Thiamine Hydrochloride

Water-soluble, B complex vitamin.a

Thiamine Deficiency

Treatment of thiamine deficiency syndromes (e.g., beriberi, Wernicke’s encephalopathy syndrome). b

Dietary Requirements

Adequate intake needed to prevent thiamine deficiency (beriberi).109

Adequate thiamine intake can be accomplished through consumption of foodstuffs.109 Enriched, fortified, or whole grain products; bread and bread products; mixed foods with grain as a main ingredient; and ready-to-eat cereals are the major contributors of thiamine in the diet of US adults and children.109

Recommended Dietary Allowance (RDA) in adults based on erythrocyte transketolase activity, urinary thiamine excretion, and other findings.109

Requirements slightly lower in women than men based on women's size and average energy utilization.109

Adequate intake (AI) established for infants ≤6 months of age based on observed mean thiamine intake of infants fed principally human milk; AI for infants 7–12 months of age based on AI for younger infants and data in adults.109

RDA for children 1–18 years of age based on data in adults.109

Metabolic Disorder

Has been used in thiamine-responsive maple syrup urine disease† and subacute necrotizing encephalomyelopathy† (Leigh's disease).a

Contraindications

Known sensitivity to thiamine or any ingredient in formulation.a b

Warnings/Precautions

Sensitivity Reactions

Possible severe hypersensitivity reactions/anaphylaxis, especially following repeated parenteral administration.b

Administer an intradermal test dose prior to parenteral administration of therapeutic doses of thiamine in patients who may be sensitive to the drug.b

General Precautions

Some thiamine hydrochloride injection preparations contain aluminum, which may be toxic.b Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired.b Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.b

Research indicates that patients with impaired kidney function, including premature neonates, who receive aluminum parenterally in quantities of >4–5 mcg/kg daily accumulate aluminum at levels associated with CNS and bone toxicity.b Tissue loading may occur at even lower rates of administration.b

Specific Populations

Category A.b

Distributed into milk.a Caution if parenteral preparation is used in nursing women.b

Common Adverse Effects

Relatively nontoxic; feelings of warmth, pruritus, urticaria, weakness, sweating, nausea, restlessness, angioedema, tightness in the throat, cyanosis, pulmonary edema, GI bleeding reported with parenteral administration.a b

Storage

Oral

Tight, light-resistant container at <40°C; preferably between 15–30°C.a

Parenteral

20–25°C.b Protect from light.b

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

• An exogenous source of thiamine is required for carbohydrate metabolism. a

• Functions as a coenzyme in the metabolism of carbohydrates and branched-chain amino acids.109