use caution. Use Caution/Monitor.moxonidineMonitor Closely (1)moxonidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nabiloneMonitor Closely (1)nabilone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.norepinephrineMonitor Closely (1)norepinephrine and caffeine both decrease sedation. Use Caution/Monitor.nortriptylineMonitor Closely (1)nortriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.olanzapineMonitor Closely (1)olanzapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.opium tinctureMonitor Closely (1)opium tincture increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of caffeine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.paliperidoneMonitor Closely (1)paliperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.papaveretumMonitor Closely (1)papaveretum increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pefloxacinMonitor Closely (1)pefloxacin will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.peginterferon alfa 2aMinor (1)peginterferon alfa 2a will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.pentazocineMonitor Closely (1)pentazocine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)pentobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.perphenazineMonitor Closely (1)perphenazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phendimetrazineMonitor Closely (1)caffeine and phendimetrazine both decrease sedation. Use Caution/Monitor.phenelzineContraindicated (1)phenelzine increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.phenobarbitalMonitor Closely (1)phenobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)phenobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.phentermineMonitor Closely (1)caffeine and phentermine both decrease sedation. Use Caution/Monitor.phenylephrineMonitor Closely (1)caffeine and phenylephrine both decrease sedation. Use Caution/Monitor.phenylephrine POMonitor Closely (1)caffeine and phenylephrine PO both decrease sedation. Use Caution/Monitor.pholcodineMonitor Closely (1)pholcodine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (1)pimozide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pipemidic acidMinor (1)pipemidic acid will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.pirbuterolMonitor Closely (1)pirbuterol and caffeine both decrease sedation. Use Caution/Monitor.posaconazoleMinor (1)posaconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.primidoneMonitor Closely (1)primidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)primidone will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.procarbazineContraindicated (1)procarbazine increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Caffeine can produce severe hypertensive crises or dangerous cardiac arrhythmias if administered to patients taking a MAOI. All preparations containing caffeine should be used sparingly.prochlorperazineMonitor Closely (1)prochlorperazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propylhexedrineMonitor Closely (1)caffeine and propylhexedrine both decrease sedation. Use Caution/Monitor.protriptylineMonitor Closely (1)protriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (1)quetiapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.rasagilineMonitor Closely (1)rasagiline increases effects of caffeine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of acute hypertensive episode.regadenosonSerious - Use Alternative (1)caffeine decreases effects of regadenoson by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid methylxanthines for 12 hours before regadenoson administration.rifampinMinor (1)rifampin will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.risperidoneMonitor Closely (1)risperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.sageMinor (1)sage increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.salmeterolMonitor Closely (1)salmeterol and caffeine both decrease sedation. Use Caution/Monitor.scullcapMonitor Closely (1)scullcap increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)secobarbital will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.selegilineMonitor Closely (1)selegiline increases effects of caffeine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of acute hypertensive episode.selegiline transdermalContraindicated (1)selegiline transdermal increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.shepherd's purseMonitor Closely (1)shepherd's purse increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.smokingMinor (1)smoking will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.solriamfetolMonitor Closely (1)caffeine and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.stiripentolMonitor Closely (1)stiripentol, caffeine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.sufentanilMonitor Closely (1)sufentanil increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.temazepamMonitor Closely (1)temazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.terbutalineMonitor Closely (1)terbutaline and caffeine both decrease sedation. Use Caution/Monitor.teriflunomideMonitor Closely (1)teriflunomide decreases levels of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.thiamineMinor (1)caffeine decreases levels of thiamine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Coffee, tea are high in anti-thiamine factors.thioridazineMonitor Closely (1)thioridazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tobacco useMinor (1)tobacco use will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.topiramateMonitor Closely (1)topiramate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)tramadol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineContraindicated (1)tranylcypromine increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneMonitor Closely (1)trazodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triazolamMonitor Closely (1)triazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (1)trifluoperazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triprolidineMonitor Closely (1)triprolidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.verapamilMinor (1)verapamil will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.voriconazoleMinor (1)voriconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.xylometazolineMonitor Closely (1)caffeine and xylometazoline both decrease sedation. Use Caution/Monitor.yerba mateMinor (1)yerba mate increases effects of caffeine by pharmacodynamic synergism. Minor/Significance Unknown.yohimbineMonitor Closely (1)caffeine and yohimbine both decrease sedation. Use Caution/Monitor.ziconotideMonitor Closely (1)ziconotide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.zileutonMinor (1)zileuton will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.ziprasidoneMonitor Closely (1)ziprasidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. Frequency Not Defined Tachycardia Palpitations (dose dependent) Insomnia Irritability Nervousness Restlessness Tremor Tinnitus Regular and decaffeinated coffee increase gastric acid & pepsin secretion Nausea Vominting Diarrhea Diuresis Withdrawal symptoms Anxiety depression Fatigue Headache (can last up to 7 days) Muscle tension Nausea Runny nose Contraindications Hypersensitivity Cautions May increase severity of fibrocystic breast disease, PMS, increase risk of bladder, ovary, colon & pancreatic cancer Carefully monitor for the development of necrotizing enterocolitis Not for use in patients with anxiety, agitation, or tremor Caution in patients with history of peptic ulcer, hepatic impairment, renal impairment, seizure disorder, or cardiovascular disease Avoid use in symptomatic arrhythmias and/or palpitations Administer therapy with caution in infants with impaired renal or hepatic function; serum concentrations of caffeine should be monitored and dose adjusted to avoid toxicity in this population; may need to monitor serum concentrations of caffeine periodically throughout treatment to avoid toxicity See Caffeine OD for caffeine content of specific foods & drinks Pregnancy Category: C (crosses placenta, can remain in fetus/neonate 64-300 hr) Lactation: enters breast milk; use with cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Methylxanthine; promotes cAMP accumulation by inhibiting phosphodiesterase; increases medullary respiratory center sensitivity to carbon dioxide; may prevent apnea by acting as an adenosine receptor antagonist Pharmacokinetics Half-Life: 72-96hr (neonates); 5 hr (>9 months and adults); decreased in tobacco user Peak plasma time: 30-120 min Peak plasma concentration: 1.5-1.8 mcg/mL Protein Bound: 17-36% Vd: 0.6-0.9 L/kg Metabolism: hepatic CYP1A2 Excretion: Urine BRAND FORM. UNIT PRICE PILL IMAGE caffeine oral- 200 mg tabletcaffeine oral- 200 mg tabletStay Awake oral- 200 mg tabletStay Awake oral- 200 mg tabletStay Awake Maximum Strength oral- 200 mg tabletVivarin oral- 200 mg tabletAlertness Aid oral- 200 mg tabletCopyright © 2010 First DataBank, Inc.Print Patient Educationcaffeine oral CAFFEINE - ORAL (KAF-een) COMMON BRAND NAME(S): No Doz, Stay Awake, Vivarin USES: This medication is used occasionally to help you stay awake and alert when you are feeling tired and/or drowsy. Caffeine is a mild stimulant.This medication should not be used to replace sleep.This medication should not be used by children younger than 12 years old. HOW TO USE: Take this product by mouth as directed. Follow all directions on the product package, or take as directed by your doctor. If you have any questions, ask your doctor or pharmacist.This medication should only be used as needed, not on a regular basis. Though very unlikely, this medication may be habit-forming. Do not increase your dose, take it more often than directed, or take it regularly for a long time.If you suddenly stop using this medication, you may have withdrawal symptoms (such as headaches, mental/mood changes such as irritation/nervousness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used caffeine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.When used for an extended period, this medication may not work as well. Talk with your doctor if this medication stops working well.Tell your doctor if your condition lasts, gets worse, or continues to occur again. If you think you may have a serious medical problem, get medical help right away. SIDE EFFECTS: Nausea, vomiting, stomach upset, trouble sleeping, or increased urination