Therapeutic Uses

The most extensively investigated and most firmly established clinical application of caffeine is the control of neonatal apnoea in premature infants. The respirogenic properties of theophylline were first reported, and caffeine is increasingly being used as a substitute for theophylline because of its wider therapeutic index. For infants with a body weight of 2.5 kg, the therapeutic loading doses varied from 5 to 30mgkg-1, followed by a maintenance dose of 3mgkg-1perday. Plasma caffeine levels must be controlled carefully to reach 10-20 mgl-1.

Because of the bronchial muscle relaxant effect, caffeine is used in chronic obstructive pulmonary disease and for the treatment of asthma. The use of caffeine in the treatment of children with minimal brain dysfunction, to increase the duration of elec-troconvulsive therapy-induced seizure, for allergic rhinitis, as well as for atopic dermatitis has also been described. Recently, caffeine has been used as a diagnostic test for malignant hyperthermia and in the diagnosis of neuroleptic malignant syndrome, a complication of neuroleptic therapy.

Caffeine is found in many drug preparations, both prescription and over-the-counter. Caffeine is present in drugs used as stimulants, pain relievers, diuretics, and cold remedies. When used as an analgesic adjuvant, the potency of the analgesic drug is significantly enhanced by the addition of caffeine.

Although caffeine has been shown to promote ther-mogenesis in humans, it is no longer allowed as an ingredient in weight-control products in the US market because long-term clinical studies demonstrate that it does not help those wishing to lose weight.

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