Thiamine hydrochloride Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Unlicensed product
To be used when stocks of intravenous Pabrinex are exhausted
Facilities for treating anaphylaxis should be available when administering this preparation

Thiamine Vitamin B1 200mg in 2ml ampoule (Hevert)

Thiamine Vitamin B1 100mg in 2ml ampoule (Ratiopharm)

Note: two different strengths available- take care in selection

Already in solution
Draw up using a 5 micron filter needle
Dilute further prior to administration

Sodium chloride 0.9% or Glucose 5%

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

Add the required dose to 100mL of infusion fluid
Administer over 30 minutes
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

Prophylaxis of Wernicke's Encephalopathy associated with alcohol-use disorders ^{(ref 2)}

Give 200 to 300mg once a day for 3 days
Then switch to oral thiamine 100 to 300mg daily, continued until patient is no longer at risk

Treatment of Suspected or Established Wernicke's Encephalopathy ^{(ref 2)}

Give 300 to 500mg* three times a day for at least 5 days (*Higher dose recommended in patients with alcohol dependence. Lower treatment doses eg 200mg three times a day recommended in patients without alcohol dependence.)
Continue until no further improvement in signs and symptoms, or Wernicke's encephalopathy has been excluded
Then switch to oral thiamine 100mg tds, continued until patient is no longer at risk

Refeeding syndrome ^{(ref 2)}

Thiamine should only be used for patients with intestinal failure at high risk or extremely high risk of refeeding syndrome where the oral or enteral route is unavailable
Give 200mg once daily for 3 days (5 days for higher-risk patients)

Store below 25⁰C

No SPC
1. Injectable medicines guide- Medusa, downloaded 26/09/2024
2. HSE guidelines July 2024

Vitamins