– Initial treatment of severe thiamine deficiency: severe acute forms of beriberi, neurological complications of chronic alcoholism (severe polyneuritis, Wernicke’s encephalopathy, Korsakoff syndrome)
Forms and strengths, route of administration
– 100 mg thiamine hydrochloride in 2 ml ampoule (50 mg/ml) for IM or very slow IV route (30 minutes)
Dosage and duration
– Infantile beriberi
25 mg by IV route then, 25 mg by IM route once or 2 times daily then, change to oral route (10 mg once daily) as soon as symptoms have improved.
– Acute beriberi
50 mg by IM injection then change to oral route (50 mg 3 times daily until symptoms improve then, 10 mg once daily)
or, depending on severity, 50 mg by IM injection every 8 hours for a few days then change to oral route (10 mg once daily).
– Wernicke’s encephalopathy, Korsakoff syndrome
250 mg once daily by IV route until the patient can take oral treatment. Higher initial doses may be required during the first 12 hours.
Contra-indications, adverse effects, precautions
– May cause: hypotension; anaphylactic reaction, especially when injected IV (inject very slowly over 30 minutes).
– Pregnancy: no contra-indication
– Breast-feeding: no contra-indication
– Thiamine is also called aneurine.
– Injectable thiamine is not included in the WHO list of essential medicines.