CAFCIT SIDE EFFECTS

  • Generic Name: caffeine citrate
  • Brand Name: Cafcit
  • Drug Class: Phosphodiesterase Enzyme Inhibitors, Nonselective, Respiratory Stimulants
Last updated on MDtodate: 10/03/2022

SIDE EFFECTS

Overall, the reported number of adverse events in the double-blind period of the controlled trial was similar for the CAFCIT (caffeine citrate) and placebo groups. The following table shows adverse events that occurred in the double-blind period of the controlled trial and that were more frequent in CAFCIT-treated patients than placebo.

ADVERSE EVENTS THAT OCCURRED MORE FREQUENTLY IN CAFCIT-TREATED PATIENTS THAN PLACEBO DURING DOUBLE-BLIND THERAPY

Adverse Event (AE) CAFCIT
N=46
n (%)
Placebo
N=39
n (%)
BODY AS A WHOLE
Accidental Injury 1 (2.2) 0 (0.0)
Feeding Intolerance 4 (8.7) 2 (5.1)
Sepsis 2 (4.3) 0 (0.0)
CARDIOVASCULAR SYSTEM
Hemorrhage 1 (2.2) 0 (0.0)
DIGESTIVE SYSTEM
Necrotizing Enterocolitis 2 (4.3) 1 (2.6)
Gastritis 1 (2.2) 0 (0.0)
Gastrointestinal Hemorrhage 1 (2.2) 0 (0.0)
HEMIC AND LYMPHATIC SYSTEM
Disseminated Intravascular Coagulation 1 (2.2) 0 (0.0)
METABOLIC AND NUTRITIVE DISORDERS
Acidosis 1 (2.2) 0 (0.0)
Healing Abnormal 1 (2.2) 0 (0.0)
NERVOUS SYSTEM
Cerebral Hemorrhage 1 (2.2) 0 (0.0)
RESPIRATORY SYSTEM
Dyspnea 1 (2.2) 0 (0.0)
Lung Edema 1 (2.2) 0 (0.0)
SKIN AND APPENDAGES
Dry Skin 1 (2.2) 0 (0.0)
Rash 4 (8.7) 3 (7.7)
Skin Breakdown 1 (2.2) 0 (0.0)
SPECIAL SENSES
Retinopathy of Prematurity 1 (2.2) 0 (0.0)
UROGENITAL SYSTEM
Kidney Failure 1 (2.2) 0 (0.0)

 

In addition to the cases above, three cases of necrotizing enterocolitis were diagnosed in patients receiving CAFCIT (caffeine citrate) during the open-label phase of the study.

Three of the infants who developed necrotizing enterocolitis during the trial died. All had been exposed to caffeine. Two were randomized to caffeine, and one placebo patient was “rescued” with open-label caffeine for uncontrolled apnea.

Adverse events described in the published literature include: central nervous system stimulation (i.e., irritability, restlessness, jitteriness), cardiovascular effects (i.e., tachycardia, increased left ventricular output, and increased stroke volume), gastrointestinal effects (i.e., increased gastric aspirate, gastrointestinal intolerance), alterations in serum glucose (i.e., hypoglycemia and hyperglycemia), and renal effects (i.e., increased urine flow rate, increased creatinine clearance, and increased sodium and calcium excretion). Published long-term follow-up studies have not shown caffeine to adversely affect neurological development or growth parameters.

A published randomized, placebo-controlled, clinical trial in premature infants with birthweights of 5001250 grams studied the safety of caffeine citrate in apnea of prematurity (NCT00182312). This trial randomized approximately 2000 premature infants with a mean gestational age of 27 weeks at birth. The median duration of caffeine therapy was 37 days. Prior to discharge home, death, ultrasonographic signs of brain injury, and necrotizing enterocolitis were not more common in the caffeine citrate group compared to the placebo. At follow up at both 18 months and 5 years corrected age, death was not more common in the caffeine citrate treated group compared to placebo, nor did caffeine citrate use adversely affect neurodevelopmental outcomes.

 

SRC: NLM .