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    For You News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
    Drugs & Diseases

    caffeine (Rx, OTC)

    Brand and Other Names:Cafcit, NoDoz, more...ReCharge, Vivarin
    • Print

    Dosing & Uses

    AdultPediatric

    Dosage Forms & Strengths

    injectable solution

    • 20mg/mL

    oral solution

    • 20mg/mL

    tablets

    • 200mg

    capsules

    • 200mg

    lozenges

    • 75mg

    Fatigue & Drowsiness

    100-200 mg PO q3-4hr; not later than 6 hours before bedtime

    Respiratory Failure

    Caffeine and sodium benzoate: 250 mg IV/IM once; may repeat PRN; alternatively, 500 mg in 1 L IV over 4 hr; not to exceed 2500 mg/24hr

    CAUTION: Use strongly discouraged

    Stimulant Diuretic (Off-label)

    500 mg IV/IM; 1 g maximum single dose

    Dosage Forms & Strengths

    injectable solution

    • 10mg/mL

    oral solution

    • 10mg/mL

    tablets

    • 200mg

    capsules

    • 200mg

    lozenges

    • 75mg

    Drowsiness or Fatigue

    < 12 years: Not recommended

    >12 years: 100-200 mg PO q3-4hr; not later than 6 hours before bedtime

    Potential toxic dose <6 years old: 15 mg/kg

    Neonatal Apnea

    Load: 10-20 mg/kg IV/PO once  

    Maintenance: 5-10 mg/kg IV/PO qDay

    Potential toxic dose <6 years old: 15 mg/kg

    Next:

    Interactions

    Interaction Checker

    and caffeine

    No Results

       activity indicator 
      No Interactions Found
      Interactions Found

      Contraindicated

        Serious - Use Alternative

          Significant - Monitor Closely

            Minor

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               activity indicator 

              Contraindicated (6)

              • isocarboxazid

                isocarboxazid increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

              • linezolid

                linezolid increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

              • phenelzine

                phenelzine increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

              • procarbazine

                procarbazine increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Caffeine can produce severe hypertensive crises or dangerous cardiac arrhythmias if administered to patients taking a MAOI. All preparations containing caffeine should be used sparingly.

              • selegiline transdermal

                selegiline transdermal increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

              • tranylcypromine

                tranylcypromine increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

              Serious - Use Alternative (7)

              • abametapir

                abametapir will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.

              • bupropion

                caffeine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

              • dipyridamole

                caffeine decreases effects of dipyridamole by pharmacodynamic antagonism. Contraindicated.

              • givosiran

                givosiran will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.

              • iobenguane I 131

                caffeine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

              • ozanimod

                ozanimod increases toxicity of caffeine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

              • regadenoson

                caffeine decreases effects of regadenoson by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid methylxanthines for 12 hours before regadenoson administration.

              Monitor Closely (166)

              • albuterol

                albuterol and caffeine both decrease sedation. Use Caution/Monitor.

              • alfentanil

                alfentanil increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • alprazolam

                alprazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • amitriptyline

                amitriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • amobarbital

                amobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • amoxapine

                amoxapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • arformoterol

                arformoterol and caffeine both decrease sedation. Use Caution/Monitor.

              • aripiprazole

                aripiprazole increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • armodafinil

                armodafinil and caffeine both decrease sedation. Use Caution/Monitor.

              • azelastine

                azelastine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • belladonna and opium

                belladonna and opium increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • benperidol

                benperidol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • benzphetamine

                caffeine and benzphetamine both decrease sedation. Use Caution/Monitor.

              • brompheniramine

                brompheniramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • buprenorphine buccal

                buprenorphine buccal increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • butabarbital

                butabarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • butalbital

                butalbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • butorphanol

                butorphanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carbinoxamine

                carbinoxamine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chloral hydrate

                chloral hydrate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlordiazepoxide

                chlordiazepoxide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpheniramine

                chlorpheniramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpromazine

                chlorpromazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cinnarizine

                cinnarizine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ciprofloxacin

                ciprofloxacin will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. The hepatic metabolism of caffeine may be decreased by ciprofloxacin; pharmacologic effects of caffeine may be increased.

              • clemastine

                clemastine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • clomipramine

                clomipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • clonazepam

                clonazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • clorazepate

                clorazepate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • clozapine

                clozapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • codeine

                codeine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cyclizine

                cyclizine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cyproheptadine

                cyproheptadine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • deferasirox

                deferasirox increases levels of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • desipramine

                desipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexchlorpheniramine

                dexchlorpheniramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexfenfluramine

                caffeine and dexfenfluramine both decrease sedation. Use Caution/Monitor.

              • dexmedetomidine

                dexmedetomidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexmethylphenidate

                caffeine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              • dextroamphetamine

                caffeine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              • dextromoramide

                dextromoramide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diamorphine

                diamorphine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diethylpropion

                caffeine and diethylpropion both decrease sedation. Use Caution/Monitor.

              • difenoxin hcl

                difenoxin hcl increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dimenhydrinate

                dimenhydrinate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diphenhydramine

                diphenhydramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diphenoxylate hcl

                diphenoxylate hcl increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dipipanone

                dipipanone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dobutamine

                dobutamine and caffeine both decrease sedation. Use Caution/Monitor.

              • dopamine

                caffeine and dopamine both decrease sedation. Use Caution/Monitor.

              • dopexamine

                dopexamine and caffeine both decrease sedation. Use Caution/Monitor.

              • doxepin

                doxepin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • droperidol

                droperidol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • droxidopa

                caffeine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension

              • ephedrine

                ephedrine and caffeine both decrease sedation. Use Caution/Monitor.

              • epinephrine

                epinephrine and caffeine both decrease sedation. Use Caution/Monitor.

              • epinephrine inhaled

                caffeine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              • epinephrine racemic

                epinephrine racemic and caffeine both decrease sedation. Use Caution/Monitor.

              • esketamine intranasal

                esketamine intranasal, caffeine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .

              • estazolam

                estazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ethanol

                ethanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ethinylestradiol

                ethinylestradiol will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • fenfluramine

                caffeine and fenfluramine both decrease sedation. Use Caution/Monitor.

              • fexinidazole

                fexinidazole will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • fluphenazine

                fluphenazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • flurazepam

                flurazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fluvoxamine

                fluvoxamine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • formoterol

                formoterol and caffeine both decrease sedation. Use Caution/Monitor.

              • green tea

                green tea increases effects of caffeine by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of CNS stimulation due to caffeine component of green tea. Caution advised.

              • guselkumab

                guselkumab, caffeine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, normalizing the formation of CYP450 enzymes. Upon initiation or discontinuation of guselkumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.

              • haloperidol

                haloperidol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hydromorphone

                hydromorphone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hydroxyzine

                hydroxyzine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • iloperidone

                iloperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • imipramine

                imipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • isoproterenol

                isoproterenol and caffeine both decrease sedation. Use Caution/Monitor.

              • ketotifen, ophthalmic

                ketotifen, ophthalmic increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • letermovir

                letermovir increases levels of caffeine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • levalbuterol

                levalbuterol and caffeine both decrease sedation. Use Caution/Monitor.

              • levorphanol

                levorphanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levothyroxine

                caffeine decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. COFFEE binds levothyroxine in the GI tract. Separate by 2 hours.

              • lisdexamfetamine

                caffeine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

              • lofepramine

                lofepramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lofexidine

                lofexidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • loprazolam

                loprazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lorazepam

                lorazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lormetazepam

                lormetazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • loxapine

                loxapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • loxapine inhaled

                loxapine inhaled increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • maprotiline

                maprotiline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • marijuana

                marijuana increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • melatonin

                melatonin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • meperidine

                meperidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • meprobamate

                meprobamate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metaproterenol

                metaproterenol and caffeine both decrease sedation. Use Caution/Monitor.

              • methadone

                methadone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methamphetamine

                caffeine and methamphetamine both decrease sedation. Use Caution/Monitor.

              • methotrexate

                caffeine decreases effects of methotrexate by pharmacodynamic antagonism. Use Caution/Monitor.

              • methylenedioxymethamphetamine

                caffeine and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

              • methylphenidate

                caffeine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.

              • midazolam

                midazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • midodrine

                caffeine and midodrine both decrease sedation. Use Caution/Monitor.

              • mirtazapine

                mirtazapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • modafinil

                caffeine and modafinil both decrease sedation. Use Caution/Monitor.

              • morphine

                morphine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • motherwort

                motherwort increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • moxonidine

                moxonidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nabilone

                nabilone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nalbuphine

                nalbuphine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • norepinephrine

                norepinephrine and caffeine both decrease sedation. Use Caution/Monitor.

              • nortriptyline

                nortriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • olanzapine

                olanzapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • opium tincture

                opium tincture increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • oxazepam

                oxazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • oxycodone

                oxycodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • oxymorphone

                oxymorphone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • paliperidone

                paliperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • papaveretum

                papaveretum increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pefloxacin

                pefloxacin will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • pentazocine

                pentazocine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pentobarbital

                pentobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • perphenazine

                perphenazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phendimetrazine

                caffeine and phendimetrazine both decrease sedation. Use Caution/Monitor.

              • phenobarbital

                phenobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phentermine

                caffeine and phentermine both decrease sedation. Use Caution/Monitor.

              • phenylephrine

                caffeine and phenylephrine both decrease sedation. Use Caution/Monitor.

              • phenylephrine PO

                caffeine and phenylephrine PO both decrease sedation. Use Caution/Monitor.

              • pholcodine

                pholcodine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pimozide

                pimozide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pirbuterol

                pirbuterol and caffeine both decrease sedation. Use Caution/Monitor.

              • primidone

                primidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • prochlorperazine

                prochlorperazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • promethazine

                promethazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • propylhexedrine

                caffeine and propylhexedrine both decrease sedation. Use Caution/Monitor.

              • protriptyline

                protriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quazepam

                quazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quetiapine

                quetiapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • rasagiline

                rasagiline increases effects of caffeine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of acute hypertensive episode.

              • risperidone

                risperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • rucaparib

                rucaparib will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.

              • salmeterol

                salmeterol and caffeine both decrease sedation. Use Caution/Monitor.

              • scullcap

                scullcap increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • secobarbital

                secobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • selegiline

                selegiline increases effects of caffeine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of acute hypertensive episode.

              • shepherd's purse

                shepherd's purse increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • solriamfetol

                caffeine and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              • stiripentol

                stiripentol, caffeine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.

              • sufentanil

                sufentanil increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tapentadol

                tapentadol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • temazepam

                temazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • terbutaline

                terbutaline and caffeine both decrease sedation. Use Caution/Monitor.

              • teriflunomide

                teriflunomide decreases levels of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • thioridazine

                thioridazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • thiothixene

                thiothixene increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • topiramate

                topiramate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • tramadol

                tramadol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • trazodone

                trazodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • triazolam

                triazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • triclofos

                triclofos increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • trifluoperazine

                trifluoperazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • trimipramine

                trimipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • triprolidine

                triprolidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • xylometazoline

                caffeine and xylometazoline both decrease sedation. Use Caution/Monitor.

              • yohimbine

                caffeine and yohimbine both decrease sedation. Use Caution/Monitor.

              • ziconotide

                ziconotide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ziprasidone

                ziprasidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              Minor (46)

              • adenosine

                caffeine decreases effects of adenosine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • amantadine

                amantadine, caffeine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential for additive CNS stimulation.

              • American ginseng

                American ginseng increases effects of caffeine by pharmacodynamic synergism. Minor/Significance Unknown.

              • amobarbital

                amobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • armodafinil

                armodafinil will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • butabarbital

                butabarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • butalbital

                butalbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • calcium acetate

                caffeine decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.

              • calcium carbonate

                caffeine decreases levels of calcium carbonate by increasing renal clearance. Minor/Significance Unknown.

              • calcium chloride

                caffeine decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.

              • calcium citrate

                caffeine decreases levels of calcium citrate by increasing renal clearance. Minor/Significance Unknown.

              • calcium gluconate

                caffeine decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.

              • carbamazepine

                carbamazepine will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • cigarette smoking

                cigarette smoking will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • cimetidine

                cimetidine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • clotrimazole

                clotrimazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • erythromycin base

                erythromycin base will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • eucalyptus

                eucalyptus increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

              • fluconazole

                fluconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • grapefruit

                grapefruit increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • guarana

                guarana increases effects of caffeine by pharmacodynamic synergism. Minor/Significance Unknown.

              • isoniazid

                isoniazid will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • itraconazole

                itraconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • ketoconazole

                ketoconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • mexiletine

                mexiletine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • miconazole vaginal

                miconazole vaginal increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • modafinil

                modafinil will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • peginterferon alfa 2a

                peginterferon alfa 2a will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • pentobarbital

                pentobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • phenobarbital

                phenobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • pipemidic acid

                pipemidic acid will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • posaconazole

                posaconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • primidone

                primidone will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • rifampin

                rifampin will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • sage

                sage increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

              • secobarbital

                secobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • smoking

                smoking will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • thiamine

                caffeine decreases levels of thiamine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Coffee, tea are high in anti-thiamine factors.

              • tobacco use

                tobacco use will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • verapamil

                verapamil will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

              • voriconazole

                voriconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.

              • yerba mate

                yerba mate increases effects of caffeine by pharmacodynamic synergism. Minor/Significance Unknown.

              • zileuton

                zileuton will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Tachycardia

              Palpitations (dose dependent)

              Insomnia

              Irritability

              Nervousness

              Restlessness

              Tremor

              Tinnitus

              Regular and decaffeinated coffee increase gastric acid & pepsin secretion

              Nausea

              Vominting

              Diarrhea

              Diuresis

              Withdrawal symptoms

              • Anxiety
              • depression
              • Fatigue
              • Headache (can last up to 7 days)
              • Muscle tension
              • Nausea
              • Runny nose
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              Warnings

              Contraindications

              Hypersensitivity

              Cautions

              May increase severity of fibrocystic breast disease, PMS, increase risk of bladder, ovary, colon & pancreatic cancer

              Carefully monitor for the development of necrotizing enterocolitis

              Not for use in patients with anxiety, agitation, or tremor

              Caution in patients with history of peptic ulcer, hepatic impairment, renal impairment, seizure disorder, or cardiovascular disease

              Avoid use in symptomatic arrhythmias and/or palpitations

              Administer therapy with caution in infants with impaired renal or hepatic function; serum concentrations of caffeine should be monitored and dose adjusted to avoid toxicity in this population; may need to monitor serum concentrations of caffeine periodically throughout treatment to avoid toxicity

              See Caffeine OD for caffeine content of specific foods & drinks

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              Pregnancy & Lactation

              Pregnancy Category: C (crosses placenta, can remain in fetus/neonate 64-300 hr)

              Lactation: enters breast milk; use with caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Methylxanthine; promotes cAMP accumulation by inhibiting phosphodiesterase; increases medullary respiratory center sensitivity to carbon dioxide; may prevent apnea by acting as an adenosine receptor antagonist

              Pharmacokinetics

              Half-Life: 72-96hr (neonates); 5 hr (>9 months and adults); decreased in tobacco user

              Peak plasma time: 30-120 min

              Peak plasma concentration: 1.5-1.8 mcg/mL

              Protein Bound: 17-36%

              Vd: 0.6-0.9 L/kg

              Metabolism: hepatic CYP1A2

              Excretion: Urine

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              caffeine oral
              -
              		200 mg tablet
              caffeine oral
              -
              		200 mg tablet
              Stay Awake Maximum Strength oral
              -
              		200 mg tablet
              Alertness Aid oral
              -
              		200 mg tablet
              Vivarin oral
              -
              		200 mg tablet
              Stay Awake oral
              -
              		200 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              caffeine oral

              CAFFEINE - ORAL

              (KAF-een)

              COMMON BRAND NAME(S): No Doz, Stay Awake, Vivarin

              USES: This medication is used occasionally to help you stay awake and alert when you are feeling tired and/or drowsy. Caffeine is a mild stimulant.This medication should not be used to replace sleep.This medication should not be used by children younger than 12 years old.

              HOW TO USE: Take this product by mouth as directed. Follow all directions on the product package, or take as directed by your doctor. If you have any questions, ask your doctor or pharmacist.This medication should only be used as needed, not on a regular basis. Though very unlikely, this medication may be habit-forming. Do not increase your dose, take it more frequently than directed, or take it regularly for a long time.If you suddenly stop using this medication, you may have withdrawal symptoms (such as headaches, mental/mood changes such as irritation/nervousness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used caffeine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.When used for an extended period, this medication may not work as well. Talk with your doctor if this medication stops working well.Tell your doctor if your condition persists, worsens, or continues to occur again. If you think you may have a serious medical problem, seek immediate medical attention.

              SIDE EFFECTS: Nausea, vomiting, stomach upset, trouble sleeping, or increased urination may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: dizziness, mental/mood changes (e.g., nervousness, agitation), shaking (tremor), fast/irregular heartbeat.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking caffeine, tell your doctor or pharmacist if you are allergic to it; or to other xanthine drugs (e.g., theophylline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (e.g., irregular heart rhythm, recent heart attack), high blood pressure, stomach/intestinal ulcers, mental/mood disorders (e.g., anxiety, nervousness).Before having surgery or certain medical procedures (such as a heart stress test or a procedure to restore a normal heart rhythm if you have an unusually fast heartbeat), tell your doctor or dentist that you use this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially trouble sleeping.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or headache medications).Avoid drinking large amounts of beverages containing caffeine (coffee, tea, certain sodas) or eating large amounts of chocolate while taking this medication.This medication may interfere with certain medical/laboratory tests (including urine VMA/catecholamines levels, dipyridamole-thallium imaging test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: stomach/abdominal pain, mental/mood changes, seizures, fast/irregular heartbeat.

              NOTES: Keep all regular medical and laboratory appointments.

              MISSED DOSE: Not applicable.

              STORAGE: Refer to storage information printed on the package. Protect from light and moisture. Do not store in the bathroom. If you have any questions about storage, ask your pharmacist. Keep all drug products away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Create Your List of Plans

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              View explanations for tiers and restrictions
              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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