Caffedrine, Dexitac, NoDoz, Quick Pep, S-250, Tirend, Vivarin
CAFFEINE AND SODIUM BENZOATE
Classifications: respiratory and cerebral stimulant; xanthine; Therapeutic: respiratory and cerebral stimulant
Pregnancy Category: C
100 mg, 150 mg, 200 mg tablets; 200 mg capsules; 10 mg/mL caffeine citrate oral solution; 10 mg/mL caffeine citrate injection
Chief action is thought to be related to inhibition of the enzyme phosphodiesterase, which results in higher concentrations
of cyclic AMP. Releases epinephrine and norepinephrine from adrenal medulla, producing CNS stimulation. Small doses improve
psychic and sensory awareness and reduce drowsiness and fatigue by stimulating cerebral cortex. Higher doses stimulate medullary,
respiratory, vasomotor, and vagal centers. Produces smooth muscle relaxation by direct action on vascular musculature. Mild
diuretic action may result from increase in renal blood flow and glomerular filtration rate and decrease in renal tubular
reabsorption of sodium and water.
Effective in managing neonatal apnea, and as an adjuvant for pain control in headaches and following dural puncture. Relief
of headache is perhaps due to mild cerebral vasoconstriction action and increased vascular tone. It acts as a bronchodilator
Orally as a mild CNS stimulant to aid in staying awake and restoring mental alertness, and as an adjunct in narcotic and
nonnarcotic analgesia. Used parenterally as an emergency stimulant in acute circulatory failure, as a diuretic, and for
Topical treatment of atopic dermatitis; to releave spinal puncture headache.
Acute MI, symptomatic cardiac arrhythmias, palpitations; peptic ulcer; pulmonary disease; insomnia, panic attacks; pregnancy
(category C). Safe use in children not established.
Diabetes mellitus; hiatal hernia; psychotic disorders; dementia; depressive disorders; hepatic disease; hypertension with
Route & Dosage
Adult: PO 100200 mg q34h prn
Adult: IM 200500 mg prn
Apnea of Prematurity (Caffeine Citrate Only)
Neonate (2833 wk gestation): PO/IV 20 mg/kg (loading dose); then, after 24 h, 5 mg/kg/d
- Give sustained-release oral preparations not less than 6 h before bedtime.
- Ensure that timed-release form of drug is not chewed or crushed. It must be swallowed whole.
- Give deep IM into a large muscle.
- Note: IV route reserved for emergency situations only.
PREPARE: IV Infusion: May be diluted for infusion in D5W.
ADMINISTER: IV Infusion: A syringe infusion pump is recommended. Give loading dose over 30 min and maintenance dose over at least 10 min.
INCOMPATIBILITIES Y-site: Acyclovir, furosemide, lorazepam, nitroglycerin, oxacillin, pantoprazole.
Adverse Effects (≥1%)CV:
Tingling of face, flushing, palpitation, tachycardia, arrhythmia, angina, ventricular ectopic beats. GI:
Nausea, vomiting; epigastric discomfort, gastric irritation (oral form), diarrhea
, hematemesis, kernicterus (neonates). CNS: Nervousness, insomnia,
restlessness, irritability, confusion, agitation, fasciculations, delirium, twitching, tremors, clonic convulsions. Respiratory:
Tachypnea. Special Senses:
Scintillating scotomas, tinnitus. Urogenital:
Increased urination, diuresis.
Diagnostic Test Interference
Caffeine reportedly may interfere with diagnosis of pheochromocytoma or neuroblastoma by increasing urinary excretion of
catecholamines, VMA, and 5-HIAA and may cause false positive increases in serum urate (by Bittner method).
Increases effects of cimetidine;
increases cardiovascular stimulating effects of beta-adrenergic agonists
; possibly increases theophylline toxicity
1545 min. Distribution:
Widely throughout body; crosses blood-brain barrier and placenta. Metabolism:
In liver. Elimination:
In urine as metabolites; excreted in breast milk in small amounts. Half-Life:
35 h in adults, 36144 h in neonates.
Assessment & Drug Effects
- Monitor vital signs closely as large doses may cause intensification rather than reversal of severe drug-induced depressions.
- Observe children closely following administration as they are more susceptible than adults to the CNS effects of caffeine.
- Lab tests: Monitor blood glucose and HbA1c levels in diabetics.
Patient & Family Education
- Caffeine in large amounts may impair glucose tolerance in diabetics.
- Do not consume large amounts of caffeine as headache, dizziness, anxiety, irritability, nervousness, and muscle tension
may result from excessive use, as well as from abrupt withdrawal of coffee (or oral caffeine). Withdrawal symptoms usually
occur 1218 h following last coffee intake.