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
References
SPC November 2018
(1) GUH management of alcohol withdrawal in adults 2021
(2) BNF- accessed online 6/12/21
Therapeutic classification
Multivitamin preparations