Caffeine

DEA Class; Rx, OTC

Common Brand Names; Cafcit, NoDoz, ReCharge, Vivarin

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).

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