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Caffeine Crash

Fatal Forty DDI: caffeine, ethinyl estradiol, ciprofloxacin, CYP1A2

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This case discusses the pharmacokinetic interaction of caffeine, ethinyl estradiol, and ciprofloxacin, resulting in caffeine toxicity Caffeine is a cytochrome P450 1A2 substrate. Both ciprofloxacin and ethinyl estradiol inhibit 1A2. The physiologic effects of ingestion of high doses of caffeine are also reviewed.


  • Pharmacokinetic
  • Caffeine
  • Inhibition
  • Inhibitor
  • Seizure
  • Ethinylestradiol
  • Ciprofloxacin
  • Methylxanthine
  • CYP1A2
  • Cytochrome
  • P450
  • 1A2
  • Cafergot
  • Adenosine
  • Status epilepticus
  • Oral contraceptive
  • OCPs
  • Alertness
  • Coffee
  • Cola
  • Cocoa
  • tea
  • Cimetidine
  • Fluvoxamine

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Correspondence to Brian Gierl MD .

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Gierl, B., Romeo, R. (2015). Caffeine Crash. In: , et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY.

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