Liverpool Hospital Emergency Department


  • Ethylene Glycol Overdose (cofactor for metabolism of glyoxylic acid) o Thiamine deficiency 
  • Alcohol misuse – Prevent Wernicke’s encephalopathy
  • Beri-Beri Syndrome
  • Malnutrition 


  • IV 100mg/ml
  • PO 100mg tablet  

Dosage and Administration 

  • Load with 300mg thiamine IV (in 100ml NaCl 0.9%) infuse over 30 minutes – best if  alcohol dependent – risk of malabsorption. 
  • 100-300mg TDS in hospital
  • 100mg PO daily on discharge 

Side Effects 

  • Extremely rare  

Pit Falls 

  • Safe in pregnancy and breast feeding
  • The traditional teaching that thiamine must be given before glucose to prevent  Wernicke’s is a myth. Please do not delay the treatment of hypoglycaemia. This is a  theoretical concern and there are no reported instances of this occurring.