Thiamine

Name: Thiamine

Thiamine Overview

Thiamine is a prescription medication used to treat thiamine deficiency or beri beri. Thiamine belongs to a group of drugs called vitamins, which help to restore levels of this vitamin in the body.

This medication is available in an injectable form to be given directly into a vein (IV) or muscle (IM) by a healthcare professional.

Common side effects of thiamine include redness, itchiness, and sensitivity to the sight of injection.

 

Thiamine dosing information

Usual Adult Dose for Beriberi:

10 to 20 mg IM three times daily for up to 2 weeks. Thereafter, use an oral therapeutic multivitamin preparation containing 5 to 10 mg thiamine daily for one month. A complete and balanced diet should follow.

Neuritis of pregnancy:
If vomiting severe to preclude oral therapy, give 5 to 10 mg IM daily.

'Wet' with myocardial failure:
Treat as an emergency cardiac condition. Thiamine is administered slowly by the IV route.

Usual Adult Dose for Thiamine Deficiency:

If dextrose administered: to patients with marginal thiamine status, give 100 mg in each of the first few liters of IV fluid to avoid precipitating heart failure.

Usual Adult Dose for Vitamin/Mineral Supplementation:

50 to 100 mg orally once a day

Usual Adult Dose for Wernicke's Encephalopathy:

100 mg IV as an initial dose followed by 50 to 100 mg/day IM or IV until the patient is on a regular, balanced, diet.

Usual Pediatric Dose for Beriberi:

10 to 25 mg IM or IV daily (if critically ill), or 10 to 50 mg orally every day for 2 weeks, then 5 to 10 mg orally daily for 1 month. If collapse occurs: 25 mg IV. Administer with caution.

Usual Pediatric Dose for Thiamine Deficiency:

If dextrose administered: to patients with marginal thiamine status, give 100 mg in each of the first few liters of IV fluid to avoid precipitating heart failure.

Usual Pediatric Dose for Vitamin/Mineral Supplementation:

Infants: 0.3 to 0.5 mg orally once a day; children: 0.5 to 1 mg orally once a day.

Contraindications

Hypersensitivity to thiamine or any component of the formulation

Administration

Parenteral form may be administered by IM or IV injection. Various rates of administration have been reported (eg, 100 mg over 5 minutes). An extended infusion time is preferred for doses ≥100 mg. Local injection reactions may be minimized by slow administration (~30 minutes) into larger, more proximal veins. Thiamine should be administered prior to parenteral glucose solutions to prevent precipitation of acute symptoms of thiamine deficiency in the poorly nourished.

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity reactions: Have been reported following repeated parenteral doses; consider skin test in individuals with history of allergic reactions.

Concurrent drug therapy issues:

• Dextrose: Administration of dextrose may precipitate acute symptoms of thiamine deficiency; use caution when thiamine status is marginal or suspect.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register 2002).

Other warnings/precautions:

• Parenteral administration: Use with caution with parenteral route (especially IV) of administration.

• Vitamin deficiency: Single vitamin deficiency is rare; evaluate for other deficiencies.

(web3)