Dosing & Uses
Dosage Forms & Strengths
tablet
- 50mg
- 100mg
- 250mg
capsule
- 50mg
injectable solution
- 100mg/mL
RDA
Males: 1.2 mg/day
Females: 1.1 mg/day
Pregnancy/Lactation: 1.4 mg/day
Beriberi
IM: 5-30 mg three times daily (if critically ill); then 5-30 mg three times daily for 1 month
Duration dependent on persistence of symptoms
Wernicke Encephalopathy
100 mg IV; then 50-100 mg/day IM or IV until consuming regular balanced diet
Thiamin Deficiency
1 tablet or capsule/day
Need for thiamin increases when carbohydrate content of diet is high
Dosage Forms & Strengths
tablet
- 50mg
- 100mg
- 250mg
capsule
- 50mg
injectable solution
- 100mg/mL
RDA
0-6 months: 0.2 mg/day
6-12 months: 0.3 mg/day
1-3 years old: 0.5 mg/day
3-8 years old: 0.6 mg/day
8-13 years old: 0.9 mg/day
13-18 years old: 1.2 mg/day (male), 1 mg/day (female)
Deficiency
10-50 mg/day PO in divided doses
Beriberi
10-25 mg IV/IM qDay (if crtically ill) or 10-50 mg/dose PO qDay for at least 2 weeks, THEN
5-10 mg/day PO for 1 month
Duration dependent on persistence of symptoms
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (9)
- azithromycin
azithromycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- clarithromycin
clarithromycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- erythromycin base
erythromycin base will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- omadacycline
thiamine will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- patiromer
patiromer will decrease the level or effect of thiamine by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- roxithromycin
roxithromycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
Minor (58)
- amikacin
amikacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- atracurium
thiamine increases effects of atracurium by unspecified interaction mechanism. Minor/Significance Unknown.
- aztreonam
aztreonam will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- bumetanide
bumetanide decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.
- caffeine
caffeine decreases levels of thiamine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Coffee, tea are high in anti-thiamine factors.
- cefadroxil
cefadroxil will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cefamandole
cefamandole will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cefpirome
cefpirome will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ceftibuten
ceftibuten will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cephalexin
cephalexin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- chlorhexidine oral
chlorhexidine oral will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ciprofloxacin
ciprofloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cisatracurium
thiamine increases effects of cisatracurium by unspecified interaction mechanism. Minor/Significance Unknown.
- clindamycin
clindamycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- dapsone
dapsone will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- demeclocycline
demeclocycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- doxycycline
doxycycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ertapenem
ertapenem will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ethacrynic acid
ethacrynic acid decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.
- ethanol
ethanol decreases levels of thiamine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Thiamine supplementation recommended in alcoholism.
- fleroxacin
fleroxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- fosfomycin
fosfomycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- furosemide
furosemide decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.
- gemifloxacin
gemifloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- gentamicin
gentamicin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- levofloxacin
levofloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- linezolid
linezolid will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- meropenem
meropenem will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- meropenem/vaborbactam
meropenem/vaborbactam will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- metronidazole
metronidazole will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- minocycline
minocycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- moxifloxacin
moxifloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- nafcillin
nafcillin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- neomycin PO
neomycin PO will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- nitrofurantoin
nitrofurantoin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ofloxacin
ofloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- pancuronium
thiamine increases effects of pancuronium by unspecified interaction mechanism. Minor/Significance Unknown.
- paromomycin
paromomycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- pivmecillinam
pivmecillinam will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- quinupristin/dalfopristin
quinupristin/dalfopristin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- rapacuronium
thiamine increases effects of rapacuronium by unspecified interaction mechanism. Minor/Significance Unknown.
- rocuronium
thiamine increases effects of rocuronium by unspecified interaction mechanism. Minor/Significance Unknown.
- streptomycin
streptomycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- succinylcholine
thiamine increases effects of succinylcholine by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfadiazine
sulfadiazine will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfisoxazole
sulfisoxazole will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- teicoplanin
teicoplanin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- temocillin
temocillin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- tetracycline
tetracycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ticarcillin
ticarcillin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- tigecycline
tigecycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- tobramycin
tobramycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- torsemide
torsemide decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.
- trimethoprim
trimethoprim will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- vancomycin
vancomycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- vecuronium
thiamine increases effects of vecuronium by unspecified interaction mechanism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Warmth
Anaphylaxis
Cyanosis
Diaphoresis
Restlessness
Angioneurotic edema
Pruritus
Urticaria
Pulmonary edema
Weakness
Tightness of the throat
Nausea
Warnings
Contraindications
Hypersensitivity
Cautions
In pregnancy (doses >RDA)
Acute thiamine deficiency reported with dextrose administration; use caution when thiamine status uncertain
Hypersensitivity reactions reported following repeated parenteral doses
Parenteral products may contain aluminum; use caution in patients with impaired renal function
Evaluate for additional vitamin deficiencies if patient diagnosed with thiamin deficiency; single vitamin deficiencies are rare
Pregnancy & Lactation
Pregnancy Category: A (injectable); C (if >RDA)
Lactation: Safe
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Nutrition
Sources: brewer's yeast, pork, ham, liver, whole grains, peas, beans, milk
Function: cofactor in glucose metabolism
Deficiency: (common in alcoholics, Asians, dialysis patients, those on high carbohydrate diet) Beriberi; causes nerve damage, dementia, heart failure; sometimes irreversible
Reduced/Destroyed by
Heat-labile thiaminases contained in milled rice, raw shellfish & freshwater fishes
Heat-stable anti-thiamine factor in coffee/tea
Sulfite-containing foods
Alcohol
High temp
Toxicity Symptoms
Toxicity: rare; intake of >400 mg/d; lethargy, balance problems, intestinal problems
Pharmacology
Mechanism of Action
Forms thiamine pyrophosphate by combining with adenosine triphosphate; essential coenzyme in carbohydrate metabolism
Pharmacokinetics
Distribution: Distributes mainly to heart, brain, kidney, and liver
Excretion: Urine
Absorption: Adequate (PO); rapid and complete (IM)
Administration
When oral administration is not feasible
When malabsorption is suspected
In patients with Wernicke's encephalopathy or high-output heart failure secondary to beriberi
IV administration preferred for high-output heart failure
Compatible with most common diluents (dextrose solutions; LR, Ringer's; dextrose-saline solutions; dextrose/LR; NS; ½NS; fat emulsion 10%; Na-lactate 1M/6
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