Indications
Caffeine is a mild stimulant. It is most often combined with Paracetamol or other pain relievers to help relieve headache, migraine and other pain, because it can make them work a little better. It is also used to reduce drowsiness and tiredness. In hospital, caffeine citrate is used to treat breathing pauses (apnoea) in premature babies.
How It Works
Caffeine blocks adenosine, a natural brain chemical that makes you feel sleepy. This increases alertness. It also narrows blood vessels in the head slightly, which can help some headaches, and helps pain relievers to be absorbed faster.
Dosage and Administration
- Combination tablets for pain: usually 1 or 2 tablets up to 3 or 4 times a day, following the pack and never more than the stated maximum (often each tablet contains 65 mg caffeine with 500 mg Paracetamol).
- For tiredness: 50 to 100 mg, repeated if needed after some hours.
- Adults should keep total caffeine from all sources (tea, coffee, soft drinks, tablets) below about 400 mg a day.
- Premature babies: given in hospital by doctors and nurses, as prescribed.
Avoid taking it late in the day, as it can disturb sleep.
Interactions
Ciprofloxacin, Fluvoxamine, Cimetidine and oral contraceptives can raise caffeine levels, causing jitteriness. Caffeine can increase side effects of Theophylline and other stimulants, may lower Lithium levels, and can work against sleeping medicines and some anti-anxiety medicines. Large amounts with decongestants such as Pseudoephedrine can raise heart rate and blood pressure.
Contraindications
- Allergy to caffeine or any ingredient of the product.
- Serious heart rhythm problems, uncontrolled high blood pressure or overactive thyroid, unless a doctor advises.
- Combination products also follow the rules of their other ingredients, for example severe liver disease for products with Paracetamol.
Side Effects
Common: trouble sleeping, nervousness, restlessness, fast heartbeat, stomach upset and frequent urination. Regular users may get headaches if they stop suddenly.
Get urgent medical help if you have chest pain, a very fast or irregular heartbeat, severe agitation or confusion, fits, or signs of a severe allergic reaction.
Pregnancy and Lactation
In pregnancy, keep total caffeine below about 200 mg a day. During breastfeeding, moderate amounts are usually fine, but large amounts can make the baby restless and sleep poorly. Ask a doctor before using combination products.
Precautions and Warnings
Count caffeine from drinks as well as medicines. Take extra care with heart disease, high blood pressure, anxiety, stomach ulcers, epilepsy and liver disease. Using painkillers with caffeine on more than 10 to 15 days a month can cause medication overuse headache. Do not take more than one product containing Paracetamol at the same time.
Overdose
Too much caffeine can cause vomiting, shaking, severe anxiety, fast or irregular heartbeat and fits. Overdose of a Paracetamol combination can also seriously damage the liver, even if you feel well at first. Get urgent medical help.
Therapeutic Class
Central nervous system stimulant (methylxanthine).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.