provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content

caffeine citrate

Generic Cafcit
Used for Sleep Apnea
Used for Sleep Apnea

Caffeine citrate (Cafcit) is a medication that works well for treating breathing problems in premature babies, but it's usually used for a short period of time. This medication is typically given to your baby in the neonatal intensive care unit (NICU). It's available as an injection into the vein (IV). There's also an oral solution form of caffeine citrate (Cafcit) for premature babies who have a feeding tube or can swallow. Sometimes, caffeine citrate (Cafcit) can cause side effects, like restlessness, jitteriness, faster heartbeat, and more diaper wetting (more urination).

Last reviewed on April 20, 2023
basics-icon

What is Caffeine citrate (Cafcit)?

What is Caffeine citrate (Cafcit) used for?

  • Apnea (condition where breathing stops and restarts repeatedly) in premature babies

How Caffeine citrate (Cafcit) works

Caffeine citrate (Cafcit) is a central nervous system stimulant. It's not completely known how the medication works. But it's thought that caffeine citrate (Cafcit) helps open up the airways and control breathing. It might also help the diaphragm muscle work better to improve breathing. This might help premature babies breathe better.

Drug Facts

Common BrandsCafcit
Drug ClassStimulant
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
coupon-save-icon

Get your GoodRx coupon

Avg retail price
$972.280
See prices
basics-icon

What are the side effects of Caffeine citrate (Cafcit)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Feeding problems (9%)
  • Rash (9%)

Other Side Effects

  • Irritability
  • Restlessness
  • Shakiness
  • Fast heart rate
  • Shortness of breath
  • Dry skin
  • More urination

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious bacterial infection in the intestine: bloating of the stomach area, vomiting, bloody stools, loss of energy
  • Accidentally getting too much caffeine (overdose): fever, fast heart rate, trouble sleeping, vomiting, shakiness, muscle problems, seizure

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Diarrhea

dizziness

fast heartbeat

hyperglycemia, including blurred vision, drowsiness, dry mouth, flushed dry skin, fruit-like breath odor, increased urination, ketones in urine, loss of appetite, nausea, stomachache, tiredness, troubled breathing, unusual thirst, or vomiting (in newborn babies)

hypoglycemia, including anxious feeling, blurred vision, cold sweats, confusion, cool pale skin, drowsiness, excessive hunger, fast heartbeat, nausea, nervousness, restless sleep, shakiness, or unusual tiredness or weakness (in newborn babies)

irritability, nervousness, or severe jitters (in newborn babies)

nausea (severe)

tremors

trouble in sleeping

vomiting

Rare

Abdominal or stomach bloating

dehydration

diarrhea (bloody)

unusual tiredness or weakness

Symptoms of overdose

Abdominal or stomach pain

agitation, anxiety, excitement, or restlessness

confusion or delirium

convulsions (seizures)—in acute overdose

dehydration

faster breathing rate

fast or irregular heartbeat

fever

frequent urination

headache

increased sensitivity to touch or pain

irritability

muscle trembling or twitching

nausea and vomiting, sometimes with blood

overextending the body with head and heels bent backward and body bowed forward

painful, swollen abdomen or vomiting (in newborn babies)

ringing or other sounds in ears

seeing flashes of "zig-zag" lights

whole-body tremors (in newborn babies)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Nausea (mild)

nervousness or jitters (mild)

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this time, check with your doctor if you notice any of the following side effects:

More common

Anxiety

dizziness

headache

irritability

muscle tension

nausea

nervousness

stuffy nose

unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Caffeine citrate (Cafcit)

thumbs-up

Pros

First choice to treat abnormal breathing in premature babies

Maintenance dose is typically given only once a day.

Available as an injection and oral solution form

thumbs-down

Cons

Can cause irritability or feeding problems in your baby

Must be careful when using the medication for babies with kidney, liver, or heart problems because of risk of side effects

Not clear how safe it is or how well it works when it's used for more than 12 days

pharmacist-tips

Pharmacist tips for Caffeine citrate (Cafcit)

pharmacist
  • Typically, the care team will give your baby caffeine citrate (Cafcit) treatment for their breathing problem in the neonatal intensive care unit (NICU). Ask the care team if you have any questions or concerns about your baby's treatment.

    • In some situations, the care team might instruct you to give caffeine citrate (Cafcit) to your baby at home after getting discharged from the hospital. This will depend on your baby's condition. If this is the case, follow the care team's directions carefully to make sure you give your baby the medication properly. Ask the care team if you have any questions about how to give your baby caffeine citrate (Cafcit).

      • If you notice that your baby is still having brief pauses in breathing or their breathing gets worse at any point during treatment, contact your baby's provider right away.

        faqs

        Frequently asked questions about Caffeine citrate (Cafcit)

        When does a neonate need caffeine citrate (Cafcit)?
        Sometimes, when babies are born before the 37th week of pregnancy (premature), their ability to breathe continuously isn't fully developed. Because of this, they might experience short periods of shallow breathing or stopped breathing. This condition, known as apnea of prematurity, is fairly common in premature babies. Providers caring for premature babies with this breathing problem commonly use caffeine citrate (Cafcit) to help them breathe regularly.
        Is caffeine citrate (Cafcit) the best treatment for apnea in premature babies?
        Caffeine citrate (Cafcit) is the medication of choice to treat abnormal breathing in premature babies. In fact, it's the only treatment that's approved by the FDA for this purpose. It's suggested that caffeine citrate (Cafcit) works better to lessen episodes of apnea and has fewer side effects than some other related medications (e.g., aminophylline, theophylline).
        How long will my baby need to take caffeine citrate (Cafcit)?
        Your baby's provider will make sure your baby gets caffeine citrate (Cafcit) for the appropriate and safe amount of time needed to improve your baby's breathing. Each hospital might have different protocols that the care team follows on how to give caffeine citrate (Cafcit) appropriately. Keep in mind that it's not clear how safe the medication is or how well it works when it's used for more than 12 days because there aren't many studies looking into long-term treatment. If your baby's breathing doesn't improve or gets worse at any point during treatment, let the care team know right away.
        Can the caffeine citrate (Cafcit) injection be given orally?
        No. Caffeine citrate (Cafcit) is available as an injection and an oral solution form. The injection form should only be given to your baby intravenously (into the vein or IV) by a healthcare professional. The oral solution can be given by mouth if your baby is able to swallow or through a feeding tube. Caffeine citrate (Cafcit) is typically given in the neonatal intensive care unit (NICU).
        Is caffeine citrate (Cafcit) bad for the liver?
        Caffeine citrate (Cafcit) doesn't cause liver damage. But, if your baby has liver problems, the care team will use the medication cautiously and watch your baby closely. Caffeine citrate (Cafcit) is primarily broken down by the liver once inside the body. If the liver isn't working properly, more medication can stay inside the body. This can raise the risk for toxicities (e.g., fever, fast breathing, trouble sleeping, stiff arms or legs, muscle spasms, seizures). If your baby has liver problems, their provider might give them a lower caffeine citrate (Cafcit) dose and watch for signs of toxicity closely.
        GoodRxEducationalIcon

        How to save using GoodRx

        Compare Prices
        1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.
        Select your free coupon
        2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.
        Show coupon to your pharmacist
        3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.
        Get free couponLearn more
        warings-icon

        What are the risks and warnings for Caffeine citrate (Cafcit)?

        Caffeine citrate (Cafcit) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

        risk-warning

        Serious bacterial infection in the intestine

        In studies, some babies who were given caffeine citrate (Cafcit) developed a serious bacterial infection in the intestine during treatment. This infection can sometimes be life-threatening. Although it isn't clear if caffeine citrate (Cafcit) can cause this bacterial gut infection, it's important to be aware of the potential risk. Signs and symptoms of this bacterial gut infection include bloating of the stomach area, vomiting, bloody stools, feeding problems, and unstable breathing or heart rate. Your baby's provider will closely watch for these signs and symptoms as they treat your baby with caffeine citrate (Cafcit). Also let your baby's care team know if you notice these signs and symptoms when you're taking care of your baby.

        risk-warning

        Caution use in babies with seizures

        Seizures can happen if too much caffeine citrate (Cafcit) is accidentally given to your baby. For this reason, your baby's provider will decide whether caffeine citrate (Cafcit) is safe for your baby if your baby has had seizures. If your baby is getting caffeine citrate (Cafcit), the provider will make sure that your baby is getting the right dose of medication.

        risk-warning

        Caution use in babies with kidney or liver problems

        If your baby has kidney or liver problems, the care team will carefully use caffeine citrate (Cafcit) to treat your baby. The kidneys and liver work to break down and remove caffeine citrate (Cafcit) from the body. If your baby's kidneys and liver aren't working properly, your baby can't get rid of the medication from their body well. It can stay in the body longer, which can potentially raise the risk of side effects and toxicity.

        risk-warning

        Stress on the heart

        From studies, caffeine citrate (Cafcit) doesn't appear to harm the heart. But, the medication can make the heart beat faster and work harder than normal. For this reason, the care team will carefully use caffeine citrate (Cafcit) to treat babies with heart problems.

        dosage

        Caffeine citrate (Cafcit) dosage forms

        Typical dosing for Caffeine citrate (Cafcit)

        Your baby's provider will calculate the right dose for your baby based on their body weight.

        The loading (starting) dose of caffeine citrate (Cafcit) is 20 mg/kg of weight given into the vein (IV) for one dose. Then, your baby will continue the medication at a maintenance dose of 5 mg/kg of weight once daily (every 24 hours). The maintenance dose can be given into the vein, by mouth, or through a feeding tube. Your baby's provider will start the maintenance dose 24 hours after the IV loading dose.

        interactions

        Interactions between Caffeine citrate (Cafcit) and other drugs

        Caffeine citrate (Cafcit) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Caffeine citrate (Cafcit). Please note that only the generic name of each medication is listed below.

        Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

        drug-cost

        How much does Caffeine citrate (Cafcit) cost?

        To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
        View prices & coupons

        Get savings updates for Caffeine citrate (Cafcit)

        Receive price alerts, news, and other messages from GoodRx about Caffeine citrate (Cafcit) and other healthcare topics and relevant savings offers.

        By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.

        References

        Best studies we found

        Adbel-Hady, H., et al. (2015). Caffeine therapy in preterm infants. World Journal of Clinical Pediatrics.

        Eichenwald, E. C., et al. (2016). Apnea of prematurity. Pediatrics.

        Kumar, V. H. S., et al. (2019). Caffeine and clinical outcomes in premature neonates. Children.

        View All References (4)

        MedlinePlus. (2021). Apnea of prematurity.

        MedlinePlus. (2021). Necrotizing enterocolitis.

        Pergolizzi, J., et al. (2022). Treating apnea of prematurity. Cureus.

        Sun Pharmaceutical Industries, Inc. (2020). CAFFEINE CITRATE injection. CAFFEINE CITRATE solution [package insert]. DailyMed.

        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
        Was this page helpful?

        Browse medications

        View All

        Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.