Pharmacokinetic profile of caffeine in the premature newborn infant with apnea (original) (raw)

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) A Vd, tt/2, ke~, and clearance following a single intravenous dose were 0.916 +_ 0.070 1/kg, 102.9 + 17.9 hours, 0.009 +_ O.O01/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 lO mg/kg. Cp s" of caffeine in infants given a high empirical dose (il.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.