Caffeine Citrate Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Caffeine Citrate Tablet contains caffeine, a xanthine derivative and central nervous system stimulant. It is mainly used in hospitals to treat breathing pauses (apnea) in premature babies, while caffeine is also combined with acetaminophen and codeine in tablets for pain relief. It works by blocking adenosine receptors in the brain to stimulate the central nervous system and breathing center.

What is Caffeine Citrate Tablet

Caffeine citrate is a stimulant medicine that acts on the central nervous system. It is a citrate salt form of caffeine, which is naturally found in coffee, tea, and cacao. It is mainly used in hospitals to treat breathing pauses (apnea) in premature babies, but caffeine itself is also combined with other pain relievers in some tablets.

Caffeine Citrate Tablet uses

• Treatment of apnea of prematurity (breathing pauses) in premature infants, given in hospital under medical supervision
• Combined with acetaminophen and codeine in tablets used for relief of mild to moderate pain such as headache, dental pain, muscle pain, rheumatic pain, menstrual pain, and fever discomfort from colds or flu

Benefits of Caffeine Citrate Tablet

• Reduces the frequency of apnea (breathing pause) episodes in premature infants
• May improve long-term neurodevelopmental outcomes in premature infants
• Helps increase alertness and reduce drowsiness
• Provides a mild diuretic effect

How Caffeine Citrate Tablet works

Caffeine works by blocking adenosine receptors in the brain. Adenosine is a natural substance that promotes sleep and slows down brain activity. By blocking it, caffeine stimulates the central nervous system, including the brain's breathing center, which helps reduce pauses in breathing in premature babies.

Caffeine Citrate Tablet dosage

When part of a combination tablet with acetaminophen and codeine, the tablet must be swallowed whole and should not be cut, broken, crushed, chewed, or dissolved. This combination tablet may be taken with or without food, with a glass of water. Dosing for the combination tablet should be on an as-needed basis every 4 to 6 hours, not on a fixed schedule. If a dose of the combination tablet is missed, take it as soon as possible, but skip it if it is almost time for the next dose; do not double up doses.

When caffeine citrate is used for premature infants, it is given in hospital by slow injection or by mouth (such as through a feeding tube), under supervision of a doctor experienced in newborn intensive care.

Use exactly as prescribed by your doctor or pharmacist.

Available forms and strengths

• Injection solution (for intravenous use in infants)
• Oral solution (for infants)

Side effects of Caffeine Citrate Tablet

Common

• Feeding intolerance and irritability (in infants)
• Nausea and vomiting
• Jitteriness or restlessness
• Increased heart rate (tachycardia)
• Insomnia or trouble sleeping
• Headache
• Increased urination (diuretic effect)
• Dry mouth
• Constipation (when combined with codeine)
• Drowsiness or dizziness (when combined with codeine)

Serious

• Seizures (rare)
• Irregular heartbeat (arrhythmia)
• Severe allergic reactions such as swelling of the face, lips, or throat, or difficulty breathing
• Necrotizing enterocolitis (a serious intestinal condition) reported in premature infants
• Significant drops in blood potassium or rises in blood sugar after overdose
• Bleeding in the brain (intraventricular hemorrhage) reported after caffeine overdose in premature infants
• Life-threatening or fatal breathing problems (when combined with codeine in tablet form)

Warnings and precautions

• When caffeine citrate is combined with codeine in a tablet, it must always be swallowed whole; cutting, breaking, crushing, chewing, or dissolving it can cause dangerous or fatal side effects.
• Even a single accidental dose of the combination tablet, especially in a child, can cause a fatal overdose.
• Caffeine citrate is a central nervous system stimulant and may cause seizures, so it should be used with extreme caution in patients with seizure disorders.
• Caffeine citrate can increase heart rate and the amount of blood pumped by the heart, so it should be used cautiously in those with heart disease.
• Caffeine citrate belongs to a group of medicines linked to a serious intestinal disease in premature babies called necrotizing enterocolitis.
• Caffeine crosses the placenta and reaches the baby. Combination tablets containing caffeine, acetaminophen, and codeine should not be used during pregnancy unless a doctor decides the benefits outweigh the risks, since prolonged use can cause withdrawal symptoms in the newborn after birth.
• Caffeine passes into breast milk. Mothers of infants being treated with caffeine citrate should not consume coffee or other high-caffeine products, and breastfeeding while taking codeine-containing tablets should only be done if a doctor judges the benefit outweighs the risk.
• People with kidney problems can have caffeine build up in the body. Caution is needed, and doses may need to be reduced and guided by blood tests measuring caffeine levels.
• Caution is needed in people with liver problems, as liver disease can affect how caffeine and other combined ingredients are processed by the body, and doses may need adjusting.
• Drinking alcohol while taking combination tablets containing caffeine, acetaminophen, and codeine should be avoided, as it can cause dangerous drowsiness, slowed breathing, or even a fatal overdose.
• Combination tablets containing caffeine, acetaminophen, and codeine can cause drowsiness, dizziness, or lightheadedness, so caution is needed before driving or using machinery, especially after starting the medicine or increasing the dose.

Storage

• Store the acetaminophen/caffeine/codeine tablets at controlled room temperature (15°C – 25°C)
• Keep the tablets in a safe place, out of sight and reach of children and pets, before, during, and after use
• Never dispose of unused or expired tablets in household trash; return them to a pharmacy for proper disposal
• For the injectable/oral solution form used in infants, store unopened ampoules at 15° to 30°C, and use immediately after opening; discard any unused portion

When to see a doctor

• Seek immediate medical help if a baby treated with caffeine/codeine-containing medicine during pregnancy shows changes in breathing, is unusually difficult to comfort, has tremors, or has increased stools, sneezing, yawning, vomiting, or fever after birth — these can be signs of life-threatening withdrawal.
• Get emergency medical help right away if signs of an allergic reaction occur, such as rash, hives, swelling of the face, lips, tongue, or throat, or difficulty swallowing or breathing.
• Contact a healthcare professional or poison control immediately if you think too much of the combination medicine has been taken, even if there are no symptoms yet.
• Tell your baby's doctor right away if signs of caffeine overdose occur in an infant, such as tremors, restlessness, rapid breathing, rapid heartbeat, vomiting, fever, jitteriness, or seizures.

Alternatives

• Theophylline
• Caffeine Citrate Oral Solution
• Caffeine Citrate Injection