Cafcit (Caffeine Citrate) - Intravenous

What Is Cafcit?

Cafcit (caffeine citrate) is a clear, colorless prescription medication used to help treat apnea of prematurity. Apnea of prematurity is a condition affecting premature newborn infants that causes their breathing to stop for brief periods.

Cafcit is an airway (bronchial) smooth muscle relaxant, a central nervous system (CNS) stimulant, a heart muscle stimulant, and a diuretic. It enhances the activity of certain receptors in the peripheral nervous system involved in maintaining adequate oxygen in the body's bloodstream. This helps allow for normal breathing again.

Once it has been prescribed by a licensed healthcare provider, this medication is administered into a vein (intravenously) in a hospital setting.

What Is Cafcit Used For?

Cafcit is used for the short-term treatment of apnea of prematurity in infants between 28 and 33 weeks of gestational age (a measure of a pregnancy's length).

Apnea of prematurity is when infants stop breathing for more than 15 to 20 seconds or stop breathing for less than 15 seconds and also have a decrease in heart rate or oxygenation.

Cafcit is also sometimes given to increase seizure activity in patients undergoing electroconvulsive therapy (ECT). This is a common off-label use of the medication.

How to Take Cafcit

Cafcit is given in a hospital setting via intravenous (IV) administration.

What Are the Side Effects of Cafcit?

This is not a complete list of possible Cafcit side effects, and others may occur. A healthcare provider can advise you on the side effects of taking this medication. If you experience other side effects, contact a provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

As with all medications, there are possible side effects an infant might experience while they are receiving Cafcit.

Common and less severe side effects include:

• Dry skin
• Feeding problems
• Skin rash

Severe Side Effects

Serious side effects with Cafcit are very rare, but can include:

• High blood sugar (hyperglycemia) or low blood sugar (hypoglycemia)
• Increased urine output
• Loss of energy
• Necrotizing enterocolitis (a condition in which the intestines become infected and die)
• Pulmonary edema (excess fluid in the lungs)
• Restlessness, irritability, and/or jitteriness 
• Retinopathy of prematurity (ROP) (a disease that affects the retina of the eye)
• Sepsis
• Fast heart rate (tachycardia)
• Vomiting

Dosage: How Much Cafcit Should Be Taken?

Cafcit is given intravenously by a healthcare provider in a hospital. The provider will determine the proper dosage of this medication.

An initial dose can be given over a 30-minute period. After that, lower doses can be administered every 24 hours over 10-minute periods.

Modifications

Caution should be used when giving Cafcit to infants with impaired kidney or liver function. A healthcare provider will carefully monitor them and adjust the dosage as needed.

Missed Dose

Cafcit injection is given in the hospital setting, so it is highly unlikely for a dose to be missed.

Overdose: What Happens If I Take Too Much Cafcit?

Cafcit is administered by a healthcare provider in a hospital setting, so an overdose is unlikely to occur. However, too much Cafcit can have adverse effects. Possible signs of Cafcit overdose in preterm infants include:

• Fever
• Increased muscle tone (hypertonia)
• Trouble sleeping (insomnia)
• Jitteriness
• Seizures
• Rapid, shallow breathing (tachypnea)
• Vomiting

Precautions

What Are Reasons I Shouldn’t Take Cafcit?

Cafcit should be avoided in patients with a known hypersensitivity to Cafcit or any of its ingredients.

What Other Medications Interact With Cafcit?

Taking Cafcit and Theo-24 (theophylline) together is not recommended.

Lower doses of Cafcit might be needed if it's taken with drugs that can decrease caffeine elimination from the body, such as cimetidine and ketoconazole. Higher doses might be needed if Cafcit is taken with drugs that increase how much caffeine is eliminated from the body, such as phenobarbital and Dilantin (phenytoin).

What Medications Are Similar?

Theophylline is also commonly used to treat apnea of prematurity. It works similarly to Cafcit, but it has been associated with higher rates of toxicity.

How to Stay Healthy While Taking Cafcit

Apnea of prematurity can be a scary diagnosis for new parents, but Cafcit is an effective and potentially life-saving treatment.

Apnea is a common problem for newborns, but most babies have favorable outcomes with treatment. For mild apnea, patting or rubbing your infant's skin can help stimulate breathing. Healthcare providers may suggest that you try changing the baby's position, slowing feed time, or providing oxygen or continuous positive airway pressure (CPAP) to help with breathing patterns.

Talk to your baby's healthcare team about any questions or concerns you have.