Caffeine citrate is a central nervous system stimulant drug that was approved for medical use on 21st September 1999. It is primarily used in the treatment of apnea in premature infants, as it helps stimulate breathing.

Caffeine citrate is used primarily to treat apnea of prematurity in newborns, particularly premature infants. It helps stimulate the central nervous system to promote regular breathing patterns and prevent respiratory issues.

Caffeine citrate is administered either as an oral solution or as an injection. For oral administration, the usual dose is based on the infant's weight, typically starting with a loading dose followed by maintenance doses. For injection, it is usually given intravenously, with similar dosing protocols involving a loading dose followed by maintenance doses, depending on the patient's response. The exact dosage and frequency are determined by the healthcare provider based on the infant's condition and weight. Both forms should be administered under medical supervision.

Side effects are unwanted symptoms caused by medicines. Although all drugs can cause side effects, not everyone experiences them.

Common side effects of Caffeine citrate:

• Irritability
• Restlessness
• Jitteriness
• Feeding intolerance
• Increased gastric aspirate
• Tachycardia
• Increased urine flow rate
• Rash
• Dry skin

Serious side effects of Caffeine citrate:

• Necrotizing enterocolitis
• Cerebral hemorrhage
• Sepsis
• Kidney failure
• Acidosis
• Disseminated intravascular coagulation

• Necrotizing Enterocolitis: Use with caution as it has been associated with a higher risk, particularly in preterm infants. Monitor for signs of this condition.
• Seizures: Use with caution in infants with seizure disorders due to the risk of caffeine overdose causing seizures.
• Cardiovascular Disease: Caffeine increases heart rate and stroke volume; use with caution in infants with cardiovascular conditions.
• Renal and Hepatic Impairment: Administer with caution in infants with impaired renal or hepatic function and monitor caffeine serum levels to avoid toxicity.
• Caffeine Toxicity: Monitor caffeine serum levels to prevent toxicity, especially if levels exceed 50 mg/L.
• Use in Preterm Infants: Carefully assess and rule out other causes of apnea before using caffeine citrate for apnea of prematurity.

Caffeine citrate should only be used for apnea of prematurity after other possible causes like brain disorders, anaemia, or infections have been ruled out. It should be used carefully in infants with a history of seizures, as too much caffeine can trigger seizures. Infants with heart, kidney, or liver problems need special care, and caffeine levels should be checked to avoid toxicity. Also, infants who were treated with theophylline or whose mothers consumed caffeine during pregnancy should have their caffeine levels tested before starting treatment.

Caffeine citrate should be carefully monitored, especially in infants with seizure disorders or cardiovascular issues. Always assess the infant’s renal and hepatic function before starting treatment. Regular monitoring of caffeine serum levels and glucose is recommended during treatment to avoid potential toxic effects.

1. KD Tripathi, Essentials of Medical Pharmacology, CNS stimulants and cognition enhancers7th edition, 2013, 488

2. Abdel-Hady H, Nasef N, Shabaan AE, Nour I. Caffeine therapy in preterm infants.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4637812/

3. Evans J, Richards JR, Battisti AS. Caffeine. [Updated 2024 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519490/

4. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/020793s019lbl.pdf

5. https://www.ema.europa.eu/en/documents/product-information/peyona-epar-product-information_en.pdf

The drug information on this page is not a substitute for medical advice. It is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you are eligible to receive this treatment.