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Caffeine

    DEA Class; Rx, OTC

    Common Brand Names; Cafcit, NoDoz, ReCharge, Vivarin

    • Respiratory Stimulants; 
    • Stimulants; 
    • Phosphodiesterase Enzyme Inhibitors, Nonselective

    Natural xanthine derivative; often combined with analgesics for the treatment of headache; used as a CNS and respiratory stimulant or mild diuretic; for prescription use for apnea of prematurity in neonates where caffeine is preferred over theophylline due to caffeine’s wide therapeutic window.

    Indicated for the treatment of neonatal apnea (i.e., apnea of prematurity).

    For the treatment of postdural lumbar puncture headache.
    For extubation facilitation.

    Hypersensitivity

    Tachycardia

    Palpitations (dose dependent)

    Insomnia

    Irritability

    Nervousness

    Restlessness

    Tremor

    Tinnitus

    Regular and decaffeinated coffee increase gastric acid & pepsin secretion

    Nausea

    Vominting

    Diarrhea

    Diuresis

    Withdrawal symptoms

    • Anxiety
    • depression
    • Fatigue
    • Headache (can last up to 7 days)
    • Muscle tension
    • Nausea
    • Runny nose

    May increase severity of fibrocystic breast disease, PMS, increase risk of bladder, ovary, colon & pancreatic cancer

    Carefully monitor for the development of necrotizing enterocolitis

    Not for use in patients with anxiety, agitation, or tremor

    Caution in patients with history of peptic ulcer, hepatic impairment, renal impairment, seizure disorder, or cardiovascular disease

    Avoid use in symptomatic arrhythmias and/or palpitations

    Administer therapy with caution in infants with impaired renal or hepatic function; serum concentrations of caffeine should be monitored and dose adjusted to avoid toxicity in this population; may need to monitor serum concentrations of caffeine periodically throughout treatment to avoid toxicity

    See Caffeine OD for caffeine content of specific foods & drinks

    Pregnancy Category: C (crosses placenta, can remain in fetus/neonate 64-300 hr)

    Lactation: enters breast milk; use with caution

    Adults

    1200 mg/day PO has been suggested.

    Geriatric

    1200 mg/day PO has been suggested.

    Adolescents

    1200 mg/day PO has been suggested.

    Children

    < 12 years: Maximum dosage information is not available.
    12 years: 1200 mg/day PO has been suggested.

    Infants

    Caffeine base 2.5—5 mg/kg/day PO or IV for maintenance dosage.

    Neonates

    Caffeine base 2.5—5 mg/kg/day PO or IV for maintenance dosage.

    Caffeine citrate

    injectable solution

    • 20mg/mL

    oral solution

    • 20mg/mL

    tablets

    • 200mg

    capsules

    • 200mg

    lozenges

    • 75mg