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caffeine citrate
generic
Adult Dosing .
Adult dosing is currently unavailable or not applicable for this drug.
Peds Dosing .
- Dosage forms: SOL: 20 mg per mL; INJ: various
Special Note
- [strength clarification]
- Info: 20 mg caffeine citrate = 10 mg caffeine base; doses expressed as caffeine citrate
apnea of prematurity
- [premature infants]
- Dose: 20 mg/kg/dose IV x1, then after 24h, 5 mg/kg/dose PO/IV q24h; Info: adjust dose based on serum levels
renal dosing
- [see below]
- renal impairment: no adjustment; Info: caution advised in premature neonates
- HD/PD: no adjustment; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: renal impairment (premature neonates)
- caution: hepatic impairment
- caution: cardiovascular dz
- caution: seizure disorder
Drug Interactions .
Overview
caffeine citrate
stimulant
- CYP1A2 substrate
- CYP1A2 inhibitor, moderate
- hypertensive effects
- tachycardia
Contraindicated
- fezolinetant
Avoid/Use Alternative
- alosetron
- aminophylline
- bendamustine
- ephedra
- furosemide
- methotrexate
- midodrine
- pirfenidone
- theophylline
- tizanidine
Monitor/Modify Tx
- abiraterone acetate
- acebutolol
- acyclovir
- adenosine
- albendazole
- albuterol
- albuterol inhaled
- aliskiren
- allopurinol
- almotriptan
- amitriptyline
- amlodipine
- amoxapine
- amphetamine
- angiotensin II
- arformoterol inhaled
- armodafinil
- asciminib
- atenolol
- atomoxetine
- atropine ophthalmic
- axitinib
- azilsartan medoxomil
- benazepril
- benzphetamine
- betamethasone
- betaxolol
- bevacizumab
- bisoprolol
- brigatinib
- budesonide
- bupropion
- butalbital
- cabozantinib
- caffeine
- cannabidiol
- cannabis
- capmatinib
- carbamazepine
- carfilzomib
- carvedilol
- celecoxib
- chlorthalidone
- cimetidine
- ciprofloxacin
- clevidipine
- clomipramine
- clonidine
- clozapine
- cocaine
- copanlisib
- corticotropin
- cortisone
- cyclosporine
- danazol
- danshen
- daprodustat
- darbepoetin alfa
- deferasirox
- deflazacort
- desipramine
- desmopressin
- desvenlafaxine
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- dihydroergotamine
- diltiazem
- disulfiram
- dobutamine
- dopamine
- doxapram
- doxazosin
- doxepin
- dronabinol
- droxidopa
- echinacea
- efavirenz
- eletriptan
- enasidenib
- enzalutamide
- ephedrine injection
- ephedrine oral
- epinephrine
- epoetin alfa
- erenumab
- ergotamine
- esketamine
- esmolol
- estetrol (contraceptive)
- estradiol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- ethinyl estradiol (contraceptive)
- ethinyl estradiol (hormone replacement)
- etodolac
- etrasimod
- famotidine
- felodipine
- fenfluramine
- fexinidazole
- fingolimod
- fludrocortisone
- flurbiprofen
- fluvoxamine
- formoterol inhaled
- fosphenytoin
- fostamatinib
- frovatriptan
- fruquintinib
- ginseng, Asian
- givosiran
- glecaprevir
- glycopyrrolate
- grape
- guanfacine
- hoodia
- hydralazine
- hydrochlorothiazide
- hydrocortisone
- hyoscyamine
- ibrutinib
- ibuprofen
- imipramine
- indomethacin
- interferon beta 1a
- interferon beta 1b
- iobenguane I 131
- irbesartan
- isocarboxazid
- isoproterenol
- ketamine
- ketorolac
- labetalol
- leflunomide
- leniolisib
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- levonordefrin
- licorice
- lidocaine
- lifileucel
- linezolid
- lisdexamfetamine
- lisinopril
- lopinavir/ritonavir
- lorlatinib
- losartan
- lumacaftor/ivacaftor
- luspatercept
- meloxicam
- meropenem
- methamphetamine
- methoxsalen
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylergonovine
- methylphenidate
- methylprednisolone
- metoclopramide
- metoprolol
- mexiletine
- milnacipran
- minoxidil
- mirabegron
- modafinil
- nadolol
- naphazoline ophthalmic
- naproxen
- naratriptan
- naxitamab
- nebivolol
- nelfinavir
- nicardipine
- nifedipine
- nilotinib
- niraparib
- norepinephrine
- nortriptyline
- obeticholic acid
- olodaterol inhaled
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pacritinib
- pazopanib
- peginterferon alfa 2a
- pentobarbital
- pentoxifylline
- pexidartinib
- phendimetrazine
- phenobarbital
- phentermine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- phenytoin
- pibrentasvir
- pindolol
- piroxicam
- pomalidomide
- ponatinib
- ponesimod
- pralsetinib
- prazosin
- prednisolone
- prednisone
- primidone
- propafenone
- propranolol
- protriptyline
- pseudoephedrine
- quetiapine
- quinapril
- ramucirumab
- rasagiline
- regorafenib
- rifampin
- ripretinib
- ritlecitinib
- ritonavir
- rizatriptan
- ropinirole
- rucaparib
- safinamide
- salmeterol inhaled
- selpercatinib
- siponimod
- sodium phenylbutyrate/taurursodiol
- solriamfetol
- somatropin
- sorafenib
- spironolactone
- St. John's wort
- stiripentol
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- telmisartan
- terazosin
- terbutaline
- teriflunomide
- testosterone
- timolol
- tipranavir
- tivozanib
- tolmetin
- trametinib
- triamcinolone
- triclabendazole
- trimipramine
- turmeric
- valacyclovir
- valproic acid
- valsartan
- vamorolone
- vandetanib
- vasopressin
- vemurafenib
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- voclosporin
- warfarin
- yohimbe
- zileuton
- ziv-aflibercept
- zolmitriptan
Caution Advised
- duloxetine
- melatonin
- ramelteon
- riluzole
- roflumilast
- roflumilast topical
Adverse Reactions .
Serious Reactions
- necrotizing enterocolitis
- sepsis
- hemorrhage
- GI bleeding
- cerebral hemorrhage
- DIC
- renal failure
- retinopathy of prematurity
- pulmonary edema
Common Reactions
- feeding intolerance
- rash
- sepsis
- necrotizing enterocolitis
- hemorrhage
- cerebral hemorrhage
- gastritis
- GI bleeding
- DIC
- renal failure
- acidosis
- dyspnea
- pulmonary edema
- abnormal healing
- xeroderma
- skin atrophy
- retinopathy of prematurity
- hypoglycemia
- hyperglycemia
Safety/Monitoring .
Therapeutic Drug Levels
5-25 mcg/mL; Toxic Levels: >50 mcg/mL; Timing: just before next dose; Info: baseline level if prior theophylline use or if born to mothers w/ caffeine use before delivery
Monitoring Parameters
serum drug levels; consider glucose
Pregnancy/Lactation .
Pregnancy
Clinical Summary
N/A; only indicated in peds pts
Lactation
Clinical Summary
N/A; only indicated in peds pts
Pharmacology .
Metabolism: liver; CYP450: 1A2 substrate; Info: 3-8% of caffeine converted to theophylline; limited metabolism in premature neonates
Excretion: urine (1% unchanged in adults, 86% unchanged in neonates); Half-life: 5h (pts 9 mo and older), 3-4 days (neonates)
Subclass: Methylxanthines, Pulmonary ; Respiratory Stimulants, Central
Mechanism of Action
exact mechanism of action in apnea of prematurity unknown; antagonizes adenosine A1 and A2 receptors (methylxanthine)
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: generic
DEA/FDA: Rx
Approximate Retail Price
from http://www.goodrx.com/caffeine-citrate
intravenous solution:
- 20 mg/mL (40 vial, 3 mL): $342.00
oral liquid:
- 20 mg/mL (10 bottle of oral solution, 3 mL): $105.00
oral liquid:
- 20 mg/mL (40 vial, 3 mL): $342.00
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