caffeine (Cafcit, NoDoz, ReCharge, Vivarin)
Classes: Stimulants; Respiratory Stimulants; Phosphodiesterase Enzyme Inhibitors, Nonselective
Dosing and uses of Cafcit, NoDoz (caffeine)
Adult dosage forms and strengths
injectable solution
- 20mg/mL
oral solution
- 20mg/mL
tablets
- 200mg
capsules
- 200mg
lozenges
- 75mg
Fatigue & Drowsiness
100-200 mg PO q3-4hr; not later than 6 hours before bedtime
Respiratory Failure
Caffeine and sodium benzoate: 250 mg IV/IM once; may repeat PRN; alternatively, 500 mg in 1 L IV over 4 hr; not to exceed 2500 mg/24hr
CAUTION: Use strongly discouraged
Stimulant Diuretic (Off-label)
500 mg IV/IM; 1 g maximum single dose
Pediatric dosage forms and strengths
injectable solution
- 10mg/mL
oral solution
- 10mg/mL
tablets
- 200mg
capsules
- 200mg
lozenges
- 75mg
Drowsiness or Fatigue
< 12 years: Not recommended
>12 years: 100-200 mg PO q3-4hr; not later than 6 hours before bedtime
Potential toxic dose <6 years old: 15 mg/kg
Neonatal Apnea
Load: 10-20 mg/kg IV/PO once
Maintenance: 5-10 mg/kg IV/PO qDay
Potential toxic dose <6 years old: 15 mg/kg
Cafcit, NoDoz (caffeine) adverse (side) effects
Frequency not defined
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
Warnings
Contraindications
Hypersensitivity
Cautions
May increase severity of fibrocystic breast disease, PMS, increase risk of bladder, ovary, colon & pancreatic cancer
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
See Caffeine OD for caffeine content of specific foods & drinks
Pregnancy and lactation
Pregnancy category: C (crosses placenta, can remain in fetus/neonate 64-300 hr)
Lactation: enters breast milk; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Cafcit, NoDoz (caffeine)
Mechanism of action
Methylxanthine; promotes cAMP accumulation by inhibiting phosphodiesterase; increases medullary respiratory center sensitivity to carbon dioxide; may prevent apnea by acting as an adenosine receptor antagonist
Pharmacokinetics
Half-Life: 72-96hr (neonates); 5 hr (>9 months and adults); decreased in tobacco user
Peak plasma time: 30-120 min
Peak plasma concentration: 1.5-1.8 mcg/mL
Protein Bound: 17-36%
Vd: 0.6-0.9 L/kg
Metabolism: hepatic CYP1A2
Excretion: Urine
