What is Pep-Back?
Pep-Back is a central nervous system stimulant. It works by stimulating the brain. Pep-Back is found naturally in foods and beverages such as coffee, tea, colas, energy and chocolate. Botanical sources of Pep-Back include kola nuts, guarana, and yerba mate. Pep-Back is also available in prescription and non-prescription medications.
Pep-Back is used to restore mental alertness or wakefulness during fatigue or drowsiness. Pep-Back is also found in some headache and migraine medications, in certain dietary supplements used for weight loss, and in many popular energy drinks.
Pep-Back citrate (Pep-Back) is available by prescription only. It is used for short-term treatment of neonatal apnea (breathing problems).
Pep-Back may also be used for other conditions as determined by your health care provider.
Pep-Back indications
Pep-Back 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 Pep-Back and other analeptics should not be used in these conditions and recommend other supportive therapy.
How should I use Pep-Back?
Use Pep-Back 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.
- Pep-Back may be taken with or without food. If Pep-Back upsets your stomach, take it with food.
- Do not exceed the recommended dose of Pep-Back. Pep-Back can be habit-forming.
- Most OTC medications used for mental alertness contain 200 milligrams of Pep-Back per tablet or capsule. The usual maximum recommended dose of OTC Pep-Back is no more than 200 mg every 3-4 hours, or 1600 mg per day.
- Do not double-up on your Pep-Back dose if you should miss the time for next dose.
- The average cup of coffee contains 150-200 milligrams (mg) of Pep-Back per cup, while a cup of tea will have about 60 mg of Pep-Back. Cola products have about 30-40 mg of Pep-Back, and most energy drinks have about 60-70 mg. Be sure to account for any dietary Pep-Back that is consumed.
Ask your health care provider any questions you may have about how to use Pep-Back.
Uses of Pep-Back in details
Use: Labeled Indications
Pep-Back citrate: Treatment of idiopathic apnea of prematurity
Pep-Back and sodium benzoate: See Off-Label uses.
Pep-Back [OTC labeling]: Restore mental alertness or wakefulness when experiencing fatigue
Off Label Uses
Augmentation of seizure induction during electroconvulsive therapy (Pep-Back and sodium benzoate)
Data from a randomized, double blind study as well as a few unblinded studies support the use of Pep-Back/sodium benzoate in the treatment of augmentation of seizure induction during electroconvulsive therapy (ECT).
Pep-Back description
A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Pep-Back'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 Pep-Back 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]
Pep-Back dosage
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 Pep-Back containing medications, foods, or beverages while taking this product because too much Pep-Back 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 Pep-Back containing medications, foods, or beverages while taking this product because too much Pep-Back 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 Pep-Back citrate, baseline serum levels of Pep-Back should be measured in infants previously treated with theophylline, since preterm infants metabolize theophylline to Pep-Back. Likewise, baseline serum levels of Pep-Back should be measured in infants born to mothers who consumed Pep-Back prior to delivery, since Pep-Back readily crosses the placenta.
Loading Dose: 20 mg/kg Pep-Back citrate intravenous (over 30 minutes) once
Maintenance Dose: 5 mg/kg Pep-Back citrate intravenous (over 10 minutes) or orally every 24 hours.
Note: The dose of Pep-Back base is one-half the dose when expressed as Pep-Back citrate (e.g., 20 mg of Pep-Back citrate is equivalent to 10 mg of Pep-Back base).
Serum concentrations of Pep-Back 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 Pep-Back citrate.
Pep-Back 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 Pep-Back citrate for longer periods of treatment have not been established.
Pep-Back interactions
See also:
What other drugs will affect Pep-Back?
Acebrophylline: May enhance the stimulatory effect of CNS Stimulants. Avoid combination
Adenosine: Pep-Back and Pep-Back Containing Products may diminish the therapeutic effect of Adenosine. Management: Monitor for decreased effect of adenosine if patient is receiving Pep-Back. Discontinue Pep-Back 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: Pep-Back and Pep-Back 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 Pep-Back and Pep-Back Containing Products. Monitor therapy
CYP1A2 Inhibitors (Moderate): May increase the serum concentration of Pep-Back and Pep-Back Containing Products. Monitor therapy
CYP1A2 Inhibitors (Strong): May increase the serum concentration of Pep-Back and Pep-Back Containing Products. Monitor therapy
Doxofylline: Pep-Back and Pep-Back Containing Products may enhance the adverse/toxic effect of Doxofylline. Avoid combination
Esketamine: May enhance the hypertensive effect of CNS Stimulants. Monitor therapy
Formoterol: Pep-Back and Pep-Back Containing Products may enhance the adverse/toxic effect of Formoterol. Pep-Back and Pep-Back 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: Pep-Back and Pep-Back Containing Products may enhance the adverse/toxic effect of Indacaterol. Pep-Back and Pep-Back 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: Pep-Back and Pep-Back Containing Products may decrease the serum concentration of Lithium. Monitor therapy
Norfloxacin: May increase the serum concentration of Pep-Back and Pep-Back Containing Products. Monitor therapy
Olodaterol: Pep-Back and Pep-Back Containing Products may enhance the adverse/toxic effect of Olodaterol. Pep-Back and Pep-Back 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 Pep-Back and Pep-Back Containing Products. Monitor therapy
Regadenoson: Pep-Back and Pep-Back Containing Products may diminish the vasodilatory effect of Regadenoson. Management: Avoiding using Pep-Back 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 Pep-Back and Pep-Back 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 Pep-Back and Pep-Back Containing Products. Monitor therapy
Pep-Back side effects
See also:
What are the possible side effects of Pep-Back?
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 (Pep-Back citrate).
EENT
Retinopathy of prematurity (Pep-Back citrate).
GI
Vomiting; nausea; diarrhea; stomach pain; necrotizing enterocolitis, gastritis, GI hemorrhage (Pep-Back citrate).
Genitourinary
Diuresis; kidney failure (Pep-Back citrate).
Hematologic
Disseminated intravascular coagulation (Pep-Back citrate).
Metabolic
Hyperglycemia; acidosis (Pep-Back citrate).
Respiratory
Dyspnea, lung edema (Pep-Back citrate).
Miscellaneous
Hypersensitivity (eg, dermatitis, rhinitis, bronchial asthma); feeding intolerance, sepsis, accidental injury, hemorrhage, cerebral hemorrhage (Pep-Back citrate).
Pep-Back contraindications
See also:
What is the most important information I should know about Pep-Back?
Pep-Back citrate should not be given to a child who has had an allergic reaction to it in the past.
Before using Pep-Back 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 Pep-Back 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 Pep-Back citrate.
To be sure Pep-Back 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 Pep-Back:
Unit description / dosage (Manufacturer) | Price, USD |
Tablet; Oral; Caffeine 100 mg | |
List of Pep-Back substitutes (brand and generic names): | |
Overtime | |
Pep-Back Peak Performance | |
Pep-back Peak Performance tablet, film coated 200 mg/1 (Alva Amco Pharmacal Companies, Inc. (US)) | |
Pep-Back ReCharge | |
Pep-Back Ultra | |
Pep-back Ultra tablet, film coated 200 mg/1 (Alva Amco Pharmacal Companies, Inc. (US)) | |
Percoffedrinol N (Luxembourg) | |
Percutafeine (Argentina, Luxembourg) | |
Gel; Local; Caffeine 5% (Asta medica) | |
Percutaféine (France, Vietnam) | |
Gel; Local; Caffeine 5% | |
Gel; Local; Caffeine 5% | |
Percutafeine Gel (Vietnam) | |
Percutafeine Gel 5 % x 1 tube 200 mL | |
Peyona (Austria, Czech Republic, Denmark, Hungary, Ireland, Portugal, Romania, Spain, United Kingdom) | |
Peyona 20mg/ml (Austria, Hungary, Switzerland) | |
Phenfree | |
Capsule; Oral; Caffeine 100 mg | |
Phensal | |
Pro (Malta, Taiwan) | |
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) | |
Pro Plus (Malta) | |
Pro-Plus (United Kingdom, Ireland) | |
Tablet; Oral; Caffeine 50 mg (Roche consumer) | |
Propoxyphene Compound-65 | |
Quick Pep (United States) | |
Quick-Pep (United States) | |
Refresh'n | |
Respia (Japan) | |
Revive | |
Revive 150 mg x 10 Blister x 10 Tablet (Allergan) | |
Sitafein (Turkey) | |
SK 65 Compound | |
Snizof Tablet | |
Snizof Tablet (Clin Medicals Pvt Ltd (Geno Pharmaceuticals Ltd)) | $ 0.02 |
Sodium Cofein Benzoat Darnitsa (Georgia) | |
Sodium Coffein Benzoat (Georgia) | |
Sodium Coffein Benzoat SIC BHFZ (Georgia) | |
Sodium Coffein Benzoat Tatchempharmpreparaty (Georgia) | |
Solution of Caffeine Sodium Benzoate 20% (Georgia) | |
Spray-n-Wake (United States) | |
Stat Awake | |
Stay Alert | |
Stay Awake | |
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 | |
Stay Awake Maximum Strength tablet 200 mg/1 (Walgreen Company (US)) | |
Stay Awakes | |
Tablet; Oral; Caffeine 200 mg | |
Stim | |
STIM TABLET 1 strip / 10 tablets each (Wens Drugs India Pvt Ltd) | $ 0.30 |
Stim NA Tablet (Wens Drugs India Pvt Ltd) | $ 0.03 |
See 342 substitutes for Pep-Back |
References
- 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).
- PubChem. "caffeine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "caffeine". http://www.drugbank.ca/drugs/DB00201 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Pep-Back are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Pep-Back. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
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Information checked by Dr. Sachin Kumar, MD Pharmacology