Oral versus intramuscular loading of caffeine in idiopathic apnoea of prematurity

The loading dose of caffeine (15 mg/kg) was administered orally to nine newborn babies and intramuscularly to nine others. The oral maintenance dose (2 mg/kg per day) was administered 24 h after the loading dose and then once a day for as long as necessary. The two groups were statistically similar with regard to gestational age, birth weight and Apgar score at 1 and 5 min. There was no statistical difference between the two groups in serum levels of caffeine at 1, 12 or 24 h and 7, 14 or 21 days. Therefore, oral administration appears to be the better route for loading, as it is effective and non-traumatic. Moreover, low maintenance doses allow therapeutic serum levels to be kept to a minimum reducing the likelihood of side-effects.