A provider-focused update on the Theophylline XR shortage in 2026: current availability, prescribing implications, alternatives, and tools for patient access.
Theophylline extended-release products have experienced recurring supply disruptions affecting patient access nationwide. While theophylline's role in respiratory management has narrowed over the past two decades — largely replaced by inhaled therapies — a significant cohort of patients with asthma and COPD remain on stable theophylline regimens. For these patients, interruptions in supply pose meaningful clinical risk.
This briefing summarizes the current state of Theophylline XR availability, the factors driving supply constraints, prescribing considerations during shortage periods, and tools to help your patients maintain access.
The supply landscape for theophylline has been gradually contracting for over a decade:
The theophylline shortage creates several clinical considerations for prescribers:
Theophylline's narrow therapeutic window (target serum levels of 10-20 mcg/mL, with many guidelines now recommending 5-15 mcg/mL) means that formulation switches — even between generic extended-release products from different manufacturers — may alter drug release characteristics and serum levels. Any change in product should prompt:
When a patient's prescribed strength is unavailable, consider whether an equivalent total daily dose using a different tablet strength is feasible. For example:
However, once-daily and twice-daily formulations are not interchangeable — they have different release profiles. Confirm the available product's dosing interval before making adjustments.
When evaluating alternatives or adjusting theophylline therapy, review the patient's medication list carefully. Key interactions include:
As of early 2026, availability by strength:
Availability can change week to week. Tools like Medfinder for Providers allow real-time stock verification across pharmacy networks.
Theophylline remains among the most affordable respiratory medications:
For uninsured or underinsured patients, discount card programs (GoodRx, SingleCare) and patient assistance resources through NeedyMeds and RxAssist can further reduce out-of-pocket costs.
Medfinder for Providers enables you to verify pharmacy-level availability before writing or adjusting a prescription, reducing fill failures and patient frustration.
The FDA maintains a searchable Drug Shortage Database (accessdata.fda.gov/scripts/drugshortages) with manufacturer-reported availability estimates and expected resolution dates when available.
When theophylline cannot be continued, consider these alternatives based on indication:
For more detail, see our clinical guide to Theophylline XR alternatives.
The structural factors driving theophylline supply instability — few manufacturers, low margins, complex production requirements — are unlikely to resolve quickly. Providers should:
Theophylline XR occupies a unique niche in respiratory medicine — it's affordable, effective, and oral, making it a valuable option for patients who can't use or afford inhaled therapies. But its supply vulnerabilities require providers to stay informed and plan proactively.
Use Medfinder for Providers to check real-time availability, and keep lines of communication open with your patients about what to do if their pharmacy can't fill their prescription.
For related provider resources, see how to help patients find Theophylline XR in stock and how to help patients save money on Theophylline XR.
You focus on staying healthy. We'll handle the rest.
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