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Caffeine is a chemical found in coffee, tea, cola, guarana, mate, and other products.
Caffeine is most commonly used to improve mental alertness, but it has many other uses. Caffeine is used by mouth or rectally in combination with painkillers (such as aspirin and acetaminophen) and a chemical called ergotamine for treating migraine headaches. It is also used with painkillers for simple headaches and preventing and treating headaches after epidural anesthesia.
Some people use caffeine by mouth for asthma, gallbladder disease, attention deficit-hyperactivity disorder (ADHD), and many other conditions, but there is no good scientific evidence to support most of these uses.
Caffeine is one of the most commonly used stimulants among athletes. Taking caffeine, within limits, is allowed by the National Collegiate Athletic Association (NCAA). Urine concentrations over 15 mcg/mL are prohibited. It takes most people about 8 cups of coffee providing 100 mg/cup to reach this urine concentration.
Some caffeine products are sold in very concentrated or pure forms. These products are a health concern. People can easily use these products in doses that are much too high by mistake. This can lead to death. As of 2018, the U.S. Food and Drug Administration (FDA) considers it unlawful for these products to be sold to consumers in bulk.
In foods, caffeine is used as an ingredient in soft drinks, energy drinks, and other beverages.
- Migraine headache. Oral caffeine in combination with acetaminophen, aspirin, and/or sumatriptan is approved by the US Food and Drug Administration (FDA) for treating migraine headache.
Login for details - Neonatal apnea. Oral or intravenous caffeine citrate is approved by the US Food and Drug Administration (FDA) for the short-term treatment of neonatal apnea in very preterm infants.
Login for details - Postoperative headache. Oral or intravenous caffeine is approved by the US Food and Drug Administration (FDA) for preventing headache in postoperative patients who regularly consume caffeinated products.
Login for details - Tension headache. Oral caffeine in combination with analgesics is approved by the US Food and Drug Administration (FDA) for treating tension headache.
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- Mental alertness. Oral caffeine increases mental alertness. However, it might not improve performance or accuracy to the same extent achieved through adequate sleep.
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- Athletic performance. Oral caffeine taken 30-150 minutes prior to physical activity seems to modestly improve muscle strength and physical endurance, although the magnitude of effect is variable and may be dependent on a number of patient- and activity-specific factors. Caffeine in excess of 800 mg per day can result in levels greater than those allowed by the National Collegiate Athletic Association (16273).
Login for details - Bronchopulmonary dysplasia. Intravenous caffeine may reduce the risk for bronchopulmonary dysplasia in preterm infants.
Login for details - Diabetes. Dietary caffeine seems to be beneficial for type 2 diabetes prevention. However, it is unclear if oral caffeine is beneficial for treating type 1 or type 2 diabetes.
Login for details - Memory. Oral caffeine seems to be beneficial for short-term memory recall in college students and extroverted personalities. It is unclear if oral caffeine is beneficial for introverted personalities or other populations.
Login for details - Obesity. Oral caffeine, when taken in combination with ephedrine or as a component of green tea, seems to be beneficial for weight loss, short-term.
Login for details - Pain (acute). Oral caffeine, when taken in combination with acetaminophen, propyphenazone, ibuprofen, or other pain-relieving agents, seems to be beneficial for acute pain.
Login for details - Postdural puncture headache. Oral or intravenous caffeine seem to be beneficial for preventing postdural puncture headache.
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- Atrial fibrillation. Oral caffeine does not seem to prevent atrial fibrillation after cardiopulmonary bypass. In addition, it might increase the risk of gastrointestinal side effects.
Login for details - Attention deficit-hyperactivity disorder (ADHD). Oral caffeine does not seem to reduce symptoms of ADHD in children.
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- Age-related cognitive decline. It is unclear if oral caffeine prevents cognitive decline with aging.
Login for details - Asthma. Oral caffeine seems to modestly improve airway function for up to 4 hours in patients with mild to moderate asthma. However, it is unclear if oral caffeine has a clinically significant effect on asthma symptoms or quality of life.
Login for details - Cancer pain. It is unclear if intravenous caffeine is beneficial for cancer pain.
Login for details - Dementia. It is unclear if oral caffeine is beneficial for preventing dementia or improving behavior in patients with dementia.
Login for details - Depression. It is unclear if oral caffeine is beneficial for depression prevention.
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- Exercise-induced hypoxemia. It is unclear if oral caffeine is beneficial for hypoxemia associated with exercise.
Login for details - Exercise-induced muscle soreness. It is unclear if oral caffeine is beneficial for reducing muscle soreness during exercise.
Login for details - Gallbladder disease. It is unclear if increased dietary caffeine intake reduces the risk of developing gallstones.
Login for details - Hepatitis C. It is unclear if increased dietary caffeine reduces the risk for hepatitis C-associated severe liver inflammation, although it may reduce the risk of developing advanced fibrosis.
Login for details - Hypnic headache. It is unclear if oral caffeine reduces the pain associated with this rare condition.
Login for details - Hypotension. It is unclear if oral caffeine is beneficial in people with low blood pressure.
Login for details - Intermittent claudication. It is unclear if oral caffeine is beneficial for intermittent claudication.
Login for details - Liver disease. It is unclear if oral caffeine is beneficial for liver disease prevention.
Login for details - Narcolepsy. It is unclear if oral caffeine is beneficial for narcolepsy.
Login for details - Neonatal resuscitation. It is unclear if oral caffeine improves the likelihood for successful extubation in preterm infants.
Login for details - Nonmelanoma skin cancer. It is unclear if oral caffeine is beneficial for nonmelanoma skin cancer prevention.
Login for details - Parkinson disease. Although consuming caffeinated beverages might reduce the risk of developing Parkinson disease, it is unclear if oral caffeine is beneficial for improving symptoms. Also, oral caffeine does not seem to prevent tardive dyskinesia.
Login for details - Stroke. It is unclear if oral caffeine is beneficial for stroke prevention.
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Caffeine works by stimulating the central nervous system (CNS), heart, muscles, and the centers that control blood pressure. Caffeine can raise blood pressure, but might not have this effect in people who use it all the time. Caffeine can also act like a "water pill" that increases urine flow. But again, it may not have this effect in people who use caffeine regularly. Also, drinking caffeine during moderate exercise is not likely to cause dehydration.
When taken by mouth: Caffeine is LIKELY SAFE for most healthy adults when used in doses up to 400 mg per day. This amount of caffeine is similar to what is found in about 4 cups of coffee.
Caffeine is POSSIBLY UNSAFE when taken by mouth for a long time or in high doses (>400 mg per day). Caffeine can cause insomnia, nervousness and restlessness, stomach irritation, nausea, increased heart rate and respiration, and other side effects. Larger doses might cause headache, anxiety, agitation, and chest pain.
Caffeine is LIKELY UNSAFE when taken by mouth in very high doses as it can cause irregular heartbeats and even death. Products with very concentrated or pure caffeine have a high risk of being used in doses that are too high. Avoid using these products.
Special Precautions & Warnings:
Children: Caffeine is POSSIBLY SAFE when given by mouth or intravenously (by IV) to preterm infants under the advice and care of a healthcare professional. Caffeine is also POSSIBLY SAFE when used by children and adolescents in amounts commonly found in foods.Pregnancy and breast-feeding: Caffeine is POSSIBLY SAFE in pregnant or breast-feeding women when used daily amounts of less than 300 mg. This is about the amount in about 3 cups of coffee. Consuming larger amounts during pregnancy or when breast-feeding is POSSIBLY UNSAFE. When consumed in larger amounts during pregnancy, caffeine might increase the chance of miscarriage and other problems. Also, caffeine can pass into breast milk, so nursing mothers should closely monitor caffeine intake to make sure it is on the low side. High intake of caffeine by nursing mothers can cause sleep disturbances, irritability, and increased bowel activity in breast-fed infants.
Anxiety disorders: Caffeine might make these conditions worse. Use with care.
Bipolar disorder: Too much caffeine might make this condition worse. In one case, a 36-year-old man with controlled bipolar disorder was hospitalized with symptoms of mania after drinking several cans of an energy drink containing caffeine, taurine, inositol, and other ingredients (Red Bull Energy Drink) over a period of 4 days. Use caffeine with care and in low amounts if you have bipolar disorder.
Bleeding disorders: There is concern that caffeine might aggravate bleeding disorders. Use caffeine with care if you have a bleeding disorder.
Heart conditions: Caffeine can cause irregular heartbeat in sensitive people. Use caffeine with caution.
Diabetes: Some research suggests that caffeine may affect the way the body uses sugar and might worsen diabetes. However, the effect of caffeinated beverages and supplements has not been studied. If you have diabetes, use caffeine with caution.
Diarrhea: Caffeine, especially when taken in large amounts, might worsen diarrhea.
Epilepsy: People with epilepsy should avoid using caffeine in high doses. Low doses of caffeine should be used cautiously.
Glaucoma: Caffeine increases the pressure inside the eye. The increase occurs within 30 minutes and lasts for at least 90 minutes after drinking caffeinated beverages.
High blood pressure: Consuming caffeine might increase blood pressure in people with high blood pressure. However, this effect might be less in people who use caffeine regularly.
Loss of bladder control: Caffeine can make bladder control worse by increasing frequency of urination and the urge to urinate.
Irritable bowel syndrome (IBS): Caffeine, especially when taken in large amounts, might worsen diarrhea in people with IBS.
Weak bones (osteoporosis): Caffeine can increase the amount of calcium that is flushed out in the urine. If you have osteoporosis or low bone density, caffeine should be limited to less than 300 mg per day (approximately 2-3 cups of coffee). It is also a good idea to get extra calcium to make up for the amount that may be lost in the urine. If you are generally healthy and getting enough calcium from your food or supplements, taking up to 400 mg of caffeine per day (3-5 cups of coffee) doesn't seem to increase the risk of getting osteoporosis. Older women with an inherited disorder that affects the way vitamin D is used should use caffeine with caution. Vitamin D works with calcium to build bones.
Parkinson disease: Taking caffeine with creatine might make Parkinson disease e get worse faster. If you have Parkinson disease and take creatine, use caffeine with caution.
Schizophrenia: Caffeine might worsen symptoms of schizophrenia.
Adenosine (Adenocard)
Interaction Rating=Moderate Be cautious with this combination.
Caffeine might block the effects of adenosine (Adenocard). Adenosine (Adenocard) is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop consuming caffeine-containing products at least 24 hours before a cardiac stress test.
Alcohol
Interaction Rating=Minor Be watchful with this combination.
The body breaks down caffeine to get rid of it. Alcohol can decrease how quickly the body breaks down caffeine. Taking caffeine along with alcohol might cause too much caffeine in the bloodstream and caffeine side effects including jitteriness, headache, and fast heartbeat.
Antibiotics (Quinolone antibiotics)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down caffeine to get rid of it. Some antibiotics might decrease how quickly the body breaks down caffeine. Taking these antibiotics along with caffeine can increase the risk of side effects including jitteriness, headache, increased heart rate, and other side effects.
Some antibiotics that decrease how quickly the body breaks down caffeine include ciprofloxacin (Cipro), enoxacin (Penetrex), norfloxacin (Chibroxin, Noroxin), sparfloxacin (Zagam), trovafloxacin (Trovan), and grepafloxacin (Raxar).
Birth control pills (Contraceptive drugs)
Interaction Rating=Minor Be watchful with this combination.
The body breaks down caffeine to get rid of it. Birth control pills can decrease how quickly the body breaks down caffeine. Taking caffeine along with birth control pills can cause jitteriness, headache, fast heartbeat, and other side effects.
Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.
Cimetidine (Tagamet)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down caffeine to get rid of it. Cimetidine (Tagamet) can decrease how quickly your body breaks down caffeine. Taking cimetidine (Tagamet) along with caffeine might increase the chance of caffeine side effects including jitteriness, headache, fast heartbeat, and others.
Clozapine (Clozaril)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down clozapine (Clozaril) to get rid of it. Caffeine seems to decrease how quickly the body breaks down clozapine (Clozaril). Taking caffeine along with clozapine (Clozaril) can increase the effects and side effects of clozapine (Clozaril).
Dipyridamole (Persantine)
Interaction Rating=Moderate Be cautious with this combination.
Caffeine might block the affects of dipyridamole (Persantine). Dipyridamole (Persantine) is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop consuming caffeine-containing products at least 24 hours before a cardiac stress test.
Disulfiram (Antabuse)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down caffeine to get rid of it. Disulfiram (Antabuse) can decrease how quickly the body gets rid of caffeine. Taking caffeine along with disulfiram (Antabuse) might increase the effects and side effects of caffeine including jitteriness, hyperactivity, irritability, and others.
Ephedrine
Interaction Rating=Major Do not take this combination.
Stimulant drugs speed up the nervous system. Caffeine and ephedrine are both stimulant drugs. Taking caffeine along with ephedrine might cause too much stimulation and sometimes serious side effects and heart problems. Do not take caffeine-containing products and ephedrine at the same time.
Estrogens
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down caffeine to get rid of it. Estrogens can decrease how quickly the body breaks down caffeine. Taking caffeine along with estrogens might cause jitteriness, headache, fast heartbeat, and other side effects. If you take estrogens limit your caffeine intake.
Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.
Fluconazole (Diflucan)
Interaction Rating=Minor Be watchful with this combination.
The body breaks down caffeine to get rid of it. Fluconazole (Diflucan) might decrease how quickly the body gets rid of caffeine. Taking caffeine along with fluconazole (Diflucan) might cause caffeine to stay in to body too long and increase the risk of side effects such as nervousness, anxiety, and insomnia.
Fluvoxamine (Luvox)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down caffeine to get rid of it. Fluvoxamine (Luvox) can decrease how quickly the body breaks down caffeine. Taking caffeine along with fluvoxamine (Luvox) might cause too much caffeine in the body, and increase the effects and side effects of caffeine.
Lithium
Interaction Rating=Moderate Be cautious with this combination.
You body naturally gets rid of lithium. Caffeine can increase how quickly your body gets rid of lithium. If you take products that contain caffeine and you take lithium, stop taking caffeine products slowly. Stopping caffeine too quickly can increase the side effects of lithium.
Medications for depression (MAOIs)
Interaction Rating=Moderate Be cautious with this combination.
Caffeine can stimulate the body. Some medications used for depression can also stimulate the body. Taking caffeine along with some medications for depression might cause serious side effects including fast heartbeat, high blood pressure, nervousness, and others.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.
Medications for diabetes (Antidiabetes drugs)
Interaction Rating=Minor Be watchful with this combination.
Caffeine might increase blood sugar. Diabetes medications are used to lower blood sugar. Taking some medications for diabetes along with caffeine might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating=Moderate Be cautious with this combination.
Caffeine might slow blood clotting. Taking caffeine along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Mexiletine (Mexitil)
Interaction Rating=Minor Be watchful with this combination.
The body breaks down caffeine to get rid of it. Mexiletine (Mexitil) can decrease how quickly the body breaks down caffeine. Taking Mexiletine (Mexitil) along with caffeine might increase the effects and side effects of caffeine.
Pentobarbital (Nembutal)
Interaction Rating=Moderate Be cautious with this combination.
The stimulant effects of caffeine can block the sleep-producing effects of pentobarbital.
Phenylpropanolamine
Interaction Rating=Moderate Be cautious with this combination.
Caffeine can stimulate the body. Phenylpropanolamine can also stimulate the body. Taking caffeine along with phenylpropanolamine might cause too much stimulation and increase heartbeat, blood pressure, and cause nervousness.
Riluzole (Rilutek)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down riluzole (Rilutek) to get rid of it. Taking caffeine along with riluzole (Rilutek) might decrease how fast the body breaks down riluzole (Rilutek) and increase the effects and side effects of riluzole (Rilutek).
Stimulant drugs
Interaction Rating=Moderate Be cautious with this combination.
Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heart rate. Caffeine might also speed up the nervous system. Taking caffeine along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with caffeine.
Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.
Terbinafine (Lamisil)
Interaction Rating=Minor Be watchful with this combination.
The body breaks down caffeine to get rid of it. Terbinafine (Lamisil) can decrease how fast the body gets rid of caffeine. Taking caffeine along with terbinafine (Lamisil) can increase the risk of caffeine side effects including jitteriness, headache, increased heartbeat, and other effects.
Theophylline
Interaction Rating=Moderate Be cautious with this combination.
Caffeine works similarly to theophylline. Caffeine can also decrease how quickly the body gets rid of theophylline. Taking theophylline along with caffeine might increase the effects and side effects of theophylline.
Verapamil (Calan, Covera, Isoptin, Verelan)
Interaction Rating=Moderate Be cautious with this combination.
The body breaks down caffeine to get rid of it. Verapamil (Calan, Covera, Isoptin, Verelan) can decrease how quickly the body gets rid of caffeine. Taking caffeine along with verapamil (Calan, Covera, Isoptin, Verelan) can increase the risk of side effects for caffeine including jitteriness, headache, and an increased heartbeat.
Bitter orange: Taking bitter orange along with caffeine can increase blood pressure and heart rate in healthy adults with normal blood pressure. This could increase the risk of serious heart conditions and stroke.
Caffeine-containing herbs and supplements: Using caffeine along with herbs and supplements that contain caffeine might increase the effects and side effects. Natural products that contain caffeine include coffee, black tea, green tea, oolong tea, guarana, mate, and cola nut.
Calcium: High doses of caffeine can lead to increased loss of calcium in the urine.
Creatine: There is some concern that combining caffeine, ephedra, and creatine might increase the risk of serious side effects. There is a report of stroke in an athlete who took 6 grams of creatine monohydrate, 400-600 mg of caffeine, 40-60 mg of ephedra, and a variety of other supplements daily for 6 weeks. Caffeine might also decrease creatine's possible benefits for athletic performance.
Danshen: The body breaks down caffeine to get rid of it. Danshen might decrease how quickly the body breaks down caffeine. Using danshen with caffeine might increase caffeine levels.
Echinacea: The body breaks down caffeine to get rid of it. Echinacea might decrease how quickly the body breaks down caffeine. Using echinacea with caffeine might increase caffeine levels.
Ephedra (Ma huang): Use of ephedra with caffeine might cause too much stimulation in the body. There is evidence that using ephedra with caffeine might increase the risk of serious life-threatening or harmful conditions such as high blood pressure, heart attack, stroke, seizures, and death. Don't take caffeine with ephedra or other stimulants.
Genistein-containing herbs and supplements: The body breaks down caffeine to get rid of it. Taking herbs or supplements that contain genistein might decrease how quickly the body breaks down caffeine. Using genistein with caffeine might increase caffeine levels.
Herbs and supplements that might slow blood clotting: Caffeine may slow blood clotting. Using it along with other herbs and supplements that might also slow blood clotting could increase the risk of bleeding in some people. Some of these herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and others.
Kudzu: The body breaks down caffeine to get rid of it. Kudzu seems to decrease how quickly the body breaks down caffeine. Using kudzu with caffeine might increase caffeine levels.
Magnesium: High doses of caffeine can lead to increased loss of magnesium in the urine.
Melatonin: Taking caffeine and melatonin together can increase melatonin levels.
There are no known interactions with foods.
The following doses have been studied in scientific research:
ADULTS
BY MOUTH:
- General: One cup of brewed coffee provides from 95-200 mg of caffeine. An 8-ounce serving of black tea provides from 40-120 mg of caffeine. An 8-ounce serving of green tea provides 15-60 mg of caffeine. Soft drinks such as cola provide from 20-80 mg of caffeine per 12 ounce serving. Sports or energy drinks typically provide from 48-300 mg of caffeine per serving.
- For migraine or tension headache: Does of 100-250 mg caffeine daily have been used. Caffeine has also been used together with acetaminophen, aspirin, ergotamine, and sumatriptan.
- For headache after epidural anesthesia: Caffeine 300 mg has been used.
- For mental alertness: Doses of 100-600 mg caffeine daily have been used. Caffeine has also been taken together with taurine, glucose and L-theanine.
- For athletic performance: 2-10 mg/kg has been used. Keep in mind that doses in excess of 800 mg per day can result in urine levels greater than the 15 mcg/mL allowed by the National Collegiate Athletic Association.
- For memory: 65-200 mg of caffeine has been used.
- For obesity: Ephedrine/caffeine combination products are commonly dosed 20 mg/200 mg three times daily. A specific combination product (Prograde Metabolism) containing 1000 mg of a combination of raspberry ketone, caffeine, capsicum extract, garlic root extract, ginger root extract, bitter orange fruit, L-theanine, and black pepper fruit extract has been used twice daily for 8 weeks.
- For acute pain: Doses of 50-130 mg caffeine have been used with pain relievers including acetaminophen, propyphenazone, and ibuprofen.
- For headache after surgery: 200 mg of caffeine has been given intravenously to prevent headache after surgery.
- For headache after epidural anesthesia: Caffeine is given intravenously (by IV) by healthcare providers for this condition.
BY MOUTH:
- For pauses in breathing that may be followed by low heart rate and low oxygen levels in newborns: Caffeine is given by mouth to infants by healthcare providers for this condition.
1,3,7-Trimethyl-1H-purine- 2,6(3H,7H)-dione, 1,3,7-trimethylxanthine, 1,3,7-triméthylxanthine, 3,7-Dihydro-1,3,7-trimethyl-1H-purine-2,6-dione, Anhydrous Caffeine, Cafeina, Caféine, Caféine Anhydre, Caféine Benzodate de Sodium, Caffeine Sodium Benzoate, Caffeine Anhydrous, Caffeine Citrate, Caffeinum, Citrate de Caféine, Citrated Caffeine, Methylxanthine, Méthylxanthine, Trimethylxanthine, Triméthylxanthine.
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