caffeine citrate at a glance
Medicine class
Methylxanthine respiratory stimulant
Licensed use
Apnoea of prematurity
Where it is used
A neonatal intensive care unit with appropriate monitoring
Administration
Depending on the product, by controlled intravenous infusion, by mouth or through a gastric feeding tube
What is caffeine citrate used for?
Selected UK products are licensed for:
Primary apnoea of premature newborns—recurrent pauses in breathing related to immature respiratory control.
How does caffeine citrate work?
Caffeine blocks adenosine receptors in the brain, stimulating the respiratory centre and increasing the response to carbon dioxide. This strengthens breathing effort, increases ventilation and helps stabilise breathing.
caffeine citrate preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg/mL
Oral solution
Route: Oral
Strengths: 10 mg/mL, 20 mg/mL
Injection
Route: Parenteral
Strengths: 10 mg/mL
How to take caffeine citrate
Caffeine citrate is administered by trained neonatal staff. Oral products may be given by mouth or through a gastric feeding tube. Intravenous products must be given as a controlled infusion, not as an intramuscular injection or rapid bolus. Staff must check the concentration and whether quantities are expressed as caffeine citrate or caffeine base.
Use only clear, colourless solution without visible particles.
Discard opened single-use containers and unused contents as directed by the product information.
Food or formula does not reduce overall oral absorption, although absorption may be slower.
caffeine citrate side effects
Common or expected effects
- Fast heartbeat
- High blood glucose
- Inflammation or phlebitis at the infusion site
Get urgent medical advice
- Seizure
- Abnormal heart rhythm
- Hypersensitivity reaction
- Possible necrotising enterocolitis, with abdominal swelling, bloody stools or worsening feeding intolerance
caffeine citrate in pregnancy
These products are licensed for premature newborns, not as treatment during pregnancy. Maternal caffeine crosses the placenta, so the neonatal team should know about substantial caffeine intake before delivery. The NHS advises limiting dietary caffeine during pregnancy.
caffeine citrate while breastfeeding
Caffeine passes into breast milk. When a breastfed premature newborn receives caffeine citrate, the product information advises the mother to avoid caffeine-containing foods, drinks and medicines because the infant may receive additional caffeine. Discuss this restriction with the neonatal team.
caffeine citrate interactions
The neonatal team should review all medicines and maternal caffeine exposure. Important interactions include:
Theophylline and other xanthines
Avoid concurrent use because caffeine and theophylline can convert into one another in premature newborns, increasing exposure and toxicity risk.
Cimetidine or ketoconazole
These may reduce caffeine elimination; plasma caffeine monitoring may be needed.
Phenobarbital or phenytoin
These may increase caffeine elimination and reduce its effect; clinical response and concentrations may need review.
Common questions about caffeine citrate
Answers are fully visible for fast scanning and source review.
Why is caffeine citrate given to premature babies?
It stimulates immature respiratory control and reduces pauses in breathing caused by apnoea of prematurity.
Is caffeine citrate the same as caffeine in coffee?
It releases the same active caffeine molecule, but neonatal caffeine citrate is a prescription formulation prepared and monitored specifically for premature newborns.
Can caffeine citrate be given through a feeding tube?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.