See Supplemental Patient Information
- Measure baseline caffeine levels prior to initiation of caffeine citrate in infants previously treated with theophyllin 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
Supplemental Patient Information
- Parents/caregivers of patients receiving caffeine citrate oral solution should be instructed not to increase the dose of caffeine citrate oral solution without medical consultation if the baby continues to have apnea events
- Parents/caregivers should be instructed to consult the physician if the baby begins to demonstrate signs of gastrointestinal intolerance, such as abdominal distention, vomiting, or bloody stools, or seems lethargic
Pregnancy Category:C
Breastfeeding: Adverse event 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).
US Trade Name(s)
US Availability
caffeine citrate (generic)
- SOLN: 20 mg/mL (10 mg base/mL ) [3 mL vial]
- SOLN: 10 mg/mL (10 mg base/mL ) [3 mL vial]
Cafcit
- SOLN: 20 mg/mL (10 mg base/mL ) [3 mL vial]
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]
