Reviewed by NICU and Dept. of Pharmacy
August 2011
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page


Management of  Caffeine Citrate  Administration


IV preparation

Oral preparation



Slow IV Infusion

  1. Filter during administration with a 0.22 micron Pall filter.
  2. Administer loading dose by slow IV infusion over 30 minutes using a syringe pump.
  3. Administer maintenance dose over 15 minutes.
  4. Compatible with sodium chloride 0.9%, glucose 5%, glucose 10%.
  5. Incompatible with aciclovir and frusemide. Do not mix with other drugs, IV solutions unless checked beforehand with Pharmacy. Do not mix with blood or blood products.
  6. Do NOT mix with Parenteral Nutrition solutions.
  7. Flush tubing with sodium chloride 0.9% before and after administration.


  1. Administer with feeds. Absorption is delayed but not decreased by feeds.

No information on IM administration.

Nursing Considerations

  1. Observe IV site for signs of extravasation.
  2. Assess for signs of adverse effects.
  3. Initial treatment should be monitored by a cardiorespiratory monitor and a pulse oximeter. Once stable, discuss apnoea monitoring with doctor.
  4. Monitor apex beat, rate and rhythm regularly. Apex beat must be taken immediately prior to administration (preferably an undisturbed rate). If the apex beat is > 180/minute withhold medication and notify doctor / NS-ANP immediately. Dose may then be administered if requested by doctor/NS-ANP.
  5. Monitor respiratory rate, quality and effort.
  6. Monitor incidence of apnoea. Continue apnoea monitoring for several days after stopping caffeine.
  7. Monitor for glycosuria.
  8. May be administered orally once the baby is tolerating 50% of full oral feed volumes.



1 Trissel LA. Handbook on Injectable Drugs. American Society of Health-System Pharmacists (ASHP) 16th Edition.
2 Phelps SJ, Hak EB, Crill CM, editors. Teddy bear book: Pediatric injectable drugs. 8th ed. Bethesda, MD: American Society of Heath-System Pharmacists; 2007.
3 Martin, J, Managing editor. BNF for children 2010-2011. London: BMJ Group, Pharmaceutical Press & RCPCH Publications Ltd; 2010.
4 Hey, E, editor. Neonatal formulary. 5th ed. Oxford: Blackwell Publishing; 2007
5 Young TE, Mangum B, editors. Neofax: A manual of drugs used in neonatal care. 18th ed. Raleigh, North Carolina, USA: Acorn Publishing; 2005.