Medicine guide

Caffeine Citrate

20 mg/mL · Injection, Solution

  • Prescription only
  • Central Nervous System Stimulant
Active substance
Caffeine Citrate
Made by
Eugia US LLC

Quoted from the official source. Not yet reviewed by Mediclarum — the leaflet in your pack is authoritative.

At a glance

Quoted from the official label · 2025-04-19

What it is

Central Nervous System Stimulant

Used for
  • Caffeine citrate injection, USP is indicated for the treatment of apnea of prematurity.
The label’s usual adult dose

Dopamine HCI Injection, USP 40 mg/mL diluted to 0.6 mg/mL with Dextrose Injection, USP 5%

Full directions ↓
Do not take it if

Caffeine citrate injection is contraindicated in patients who have demonstrated hypersensitivity to any of its components.

All warnings ↓
Good to know
  • Prescription only
  • FDA enforcement reports list no ongoing recall, and none from the last two years, for this product code · checked 2026-10-02
12other products contain Caffeine Citrate — compare makers, forms and strengths

Every line above is selected, not written, from the official label. Nothing is reworded. DailyMed

What it is for

  • Caffeine citrate injection, USP is indicated for the treatment of apnea of prematurity.

From the official label · 2025-04-19 · DailyMed

How it works

From this product’s own US prescribing label.

Caffeine is structurally related to other methylxanthines, theophylline, and theobromine.

It is a bronchial smooth muscle relaxant, a CNS stimulant, a cardiac muscle stimulant, and a diuretic.

Peak level after30 min
How the body breaks it down

Caffeine metabolism in preterm neonates is limited due to their immature hepatic enzyme systems.

How it leaves the body

Mean half-life (T 1/2 ) and fraction excreted unchanged in urine (A e ) of caffeine in infants have been shown to be inversely related to gestational/postconceptual age.

Quoted from the prescribing label, sections “Mechanism of Action” and “Pharmacokinetics”. DailyMed · 2025-04-19

Do not take it if

Caffeine citrate injection is contraindicated in patients who have demonstrated hypersensitivity to any of its components.

Quoted from the official label, section “Contraindications”.

How to take it

These directions are for this exact strength and form. Another one is different.

  • Prior to initiation of caffeine citrate injection USP, baseline serum levels of caffeine should be measured in infants previously treated with theophylline, since preterm infants metabolize theophylline to caffeine. Likewise, baseline serum levels of caffeine should be measured in infants born to mothers who consumed caffeine prior to delivery, since caffeine readily crosses the placenta. The recommended loading dose and maintenance doses of caffeine citrate injection, USP follow. * Using a syringe infusion pump ** Beginning 24 hours after the loading dose Dose of Caffeine Citrate Injection, USP Volume Dose of Caffeine Citrate Injection, USP mg/kg Route Frequency Loading Dose 1 mL/kg 20 mg/kg Intravenous * (over 30 minutes) One time Maintenance Dose 0.25 mL/kg 5 mg/kg Intravenous * (over 10 minutes) or Orally Every 24 hours ** NOTE THAT THE DOSE OF CAFFEINE BASE IS ONE-HALF THE DOSE WHEN EXPRESSED AS CAFFEINE CITRATE (e.g., 20 mg of caffeine citrate is equivalent to 10 mg of caffeine base). Serum concentrations of caffeine may need to be monitored periodically throughout treatment to
  • avoid toxicity. Serious toxicity has been associated with serum levels greater than 50 mg/L. Caffeine citrate injection, USP should be inspected visually for particulate matter and discoloration prior to administration. Vials containing discolored solution or visible particulate matter should be discarded. Drug Compatibility To test for drug compatibility with common intravenous solutions or medications, 20 mL of caffeine citrate injection, USP were combined with 20 mL of a solution or medication, with the exception of an Intralipid ® admixture, which was combined as 80 mL/80 mL. The physical appearance of the combined solutions was evaluated for precipitation. The admixtures were mixed for 10 minutes and then assayed for caffeine. The admixtures were then continually mixed for 24 hours, with further sampling for caffeine assays at 2, 4, 8, and 24 hours. Based on this testing, caffeine citrate injection USP, 60 mg/3 mL is chemically stable for 24 hours at room temperature when combined with the following test products.
  • Dextrose Injection, USP 5%
  • 50% Dextrose Injection USP
  • Intralipid ® 20% IV Fat Emulsion
  • Aminosyn ® 8.5% Crystalline Amino Acid Solution
  • Dopamine HCI Injection, USP 40 mg/mL diluted to 0.6 mg/mL with Dextrose Injection, USP 5%
  • Calcium Gluconate Injection, USP 10% (0.465 mEq/Ca +2 /mL)
  • Heparin Sodium Injection, USP 1000 units/mL diluted to 1 unit/mL with Dextrose Injection, USP 5%
  • Fentanyl Citrate Injection, USP 50 mcg/mL diluted to 10 mcg/mL with Dextrose Injection, USP 5%

Quoted from the official label, section “Dosage & Administration”.

Other warnings

  • Necrotizing Enterocolitis During the double-blind, placebo-controlled clinical trial, 6 cases of necrotizing enterocolitis developed among the 85 infants studied (caffeine=46, placebo=39), with 3 cases resulting in death.
  • Five of the six patients with necrotizing enterocolitis were randomized to or had been exposed to caffeine citrate.
  • Reports in the published literature have raised a question regarding the possible association between the use of methylxanthines and development of necrotizing enterocolitis, although a causal relationship between methylxanthine use and necrotizing enterocolitis has not been established.
  • In a published randomized, placebo-controlled, clinical trial that studied the use of caffeine citrate in apnea of prematurity in approximately 2,000 patients, necrotizing enterocolitis was not more common in caffeine treated patients compared to placebo.
  • As with all preterm infants, patients being treated with caffeine citrate should be carefully monitored for the development of necrotizing enterocolitis.
  • General Apnea of prematurity is a diagnosis of exclusion.
  • Other causes of apnea (e.g., central nervous system disorders, primary lung disease, anemia, sepsis, metabolic disturbances, cardiovascular abnormalities, or obstructive apnea) should be ruled out or properly treated prior to initiation of caffeine citrate.
  • Caffeine is a central nervous system stimulant and in cases of caffeine overdose, seizures have been reported.
  • Caffeine citrate should be used with caution in infants with seizure disorders.
  • The duration of treatment of apnea of prematurity in the placebo-controlled trial was limited to 10 to 12 days.
  • The efficacy of caffeine citrate for longer periods of treatment has not been established.
  • Safety and efficacy of caffeine citrate for use in the prophylactic treatment of sudden infant death syndrome (SIDS) or prior to extubation in mechanically ventilated infants have also not been established.
  • Cardiovascular Although no cases of cardiac toxicity were reported in the placebo-controlled trial, caffeine has been shown to increase heart rate, left ventricular output, and stroke volume in published studies.
  • Therefore, caffeine citrate should be used with caution in infants with cardiovascular disease.
  • Renal and Hepatic Systems Caffeine citrate should be administered with caution in infants with impaired renal or hepatic function.
  • Serum concentrations of caffeine should be monitored and dose administration of caffeine citrate should be adjusted to
  • avoid toxicity in this population.
  • (See CLINICAL PHARMACOLOGY , Elimination and Special Populations .) Laboratory Tests Prior to initiation of caffeine citrate, baseline serum levels of caffeine should be measured in infants previously treated with theophylline, since preterm infants metabolize theophylline to caffeine.
  • In the placebo-controlled clinical trial, caffeine levels ranged from 8 to 40 mg/L.
  • A therapeutic plasma concentration range of caffeine could not be determined from the placebo-controlled clinical trial.
  • Serious toxicity has been reported in the literature when serum caffeine levels exceed 50 mg/L.
  • avoid toxicity.
  • In clinical studies reported in the literature, cases of hypoglycemia and hyperglycemia have been observed.
  • Therefore, serum glucose may need to be periodically monitored in infants receiving caffeine citrate.
  • Drug Interactions Cytochrome P450 1A2 (CYP1A2) is known to be the major enzyme involved in the metabolism of caffeine.
  • Carcinogenesis, Mutagenesis, Impairment of Fertility In a 2-year study in Sprague-Dawley rats, caffeine (as caffeine base) administered in drinking water was not carcinogenic in male rats at doses up to 102 mg/kg or in female rats at doses up to 170 mg/kg (approximately 2 and 4 times, respectively, the maximum recommended intravenous loading dose for infants on a mg/m 2 basis).
  • In an 18-month study in C57BL/6 mice, no evidence of tumorigenicity was seen at dietary doses up to 55 mg/kg (less than the maximum recommended intravenous loading dose for infants on a mg/m 2 basis).
  • Caffeine (as caffeine base) increased the sister chromatid exchange (SCE) SCE/cell metaphase (exposure time dependent) in an in vivo mouse metaphase analysis.
  • Caffeine also potentiated the genotoxicity of known mutagens and enhanced the micronuclei formation (5-fold) in folate-deficient mice.
  • However, caffeine did not increase chromosomal aberrations in in vitro Chinese hamster ovary cell (CHO) and human lymphocyte assays and was not mutagenic in an in vitro CHO/hypoxanthine guanine phosphoribosyltransferase (HGPRT) gene mutation assay, except at cytotoxic concentrations.
  • In addition, caffeine was not clastogenic in an in vivo mouse micronucleus assay.
  • Caffeine (as caffeine base) administered to male rats at 50 mg/kg/day subcutaneously (approximately equal to the maximum recommended intravenous loading dose for infants on a mg/m 2 basis) for 4 days prior to mating with untreated females, caused decreased male reproductive performance in addition to causing embryotoxicity.
  • In addition, long-term exposure to high oral doses of caffeine (3 g over 7 weeks) was toxic to rat testes as manifested by spermatogenic cell degeneration.
  • Pregnancy Concern for the teratogenicity of caffeine is not relevant when administered to infants.
  • General Apnea of prematurity is a diagnosis of exclusion.
  • Other causes of apnea (e.g., central nervous system disorders, primary lung disease, anemia, sepsis, metabolic disturbances, cardiovascular abnormalities, or obstructive apnea) should be ruled out or properly treated prior to initiation of caffeine citrate.
  • Caffeine is a central nervous system stimulant and in cases of caffeine overdose, seizures have been reported.
  • Caffeine citrate should be used with caution in infants with seizure disorders.
  • The duration of treatment of apnea of prematurity in the placebo-controlled trial was limited to 10 to 12 days.
  • The efficacy of caffeine citrate for longer periods of treatment has not been established.
  • Safety and efficacy of caffeine citrate for use in the prophylactic treatment of sudden infant death syndrome (SIDS) or prior to extubation in mechanically ventilated infants have also not been established.

Quoted from the official label, section “Warnings”.

Pregnancy and breastfeeding

  • Concern for the teratogenicity of caffeine is not relevant when administered to infants.
  • In studies performed in adult animals, caffeine (as caffeine base) administered to pregnant mice as sustained release pellets at 50 mg/kg (less than the maximum recommended intravenous loading dose for infants on a mg/m 2 basis), during the period of organogenesis, caused a low incidence of cleft palate and exencephaly in the fetuses.
  • There are no adequate and well-controlled studies in pregnant women.

Quoted from the official label, section “OTC — Pregnancy or Breast Feeding”.

Other medicines

  • Cytochrome P450 1A2 (CYP1A2) is known to be the major enzyme involved in the metabolism of caffeine.
  • Therefore, caffeine has the potential to interact with drugs that are substrates for CYP1A2, inhibit CYP1A2, or induce CYP1A2.
  • Few data exist on drug interactions with caffeine in preterm neonates.
  • Based on adult data, lower doses of caffeine may be needed following coadministration of drugs which are reported to decrease caffeine elimination (e.g., cimetidine and ketoconazole) and higher caffeine doses may be needed following coadministration of drugs that increase caffeine elimination (e.g., phenobarbital and phenytoin).
  • Caffeine administered concurrently with ketoprofen reduced the urine volume in four healthy volunteers.
  • The clinical significance of this interaction in preterm neonates is not known.
  • Interconversion between caffeine and theophylline has been reported in preterm neonates.
  • The concurrent use of these drugs is not recommended.

Quoted from the official label, section “Drug Interactions”.

If you take too much

In an emergency, call your local emergency number or a poison control centre.

  • Following overdose, serum caffeine levels have ranged from approximately 24 mg/L (a postmarketing spontaneous case report in which an infant exhibited irritability, poor feeding, and insomnia) to 350 mg/L.
  • Serious toxicity has been associated with serum levels greater than 50 mg/L (see PRECAUTIONS, Laboratory Tests and DOSAGE AND ADMINISTRATION ).
  • Signs and symptoms reported in the literature after caffeine overdose in preterm infants include fever, tachypnea, jitteriness, insomnia, fine tremor of the extremities, hypertonia, opisthotonos, tonic-clonic movements, nonpurposeful jaw and lip movements, vomiting, hyperglycemia, elevated blood urea nitrogen, and elevated total leukocyte concentration.
  • Seizures have also been reported in cases of overdose.
  • One case of caffeine overdose complicated by development of intraventricular hemorrhage and long-term neurological sequelae has been reported.
  • Another case of caffeine citrate overdose (from New Zealand) of an estimated 600 mg caffeine citrate (approximately 322 mg/kg) administered over 40 minutes was complicated by tachycardia, ST depression, respiratory distress, heart failure, gastric distention, acidosis, and a severe extravasation burn with tissue necrosis at the peripheral intravenous injection site.
  • No deaths associated with caffeine overdose have been reported in preterm infants.
  • Treatment of caffeine overdose is primarily symptomatic and supportive.
  • Caffeine levels have been shown to decrease after exchange transfusions.
  • Convulsions may be treated with intravenous administration of diazepam or a barbiturate such as pentobarbital sodium.

Quoted from the official label, section “Overdosage”.

Side effects

  • Overall, the reported number of adverse events in the double-blind period of the controlled trial was similar for the caffeine citrate and placebo groups.
  • The following table shows adverse events that occurred in the double-blind period of the controlled trial and that were more frequent in caffeine citrate-treated patients than placebo.
  • ADVERSE EVENTS THAT OCCURRED MORE FREQUENTLY IN CAFFEINE CITRATE-TREATED PATIENTS THAN PLACEBO DURING DOUBLE-BLIND THERAPY Adverse Event (AE) Caffeine Citrate N=46 n (%) Placebo N=39 n (%) BODY AS A WHOLE Accidental Injury 1 (2.2) 0 (0) Feeding Intolerance 4 (8.7) 2 (5.1) Sepsis 2 (4.3) 0 (0) CARDIOVASCULAR SYSTEM Hemorrhage 1 (2.2) 0 (0) DIGESTIVE SYSTEM Necrotizing Enterocolitis 2 (4.3) 1 (2.6) Gastritis 1 (2.2) 0 (0) Gastrointestinal Hemorrhage 1 (2.2) 0 (0) HEMIC AND LYMPHATIC SYSTEM Disseminated Intravascular Coagulation 1 (2.2) 0 (0) METABOLIC AND NUTRITIVE DISORDERS Acidosis 1 (2.2) 0 (0) Healing Abnormal 1 (2.2) 0 (0) NERVOUS SYSTEM Cerebral Hemorrhage 1 (2.2) 0 (0) RESPIRATORY SYSTEM Dyspnea 1 (2.2) 0 (0) Lung Edema 1 (2.2) 0 (0) SKIN AND APPENDAGES Dry Skin 1 (2.2) 0 (0) Rash 4 (8.7) 3 (7.7) Skin Breakdown 1 (2.2) 0 (0) SPECIAL SENSES Retinopathy of Prematurity 1 (2.2) 0 (0) UROGENITAL SYSTEM Kidney Failure 1 (2.2) 0 (0) In addition to the cases above, three cases of necrotizing enterocolitis were diagnosed in patients receiving caffeine citrate during the open-label phase of the study.
  • Three of the infants who developed necrotizing enterocolitis during the trial died.
  • All had been exposed to caffeine.
  • Two were randomized to caffeine, and one placebo patient was “rescued” with open-label caffeine for uncontrolled apnea.
  • Adverse events described in the published literature include:
  • central nervous system stimulation (i.e., irritability, restlessness, jitteriness), cardiovascular effects (i.e., tachycardia, increased left ventricular output, and increased stroke volume), gastrointestinal effects (i.e., increased gastric aspirate, gastrointestinal intolerance), alterations in serum glucose (i.e., hypoglycemia and hyperglycemia), and renal effects (i.e., increased urine flow rate, increased creatinine clearance, and increased sodium and calcium excretion).
  • Published long-term follow-up studies have not shown caffeine to adversely affect neurological development or growth parameters.
  • A published randomized, placebo-controlled, clinical trial in premature infants with birthweights of 500 to 1,250 grams studied the safety of caffeine citrate in apnea of prematurity (NCT00182312).
  • This trial randomized approximately 2,000 premature infants with a mean gestational age of 27 weeks at birth.
  • The median duration of caffeine therapy was 37 days.
  • Prior to discharge home, death, ultrasonographic signs of brain injury, and necrotizing enterocolitis were not more common in the caffeine citrate group compared to the placebo.
  • At follow up at both 18 months and 5 years corrected age, death was not more common in the caffeine citrate treated group compared to placebo, nor did caffeine citrate use adversely affect neurodevelopmental outcomes.

Quoted from the official label, section “Adverse Reactions”.

What it looks like and how it is packed

  • Caffeine citrate injection, USP is available as a clear, colorless, sterile, non-pyrogenic, preservative-free, aqueous solution in 5 mL colorless glass vial.
  • The vials are sealed with a gray rubber stopper and an aluminum overseal with a white polypropylene disk inset.
  • The vials contain 3 mL solution at a concentration of 20 mg/mL caffeine citrate (60 mg/vial) equivalent to 10 mg/mL caffeine base (30 mg/vial).
  • Caffeine citrate injection, USP is supplied as:
  • 3 mL Single-Dose Vial, individually packaged in a carton.
  • NDC 55150-187-03
  • Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].
  • The vial stopper is not made with natural rubber latex.
  • Preservative free.
  • For single-dose only.
  • Discard unused portion .
  • Intralipid ® is a registered trademark of Fresenius Kabi AB.
  • Aminosyn ® is a registered trademark of Hospira, Inc.
  • To report SUSPECTED ADVERSE REACTIONS, contact Eugia US LLC at 1-866-850-2876 or eugiaus.com or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
  • For Product Inquiry call 1-866-850-2876.
  • Distributed by: Eugia US LLC 279 Princeton-Hightstown Rd.
  • E.
  • Windsor, NJ 08520 Manufactured by:
  • Eugia Pharma Specialities Limited Hyderabad - 500032 India Revised:
  • April 2025

Quoted from the official label, section “How Supplied”.

What is in it

  • Caffeine citrate injection, USP for intravenous administration is a clear, colorless, sterile, non-pyrogenic, preservative-free, aqueous solution adjusted to pH 4.7.
  • Each mL contains 20 mg caffeine citrate (equivalent to 10 mg of caffeine base) prepared in solution by the addition of 10 mg caffeine (anhydrous) USP to 5 mg citric acid monohydrate, 8.3 mg sodium citrate dihydrate and Water for Injection, USP.
  • Caffeine (anhydrous) USP, a central nervous system stimulant, is an odorless white crystalline powder or granules, with a bitter taste.
  • It is sparingly soluble in water and ethanol at room temperature.
  • The chemical name of caffeine is 3,7-dihydro-1,3,7-trimethyl-1 H- purine-2,6-dione.
  • In the presence of citric acid it forms caffeine citrate salt in solution.
  • The structural formula and molecular weight of caffeine citrate follows. checmical-structure

Quoted from the official label, section “Description”.

Ingredients people check for

Lactose, gluten, dyes, sugars and other ingredients that matter with an allergy, intolerance or diet — as this product’s FDA label lists them.

The stored label for this product has no list of inactive ingredients. The list on the pack is the one to check.

Quoted from the FDA label. A label that does not name an ingredient is not a guarantee that the product is free of it, and formulations change. With an allergy, check the pack and ask a pharmacist.

Same active substance, strength and form in other countries

Matched on active substance, strength and kind of form only. This is not a statement that the products are equivalent or interchangeable: other ingredients, release and approved uses can differ — ask a pharmacist before swapping.

Medicine passport: one printable page to show a pharmacist abroad

European UnionNo exact match for this strength and form

CanadaNo exact match for this strength and form

Details

Made byEugia US LLC
Active substanceCaffeine Citrate
Used inBreathing, airways, allergies and cough
Strength20 mg/mL
FormInjection, Solution
RouteIntravenous
Packs1 VIAL, SINGLE-DOSE in 1 CARTON / 3 mL in 1 VIAL, SINGLE-DOSE
NDC55150-187

Source: NDC Directory · 2026-09-13 · not reviewed by a clinician

Source: US Food and Drug Administration, NDC Directory. Reuse terms: US government work (FDA).

Other strengths and forms

12 products are sold under this name. Grouped by form; a number on a strength means several companies make it.

Same active substance

These contain the same substance. That does not mean one can replace another — ask a pharmacist.