Caffeine citrate


Caffeine citrate, sold under the trade name Cafcit among others, is a medication used to treat a lack of breathing in premature babies. Specifically it is given to babies who are born at less than 35 weeks or weigh less than once other causes are ruled out. It is given by mouth or slow injection into a vein.
Side effects can include problems feeding, increased heart rate, low blood sugar, necrotizing enterocolitis, and kidney problems. Testing blood caffeine levels is occasionally recommended. It is a citric acid salt of caffeine. Caffeine citrate is in the xanthine family of medication. It works by stimulating the respiratory centers in the brain.
Caffeine was discovered in 1819. It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system. In the United Kingdom a 10 mg vial costs £4.90. The intravenous form may also be taken by mouth.
In June 2020, the Committee for Medicinal Products for Human Use of the European Medicines Agency recommended the approval of Gencebok.

Medical uses

Caffeine citrate is generally the preferred treatment for apnea of prematurity. It has fewer side effects as compared to theophylline.
Caffeine improves airway function in asthma, increasing forced expiratory volume by 5% to 18%, with this effect lasting for up to four hours.

Mechanism

In method of action, the preparation is exactly identical to that of caffeine base as the citrate counter ion dissociates in water. Doses of caffeine citrate, due to the added weight of the citrate moiety, are understandably higher than with caffeine base, i.e., it takes a larger dose to get the same amount of caffeine. The ratio of therapeutic doses of caffeine base to its citrate salt is typically 1:2. Dosing should therefore be clearly distinguished.

Manufacture

The drug is prepared by combining anhydrous caffeine with citric acid monohydrate and sodium citrate dihydrate.