consent to participation in the study, which had been