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Pharmacokinetic profile of caffeine in the premature newborn infant with apnea

Author(s): Aranda JV, Cook CE, Gorman W, Collinge JM, Loughnan PM, et al.


The pharmacokinetic profile of caffeine was studied in 32 premature newborn infants with apnea: 12 following a single intravenous dose; 3 after a single oral dose; 7 during treatment with an initial empirical (high) maintenance dose schedule; and 10 during treatment with a revised (lower) dose schedule. Mean (±SE) AVd, t 1/2 kel, and clearance following a single intravenous dose were 0.916±0.070 1/kg, 102.9±17.9 hours, 0.009±0.001/hours and 8.9±1.5 ml/kg/hour, respectively. Rapid absorption was noted with plasma concentrations of 6 to 10 mg/l achieved within 30 minutes to two hours following an oral dose of 10 mg/kg. Cpss of caffeine in infants given a high empirical dose (11.2±1.5 mg/kg/day) ranged from 22.5 to 84.2 mg/l (mean=45.3) whereas a dose schedule based on kinetic data (2.5 mg/kg/day) yielded plasma concentrations ranging from 7.4 to 19.4 mg/l (mean=13.7). We suggest a loading dose of 10 mg/kg intravenously or orally followed by a daily maintenance dose of 2.5 mg/kg/day administered as a single dose for the treatment and prevention of neonatal apnea.

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