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Pabrinex (Vitamins B and C) Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Please ensure adequate doses are being used- for the treatment of coma or delerium from alcohol, the dose is two to three PAIRS of ampoules THREE times daily (ref 1)
  • Two formulations available - one for IV one for IM use (IM preparation not routinely stocked in UCH). Please ensure the correct formulation is being used for the required route.  
  • Facilities for treating anaphylaxis should be available when administering this preparation

Available preparations

Pabrinex IV (2 ampoules) 2 x 5ml ampoules

Ampoule No. 1 contains Ampoule No. 2 contains

Thiamine Hydrochloride Ph. Eur. 250mg

Riboflavine (as Phosphate Sodium BP) 4mg

Pyridoxine Hydrochloride Ph. Eur. 50mg

Ascorbic Acid Ph. Eur. 500mg

Nicotinamide Ph. Eur. 160mg

Anhydrous Glucose Ph. Eur. 1g

 

Reconstitution

Already in solution

Draw up using a 5 micron filter needle

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Intermittent intravenous infusion (administer using an electronically controlled infusion device)

  • Equal volumes of the contents of ampoules no. 1 and 2 should be added to 100ml infusion fluid
  • Administer over 30 minutes
  • Up to three pairs of ampoules may be added to 100ml bag
  • A 50ml infusion may be used if required (eg fluid restriction) but the residual volume in the infusion line must be flushed through at the same rate to avoid significant underdosing

Dose in adults

    Alcohol withdrawal (ref 1)

    • Severe symptoms

      • Two to three pairs of ampoules every eight hours for three days
      • If cognitive impairment improves, continue with two pairs daily for at least five days or for as long as improvement continues
      • Then thiamine 100mg po tds for six weeks or until adequate nutritional status
    • Moderate symptoms
      • Two pairs of ampoules every eight hours for three days at least, longer if in-patient/cognitive change 
      • Then thiamine 100mg po tds for six weeks or until adequate nutritional status

    Treatment of suspected or established Wernicke's encephalopathy (ref 2)

    • Give two to three pairs every eight hours for three to five days, followed by one pair once daily for a further three to five days or for as long as improvement continues

    Psychosis following narcosis or E.C.T; toxicity from acute infections (unlicensed- ref 2)

    • One pair of ampoules (2 x 5ml) twice daily for up to seven days

    Haemodialysis (unlicensed- ref 2)

    • One pair of ampoules every two weeks at the end of dialysis

    Storage

    • Store below 25°C

    References

    SPC November 2018

    (1) GUH management of alcohol withdrawal in adults 2021

    (2) BNF- accessed online 6/12/21

    Therapeutic classification

    Multivitamin preparations

    IV Guide Type