Caffeine administration


These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline. 

Read the full PCH Emergency Department disclaimer.


To guide medical and nursing staff in the use of caffeine administration.


A neonate who presents with apnoea to the Emergency Department may benefit from caffeine administration. The decision to prescribe caffeine is made in consultation with a senior clinician.


  • CAUTION:  Caffeine Base 1mg = Caffeine Citrate 2mg
  • To minimise dosing errors, always prescribe as Caffeine Base or Caffeine Citrate
  • Caffeine Base is the preparation used at PCH.


  • Stimulates central inspiratory drive
  • Increases sensitivity of the medullary centre to CO2.


Used for prevention or treatment of apnoea of prematurity or apnoea associated with respiratory infection or anaesthesia.

See Caffeine - Neonatal Medication Monograph (internal WA Health only) for doses and administration. 

Nursing observations

Observe infants for symptoms of toxicity:

  • Tachycardia
  • Jitteriness
  • Tremors
  • Unexplained seizures
  • Vomiting.


  1. AMH Children’s Dosing Companion (online). Adelaide: Australian Medicines Handbook Pty Ltd; 2014 July. Available from:
  2. Paediatric Dosage Handbook International 17th Edition (2011) EMIMS 2012.

Endorsed by:  Co-Director, Surgical Services  Date:  Oct 2021

 Review date:   Aug 2024

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Related guidelines