Adult Dosing

• Adult dosing is currently unavailable or not applicable for this drug

Pediatric Dosing

Apnea of prematurity

• Loading dose: 20 mg/kg IV or 1 mL/kg IV x 1 over 30 mins
• Maintenance Dose: 5 mg/kg IV or 0.25 mL/kg IV over 10 mins q24 hrs

• The dose of caffeine base is one half the dose when expressed as caffeine citrate
• Measure baseline caffeine levels prior to initiation of caffeine citrate in infants previously treated with theophylline or infants born to mothers who consumed caffeine prior to delivery
• Serious caffeine toxicity is associated with serum levels greater than 50 mg/L

[Outline]

• Adult Dosing
• Pediatric Dosing

• Short term treatment of apnea of prematurity in infants between 28 and <33 weeks gestational age

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustments

• Renal impairment: Use cautiously, dose adjustments not defined

Hepatic Dose Adjustments

• Hepatic impairment: Use cautiously, dose adjustments not defined

• Measure baseline caffeine levels prior to initiation of caffeine citrate in infants previously treated with theophylline as preterm infants metabolize theophylline to caffeine and also in infants born to mothers who consumed caffeine prior to delivery, since caffeine readily crosses the placenta. Also measure it periodically during the treatment to avoid toxicity
• Necrotizing enterocolitis sometimes fatal can develop in infants receiving caffeine citrate, carefully monitor all the infants on caffeine citrate therapy
• Other causes of apnea like central nervous system disorders, primary lung disease, anemia, sepsis, metabolic disturbances, cardiovascular abnormalities, or obstructive apnea should be ruled out or properly treated prior to initiation of caffeine citrate
• Caffeine is a central nervous system stimulant and overdosage can cause seizures, use cautiously in infants with seizure disorders
• The safety and efficacy of caffeine citrate for longer period and for prophylactic treatment of sudden infant death syndrome (SIDS) or prior to extubation in mechanically ventilated infants have not been established
• As per published data caffeine increase heart rate, left ventricular output, and stroke volume, therefore use cautiously in infants with cardiovascular disease

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Seizure disorders
• Cardiovascular diseases

Pregnancy Category:C

Breastfeeding: Adverse events like fussiness, jitteriness and poor sleep patterns have been reported in the infants of mothers with very high caffeine intakes equivalent to 10 or more cups of coffee daily. No stimulatory effects found on infants 3 wks were observed in mothers taking 5 cups of coffee daily. Preterm and younger newborn infants metabolize caffeine very slowly and may have serum levels of caffeine and other active caffeine metabolites similar to their mothers. Decreased breastmilk iron concentrations causing mild iron deficiency anemia in some breastfed infants may occur on intake of >450 mL of coffee. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 4 February 2011).

• CNS: Cerebral hemorrhage, seizures, irritability, restlessness, jitteriness
• CVS: Tachycardia, increased left ventricular output, increased stroke volume
• RESP: Dyspnea, lung edema
• GI: Necrotizing Enterocolitis, gastrointestinal hemorrhage, gastritis, vomiting
• HEMA: Disseminated intravascular coagulation
• METABOLIC: Acidosis
• DERM: Dry skin, rash, skin breakdown
• EENT: Retinopathy of prematurity
• GU: Renal failure
• MISC: Accidental injury, feeding intolerance, sepsis, abnormal healing

• Central Nervous System Stimulants; Caffeine stimulates medullary, vagal, vasomotor, and respiratory centers, promoting bradycardia, vasoconstriction, and increased respiratory rate, by increasing intracellular cyclic 3',5'-adenosine monophosphate (cyclic AMP) following inhibition of phosphodiesterase, the enzyme that degrades cyclic AMP
• Metabolized by liver; CYP450: 1A2 substrate
• Renally excreted (1% unchanged in adults and 86% unchanged in neonates)
• Half life
• Neonates: 3-4 days
• Adults: 5 hrs

US Trade Name(s)

• Cafcit

US Availability

caffeine citrate (generic)

• INJ: 20 mg/mL (10 mg base/mL ) [3 mL vial]

Cafcit

• INJ: 20 mg/mL (10 mg base/mL ) [3 mL vial]

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Psychiatric

CNS Stimulants

Pulmonary

Respiratory Stimulants