Pronunciation: THIGH-uh-min HIGH-droe-KLOR-ide
Class: Water-soluble vitamin
- Tablets 50 mg
- Tablets 100 mg
- Tablets 250 mg
- Tablets 500 mg
- Injection 100 mg/mL
Thiamin, after conversion to thiamin pyrophosphate, functions with adenosine triphosphate (ATP) in carbohydrate metabolism. Deficiencies result in beriberi, characterized by GI manifestations, peripheral neuropathy, and cerebral deficits.
Thiamin is a water-soluble vitamin. It is absorbed by both diffusion and active transport mechanisms. Absorption following IM administration is rapid and complete.
Thiamin is widely distributed in all tissues, with highest concentrations in liver, brain, kidney, and heart. When thiamin intake exceeds needs, tissue stores increase more than 2 to 3 times. If intake is insufficient, tissues become depleted of their vitamin content.
Thiamin undergoes rapid metabolism. Thiamine + ATP → thiamine pyrophosphate (cocarboxylase) coenzyme.
Excess thiamin is excreted in urine. Depletion of vitamin B 1 occurs about 3 wk with absence of thiamin in diet.
Indications and Usage
Prophylaxis or treatment of thiamin deficiency (beriberi). Parenteral use indicated when oral therapy not feasible or advisable.
Mosquito repellant; treatment of ulcerative colitis, chronic diarrhea, cerebellar syndrome, polyneuritis; appetite stimulant; prevention of Wernicke-Korsakoff syndrome.
Dosage and AdministrationAdults
PO 0.5 mg per 1,000 kcal intake. RDA is 1.2 to 1.5 mg (adult men), 1 to 1.1 mg (adult women).Children 6 to 10 yr of age
0.8 to 1 mg.Children younger than 6 yr of age
0.3 to 0.5 mg (infants).Wet Beriberi with Myocardial Failure
IV 10 to 30 mg 3 times daily. Treat as emergency cardiac condition.Beriberi
IM 10 to 20 mg 3 times daily for 2 wk, then PO 5 to 10 mg (as part of multivitamin) for 1 mo.Children
IV 10 mg initially followed by IM 10 mg twice daily for 3 days, then 10 mg daily for 6 wk.Thiamin Deficiency Secondary to Alcoholism (Wernicke Encephalopathy)
IV 50 to 100 mg; then IM/IV 50 to 100 mg/day until consuming normal diet; then PO 40 mg/day.Metabolic Disorders
PO 10 to 20 mg daily; max doses of 4 g daily have been used.
Store in light-resistant container.
Drug InteractionsIV incompatibilities
Unstable in neutral or alkaline solutions. Incompatible with sulfite containing solutions. Incompatible with barbiturates, erythromycin, lactobionate, citrates.
Laboratory Test Interactions
None well documented.
CV collapse; hypotension; death.
Tightness of throat.
Nausea; hemorrhage into GI tract.
Pulmonary edema; cyanosis.
Feeling of warmth; sweating; anaphylaxis; angioneurotic edema; local tenderness and induration (after IM use).
Category A ; ( Category C if used in doses greater than the RDA.)
Can occur. Deaths have resulted from IV administration. Intradermal test dose is recommended if sensitivity is suspected.
Single vitamin B 1 deficiency is rare; suspect multiple vitamin deficiencies.
May occur or worsen suddenly in thiamin-deficient patients given glucose. If deficiency is suspected, give thiamin before or with dextrose-containing fluids.
- Alert patient to potential lab test abnormalities.
- Inform patient of all potential adverse reactions and of importance of reporting problems to health care provider.
- Teach patient about proper nutritional balance needed in diet. Thiamin-rich foods are yeast, beef, liver, legumes, beans, and whole grains.
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