Caffeine; Caffeine and Sodium Benzoate Injection; Caffeine Citrate and Cardiotoxicity

• Generic Name: caffeine / sodium benzoate
• Dosage Forms: n.a.
• Other Brand Names: Cafcit, No Doz, Vivarin

Used orally as an aid in staying awake and to restore mental alertness in fatigued patients.

Used in combination with antihistamines to overcome the sedative properties of antihistamines; however, efficacy and dosage required not adequately established.

Caffeine and sodium benzoate injection has been used in conjunction with supportive measures to treat respiratory depression associated with overdosage of CNS depressant drugs (e.g., opiate analgesics, alcohol) and with electric shock. However, most authorities believe caffeine and other analeptics should not be used in these conditions and recommend other supportive therapy because of caffeine’s questionable benefit and transient action.

Short-term (10–12 days) treatment (as oral or IV caffeine citrate) of apnea of prematurity in neonates who are 28 to <33 weeks of gestational age (designated an orphan drug by FDA for this use).

Use only after other causes of apnea (e.g., CNS disorders, primary lung disease, anemia, sepsis, metabolic disturbances, cardiovascular abnormalities, obstructive apnea) have been ruled out or treated appropriately.

Used in combination with ergotamine to prevent or abort vascular headaches (e.g., migraine and cluster headaches). However, there is conflicting evidence regarding efficacy of this combination in the treatment of acute migraine attacks.

Used orally alone and in combination with analgesics (e.g., acetaminophen, aspirin) for treatment of headache, including migraine attacks.

Some evidence that analgesic-caffeine combinations may produce slightly more analgesia than analgesic agents alone and may have beneficial effect on mood; however, these results have not always been reproducible in well-controlled studies. Additional studies needed to determine the role, if any, of caffeine as an analgesic adjuvant.

Some experts state that the combination of acetaminophen, aspirin, and caffeine is a reasonable first-line therapy for mild to moderate migraine attacks or for severe migraine attacks that previously have responded to NSAIAs or nonopiate analgesics.

Caffeine and sodium benzoate injection has been used for the symptomatic relief of headache following spinal puncture.

Safety and efficacy of caffeine citrate in the prevention of sudden infant death syndrome (SIDS) or prior to extubation in mechanically ventilated infants not established.

Has been used orally alone and in combination with other drugs (e.g., analgesics, diuretics) to relieve tension, fatigue, and fluid retention associated with menstruation. Usefulness is questionable because caffeine’s diuretic activity in patients with fluid retention is minimal.