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Kimberly A. Parks, DO, FACC, cardiologist at Massachusetts General Hospital and James Mojica, MD, associate program director of the Harvard Pulmonary Critical Care Medicine Fellowship Training Program discuss the safety of caffeine inhalers

Are caffeine inhalers safe?

By Dr. Kimberly A. Parks and Dr. James Mojica

29/Nov/2011

Dr. James Mojica

Dr. Kimberly A.Parks

The headlines are enticing. A company launches its newest product: caffeine inhalers. Each puff of these inhalers will deliver tiny particles of caffeine, and will provide an instant shot of energy. We suspect this product will be appealing to consumers… But, is it safe?

For starters, though the product is being promoted as “inhaled,” it’s not actually inhaled at all. Particles coat the back of the throat and are then swallowed. Each inhaler contains a total of 100mg of caffeine, roughly the amount in one small cup of coffee. That amount of caffeine is distributed over five or six puffs.

Caffeine delivered in this way is not regulated by the FDA, which leaves potential for adulteration of the substances that will be contained in the product.  Additionally, one could not be certain that the dose reported on the label given with each puff is correct.  And, since “inhaling” caffeine is so easy, one could quickly ingest doses that could have toxic side effects.  It takes a lot longer to drink five cups of coffee than it does to get the same dose from a few caffeine inhalers.  And what happens if you do go through multiple caffeine inhalers in a row? 

Caffeine used in moderate doses has been shown to be safe, but abuse of the caffeine inhalers could have ominous effects. In high enough doses (greater than 8000 mg, or 80 inhalers), an overdose of caffeine could lead to death, usually due to an abnormal rhythm of the heart called ventricular fibrillation. There is also potential for caffeine intoxication.  Caffeine intoxication manifests with symptoms such as restlessness, anxiety, flushing of the face, poor judgment, rapid or irregular heart beat, insomnia and gastrointestinal disturbance. And, although caffeine is not currently recognized as a substance at risk for abuse or dependence, studies have demonstrated behavior patterns that mimic other drugs of abuse.  Heavy caffeine use has been associated with other forms of addictive behavior such as smoking, increased alcohol intake and gambling.

Some effects of caffeine can be considered positive. It can improve alertness, as well as reasoning, memory, orientation, attention and perception. It can also be used as analgesia for headaches. In fact, there is some evidence to suggest that drinking two cups of coffee (caffeinated or decaffeinated) per day may actually reduce the risk of death related to cardiovascular disease in certain people. For better or worse, the effects of caffeine are gone anywhere from 10 to 60 hours after the body ingests it, depending on an individual’s ability to metabolize caffeine. 

The effects of caffeine ingestion during typical daily consumption (200mg up to 700mg per day, or two to six cups of coffee) have been well studied and have not been shown to increase the risk of cardiovascular events.  There is no increase in heart arrhythmias, and while it can acutely raise blood pressure, there appears to be no long term increase in blood pressure in chronic consumers of coffee.   We are not suggesting that everyone add six cups of coffee (or equivalent caffeinated beverages or puffs) to their daily diet, but certainly it is safe to consume a couple of cups of java per day--or just a couple of puffs from a caffeine inhaler.

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