Overtime Uses

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What is Overtime?

Overtime is a central nervous system stimulant. It works by stimulating the brain. Overtime is found naturally in foods and beverages such as coffee, tea, colas, energy and chocolate. Botanical sources of Overtime include kola nuts, guarana, and yerba mate. Overtime is also available in prescription and non-prescription medications.

Overtime is used to restore mental alertness or wakefulness during fatigue or drowsiness. Overtime is also found in some headache and migraine medications, in certain dietary supplements used for weight loss, and in many popular energy drinks.

Overtime citrate (Overtime) is available by prescription only. It is used for short-term treatment of neonatal apnea (breathing problems).

Overtime may also be used for other conditions as determined by your health care provider.

Overtime indications

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Overtime and Sodium Benzoate Injection has been used in conjunction with supportive measure to treat respiratory depression associated with overdosage with CNS depressant drugs (e.g., narcotic analgesics, alcohol). However, because of questionable benefit and transient action, most authorities believe Overtime and other analeptics should not be used in these conditions and recommend other supportive therapy.

How should I use Overtime?

Use Overtime as directed by your health care provider. If the medication is OTC, check the label on the bottle for the exact dosing instructions. If you have any questions about the use of an OTC medication, ask your pharmacist.

Ask your health care provider any questions you may have about how to use Overtime.

Uses of Overtime in details

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Use: Labeled Indications

Overtime citrate: Treatment of idiopathic apnea of prematurity

Overtime and sodium benzoate: See Off-Label uses.

Overtime [OTC labeling]: Restore mental alertness or wakefulness when experiencing fatigue

Off Label Uses

Augmentation of seizure induction during electroconvulsive therapy (Overtime and sodium benzoate)

Data from a randomized, double blind study as well as a few unblinded studies support the use of Overtime/sodium benzoate in the treatment of augmentation of seizure induction during electroconvulsive therapy (ECT).

Overtime description

A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Overtime's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of Overtime have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [PubChem]

Overtime dosage

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Usual Adult Dose for Drowsiness:

100 to 200 mg orally not more often than every 3 to 4 hours.

For occasional use only.

Not intended for use as a substitute for sleep.

Limit the use of Overtime containing medications, foods, or beverages while taking this product because too much Overtime may cause nervousness, irritability, sleeplessness, and occasionally, rapid heartbeat.

Usual Pediatric Dose for Drowsiness:

>= 12 years: 100 to 200 mg not more often than every 3 to 4 hours.

For occasional use only.

Not intended for use as a substitute for sleep.

Limit the use of Overtime containing medications, foods, or beverages while taking this product because too much Overtime may cause nervousness, irritability, sleeplessness, and occasionally, rapid heartbeat.

Usual Pediatric Dose for Apnea of Prematurity:

For short term treatment of apnea of prematurity in infants between 28 and <33 weeks gestational age.

Prior to initiation of Overtime citrate, baseline serum levels of Overtime should be measured in infants previously treated with theophylline, since preterm infants metabolize theophylline to Overtime. Likewise, baseline serum levels of Overtime should be measured in infants born to mothers who consumed Overtime prior to delivery, since Overtime readily crosses the placenta.

Loading Dose: 20 mg/kg Overtime citrate intravenous (over 30 minutes) once

Maintenance Dose: 5 mg/kg Overtime citrate intravenous (over 10 minutes) or orally every 24 hours.

Note: The dose of Overtime base is one-half the dose when expressed as Overtime citrate (e.g., 20 mg of Overtime citrate is equivalent to 10 mg of Overtime base).

Serum concentrations of Overtime may need to be monitored periodically throughout treatment to avoid toxicity. Serious toxicity has been associated with serum levels greater than 50 mg/L.

Apnea of prematurity is a diagnosis of exclusion. Other causes of apnea (e.g., central nervous system disorders, primary lung disease, anemia, sepsis, metabolic disturbances, cardiovascular abnormalities, or obstructive apnea) should be ruled out or properly treated prior to initiation of Overtime citrate.

Overtime citrate should be used with caution in infants with seizure disorders or cardiovascular disease.

The duration of treatment of apnea of prematurity in the placebo-controlled trial was limited to 10 to 12 days. The safety and efficacy of Overtime citrate for longer periods of treatment have not been established.

Overtime interactions

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What other drugs will affect Overtime?

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Acebrophylline: May enhance the stimulatory effect of CNS Stimulants. Avoid combination

Adenosine: Overtime and Overtime Containing Products may diminish the therapeutic effect of Adenosine. Management: Monitor for decreased effect of adenosine if patient is receiving Overtime. Discontinue Overtime in advance of scheduled diagnostic use of adenosine whenever possible. Consider therapy modification

Amifampridine: Agents With Seizure Threshold Lowering Potential may enhance the neuroexcitatory and/or seizure-potentiating effect of Amifampridine. Monitor therapy

AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Broccoli: May decrease the serum concentration of CYP1A2 Substrates (High risk with Inducers). Monitor therapy

Bromperidol: Overtime and Overtime Containing Products may decrease the absorption of Bromperidol. Monitor therapy

BuPROPion: May enhance the neuroexcitatory and/or seizure-potentiating effect of Agents With Seizure Threshold Lowering Potential. Monitor therapy

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy

Cannabis: May decrease the serum concentration of CYP1A2 Substrates (High risk with Inducers). Monitor therapy

CloZAPine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of CloZAPine. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy

Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification

CYP1A2 Inducers (Moderate): May decrease the serum concentration of Overtime and Overtime Containing Products. Monitor therapy

CYP1A2 Inhibitors (Moderate): May increase the serum concentration of Overtime and Overtime Containing Products. Monitor therapy

CYP1A2 Inhibitors (Strong): May increase the serum concentration of Overtime and Overtime Containing Products. Monitor therapy

Doxofylline: Overtime and Overtime Containing Products may enhance the adverse/toxic effect of Doxofylline. Avoid combination

Esketamine: May enhance the hypertensive effect of CNS Stimulants. Monitor therapy

Formoterol: Overtime and Overtime Containing Products may enhance the adverse/toxic effect of Formoterol. Overtime and Overtime Containing Products may enhance the hypokalemic effect of Formoterol. Monitor therapy

Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy

Indacaterol: Overtime and Overtime Containing Products may enhance the adverse/toxic effect of Indacaterol. Overtime and Overtime Containing Products may enhance the hypokalemic effect of Indacaterol. Monitor therapy

Iohexol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iohexol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iohexol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification

Iomeprol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iomeprol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iomeprol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification

Iopamidol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iopamidol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification

Lithium: Overtime and Overtime Containing Products may decrease the serum concentration of Lithium. Monitor therapy

Norfloxacin: May increase the serum concentration of Overtime and Overtime Containing Products. Monitor therapy

Olodaterol: Overtime and Overtime Containing Products may enhance the adverse/toxic effect of Olodaterol. Overtime and Overtime Containing Products may enhance the hypokalemic effect of Olodaterol. Monitor therapy

Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification

Pipemidic Acid: May increase the serum concentration of Overtime and Overtime Containing Products. Monitor therapy

Regadenoson: Overtime and Overtime Containing Products may diminish the vasodilatory effect of Regadenoson. Management: Avoiding using Overtime or other methylxanthine containing products (e.g., theophylline) for at least 12 hours prior to the administration of regadenoson. Consider therapy modification

Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy

Solriamfetol: CNS Stimulants may enhance the hypertensive effect of Solriamfetol. CNS Stimulants may enhance the tachycardic effect of Solriamfetol. Monitor therapy

Stiripentol: May increase the serum concentration of Overtime and Overtime Containing Products. Avoid combination

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Theophylline Derivatives: CYP1A2 Inhibitors (Weak) may increase the serum concentration of Theophylline Derivatives. Exceptions: Dyphylline. Monitor therapy

TiZANidine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of TiZANidine. Management: Avoid these combinations when possible. If combined use is necessary, initiate tizanidine at an adult dose of 2 mg and increase in 2 to 4 mg increments based on patient response. Monitor for increased effects of tizanidine, including adverse reactions. Consider therapy modification

Tobacco (Smoked): May decrease the serum concentration of Overtime and Overtime Containing Products. Monitor therapy

Overtime side effects

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What are the possible side effects of Overtime?

Cardiovascular

Tachycardia; extrasystoles; palpitations; other cardiac arrhythmias.

CNS

Insomnia; restlessness; excitement; nervousness; tinnitus; scintillating scotoma; muscular tremor; headache; lightheadedness.

Dermatologic

Urticaria; rash, dry skin, skin breakdown (Overtime citrate).

EENT

Retinopathy of prematurity (Overtime citrate).

GI

Vomiting; nausea; diarrhea; stomach pain; necrotizing enterocolitis, gastritis, GI hemorrhage (Overtime citrate).

Genitourinary

Diuresis; kidney failure (Overtime citrate).

Hematologic

Disseminated intravascular coagulation (Overtime citrate).

Metabolic

Hyperglycemia; acidosis (Overtime citrate).

Respiratory

Dyspnea, lung edema (Overtime citrate).

Miscellaneous

Hypersensitivity (eg, dermatitis, rhinitis, bronchial asthma); feeding intolerance, sepsis, accidental injury, hemorrhage, cerebral hemorrhage (Overtime citrate).

Overtime contraindications

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What is the most important information I should know about Overtime?

Overtime citrate should not be given to a child who has had an allergic reaction to it in the past.

Before using Overtime citrate, tell the doctor if your child is allergic to any drugs, or has a seizure disorder, heart disease, kidney disease, liver disease, or high or low blood sugar.

Do not use the medication for longer than 12 days without the advice of your child's doctor.

Each bottle of Overtime citrate is for one use only, even if your child does not use the entire bottle for a single dose. Throw away any medication left over in the bottle after measuring your child's dose.

Call your doctor if the child's breathing symptoms do not improve after using Overtime citrate.

To be sure Overtime citrate is helping your child's condition, the child's blood will need to be tested on a regular basis. Do not miss any scheduled appointments.



Active ingredient matches for Overtime:

Caffeine


List of Overtime substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Tablet; Oral; Caffeine 100 mg
Pep-back Peak Performance tablet, film coated 200 mg/1 (Alva Amco Pharmacal Companies, Inc. (US))
Pep-back Ultra tablet, film coated 200 mg/1 (Alva Amco Pharmacal Companies, Inc. (US))
Gel; Local; Caffeine 5% (Asta medica)
Gel; Local; Caffeine 5%
Gel; Local; Caffeine 5%
Percutafeine Gel 5 % x 1 tube 200 mL
Capsule; Oral; Caffeine 100 mg
Pro / Y.C. 10 mg/1 g x 1 g (Dunhall)
Pro / Y.C. 10 mg/1 g x 10 g (Dunhall)
Pro / Y.C. 10 mg/1 g x 20 g (Dunhall)
Pro / Y.C. 10 mg/1 g x 40 g (Dunhall)
Tablet; Oral; Caffeine 50 mg (Roche consumer)
Revive 150 mg x 10 Blister x 10 Tablet (Allergan)
Snizof Tablet (Clin Medicals Pvt Ltd (Geno Pharmaceuticals Ltd))$ 0.02
Stay Awake tablet 200 mg/1 (Chain Drug Marketing Association (US))
Stay Awake tablet, film coated 200 mg/1 (Rite Aid (US))
Stay Awake Maximum Strength tablet 200 mg/1 (Walgreen Company (US))
Tablet; Oral; Caffeine 200 mg
STIM TABLET 1 strip / 10 tablets each (Wens Drugs India Pvt Ltd)$ 0.30

References

  1. DailyMed. "CAFFEINE; ERGOTAMINE TARTRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "caffeine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "caffeine". http://www.drugbank.ca/drugs/DB00201 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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