The place in therapy of theophylline MR is under review. The role of theophylline in the management of asthma and COPD has changed and become much more limited now that more effective, and safer treatments are available.  Therapeutic drug monitoring is required in patients on theophylline, which further limits its usefulness. Recent national guidance emphasises the need for organisations to ensure they have management systems in place to support the safe use of this medicine.  It is not recommended that GPs initiate theophylline in primary care without seeking specialist advice.