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The Taste and Smell Clinic

November 2017

Comparison of Oral with Intranasal Treatment of Hyposmia


We have demonstrated efficacy of both oral and intranasal theophylline to treat smell loss (hyposmia). While both modes of treatment are effective, treatment methods are quite different for each mode of drug administration.

DOSE

Oral Theophylline: 200-800 mg of theophylline is necessary to improve hyposmia
Intranasal Theophylline: 20-80 g of theophylline is sufficient to improve hyposmia

TREATMENT LENGTH

Oral Theophylline: treatment requires continual drug use for 2-8 months in order to improve hyposmia
Intranasal Theophylline: improvement of hyposmia usually occurs after 2-8 weeks of treatment

BLOOD LEVELS

Oral Theophylline: serum drug levels of 2-20 mg/dL are necessary to improve hyposmia
Intranasal Theophylline: serum levels of theophylline are not measureable when hyposmia is improved

SIDE EFFECTS

Oral Theophylline: drug administration can induce multiple and severe side effects tachycardia, cardiac palpitations, gastrointestinal upset, sleep disturbances, excitability.
Intranasal Theophylline: no side effects except occasional nasal irritation

CONCLUSION

Based upon these observations treatment with intranasal theophylline is superior to treatment with oral theophylline.