Ingredient: Caffeine.

Dosage Form:

Maximum Strength Caplets: Caffeine 200 mg.

FDA Indication/Dosages:

As an aid in staying awake and restoring mental alertness: 200 mg every 3-4 hours as needed. Not recommended for children.

Pharmacology: Caffeine produces central nervous system stimulation by two different mechanisms. It inhibits phosphodiesterase thereby increasing the accumulation of cyclic AMP and it blocks receptors for adenosine. The primary mechanism of action in the CNS seems to be the latter of the two.

Evaluation: Chronic fatigue can be caused by abnormal sleep patterns or a more serious medical condition. Stimulants can be helpful for short-term use in combating boredom with monotonous activities such as driving. Stimulants should not be used for fatigue associated with irregular sleep patterns, depression, or to offset the use of sedatives.

Contraindications/Precautions: Use with caution in patients with extremely high blood pressure, cardiac arrhythmias, or congestive heart failure. Use in moderation during pregnancy. Oral contraceptives, cimetidine, disulfiram, phenylpropanolamine, and fluoroquinolone antibiotics may increase serum caffeine levels. The following list shows approximate caffeine levels in commonly ingested beverages and foods:

Cup of brewed coffee: 100-150 mg.

Cup of instant coffee: 75-100 mg.

Cup of decaffeinated coffee: 2-5 mg.

Cup of tea: 50-75 mg.

12 ounces of cola drink: 50-75 mg.

Cup of cocoa: 25-50 mg.

Ounce of Baker’s chocolate: 25 mg.

Ounce of milk chocolate: 3-6 mg.

Adverse Effects: Restlessness, nervousness, insomnia, tinnitus, and rebound headache.

Patient Consultation:

Ask the patient why they believe they need the medication and for how long they plan on using it.

Ask the patient if they are a regular drinker of coffee or tea.

Advise the patient to keep within the recommended dosage.