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      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

                All Interactions Sort By:
                 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 (47)

                • 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.

                • levoketoconazole

                  levoketoconazole 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
                Alertness Aid oral
                -
                		200 mg tablet
                caffeine oral
                -
                		200 mg tablet
                caffeine oral
                -
                		200 mg tablet
                Vivarin oral
                -
                		200 mg tablet
                Stay Awake oral
                -
                		200 mg tablet
                Stay Awake Maximum Strength 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 lasts, gets worse, 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 last or get worse, 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 you have any serious side effects, including: dizziness, mental/mood changes (such as nervousness, agitation), shaking (tremor), fast/irregular heartbeat.A very serious allergic reaction to this drug is rare. However, get medical help right away 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 (such as 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 (such as irregular heart rhythm, recent heart attack), high blood pressure, stomach/intestinal ulcers, mental/mood disorders (such as 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 medications 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.

                Information last revised November 2022. Copyright(c) 2022 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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