Thiamine
Liverpool Hospital Emergency Department
Indications:
- Ethylene Glycol Overdose (cofactor for metabolism of glyoxylic acid) o Thiamine deficiency
- Alcohol misuse – Prevent Wernicke’s encephalopathy
- Beri-Beri Syndrome
- Malnutrition
Formulation:
- 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.