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Calcium Supplements in Combination with Other AgentsThiamine/Vitamin B1 Supplements
Water-soluble vitamin; found in yeast, cereal grains, legumes, peas, nuts, pork, and beef; deficiency causes beriberi; considered a standard agent in the treatment of a patient with undiagnosed coma and to prevent Wernicke/Korsakoff syndrome.
Thiamine (Vitamin B1)/Thiamine Hydrochloride (Vitamin B1) Intramuscular Inj Sol: 1mL, 100mgThiamine (Vitamin B1)/Thiamine Hydrochloride (Vitamin B1) Intravenous Inj Sol: 1mL, 100mg
1.4 mg PO per day.
1.2 mg PO per day.
1.1 mg PO per day.
1 mg PO per day.
0.9 mg PO per day.
0.6 mg PO per day.
0.5 mg PO per day.
0.3 mg PO per day is the Adequate Intake (AI). An RDA has not been established.
0.2 mg/day PO is the Adequate Intake (AI). An RDA has not been established.
3 mg IV per day admixed with TPN.
5—30 mg PO once daily or given in 3 divided doses for 1 month.
10—50 mg PO once daily for 2 weeks, then 5—10 mg PO once daily for 1 month.
NOTE: Some clinicians prefer IV administration when beriberi is accompanied by high-output heart failure.
5—30 mg IV or IM once daily or in 3 divided doses initially; then convert to 5—30 mg PO once daily or in 3 divided doses once patient is taking PO. Total treatment duration is 1 month.
10—25 mg IV or IM per day for 2 weeks, then 5—10 mg PO once daily for 1 month.
Initially, 100 mg IV, followed by 50—100 mg IM daily until normal dietary intake is established. Clinical practice guidelines recommend 200—500 mg IV or IM three times daily for 5—7 days or until there is no further improvement in symptoms. Initiate treatment with 500 mg IV or IM three times daily in alcoholic patients. Intravenous administration is preferred.
10—20 mg/day PO as a single dose. Up to 4 g/day in divided doses has been used.
Upper tolerable intake levels in healthy, non-vitamin deficient individuals are not determinable due to a lack of data.
It appears that no dosage adjustments are needed.
It appears that no dosage adjustments are needed. Intermittent hemodialysisPatients on dialysis may have increased needs for thiamine. Peritoneal dialysisPatients on dialysis may have increased needs for thiamine.
Thiamine, vitamin B1 may be administered without regard to meals.
Administer intramuscularly or intravenously. Parenteral therapy is usually reserved for patients for which oral thiamine is not feasible.Prior to intravenous administration, an intradermal test dose should be administered to patients in whom a sensitivity might be suspected.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
Direct IV injection:No dilution is necessary.Inject each 100 mg thiamine, vitamin B1 via slow IV push. Continuous IV infusion:Dilute thiamine, vitamin B1 in a compatible infusion solution.Administer at a rate prescribed by the physician.
Inject thiamine, vitamin B1 deeply into a large muscle.Tenderness and induration may occur at the injection site. Discomfort may be reduced by applying cool compresses.
Generic:- Store at room temperature (between 59 to 86 degrees F)
Wernicke's encephalopathy may be precipitated or worsened if intravenous glucose is administered to a thiamine-deficient patient. Thiamine (vitamin B1) should be administered prior to glucose. Clinicians should note that parenteral glucose should never be administered to a comatose patient without the prior administration of thiamine.
Thiamine is classified as FDA pregnancy risk category A. Appropriate maternal thiamine (vitamin B1) intake is encouraged during pregnancy, and no maternal or fetal complications associated with maternal dietary intake or supplementation to achieve adequate intake goals have been reported. As with other water-soluble vitamins, the pregnancy risk factor increases to FDA risk category C if the vitamin is used in dosages exceeding the Recommended Dietary Allowance (RDA) during pregnancy.
According to the manufacturer, caution should be exercised when thiamine is administered during breast-feeding. However, while thiamine is excreted in human milk, appropriate maternal intake of thiamine (vitamin B1) is important during lactation, and no maternal or fetal complications have been identified with maternal supplementation to achieve adequate intake goals during breast-feeding. Seizures have occurred in nursing infants of mothers with thiamine deficiency, although causality has not been established. Supplementation with thiamine is recommended in lactating women whose diets do not provide adequate amounts of thiamine. The American Academy of Pediatrics classifies thiamine as compatible with breast-feeding. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, healthcare providers are encouraged to report the adverse effect to the FDA.
angioedema / Rapid / Incidence not knownanaphylactoid reactions / Rapid / Incidence not knownpulmonary edema / Early / Incidence not knownGI bleeding / Delayed / Incidence not knowncyanosis / Early / Incidence not known
pruritus / Rapid / 1.0-1.0restlessness / Early / Incidence not knowndiaphoresis / Early / Incidence not knownsneezing / Early / Incidence not knownurticaria / Rapid / Incidence not knownnausea / Early / Incidence not knownweakness / Early / Incidence not knowninjection site reaction / Rapid / Incidence not known
There are no drug interactions associated with Thiamine, Vitamin B1 products.
Mechanism of Action: Thiamine combines with adenosine triphosphate (ATP) in the liver, kidneys, and leukocytes to produce thiamine diphosphate. Thiamine diphosphate acts as a coenzyme in carbohydrate metabolism, in transketolation reactions, and in the utilization of hexose in the hexose-monophosphate shunt. Without adequate thiamine, pyruvic acid does not undergo conversion to acetyl-CoA and cannot enter the Krebs cycle. Pyruvic acid accumulates in the blood and is subsequently converted to lactic acid, with the potential development of lactic acidosis. Diminished production of NADH in the Krebs cycle also results in lactic acid production through facilitation of anaerobic glycolysis.Thiamine deficiency appears as a nonspecific syndrome: headache, nausea, malaise, myalgias. Severe thiamine deficiency causes beriberi. Beriberi can affect the cardiovascular system (wet beriberi) and the nervous system (dry beriberi and the Wernicke-Korsakoff syndrome). Cardiovascular manifestations include peripheral vasodilation, biventricular failure, and edema. Neurologic symptoms include neuropathy, ataxia, retrograde amnesia, impaired ability to learn, and confabulation. Once Korsakoff's syndrome appears, thiamine supplementation is successful in only half of the patients.
Thiamine is administered orally and by intramuscular or intravenous injection. Thiamine is widely distributed. Body storage of thiamine is limited to about 30 mg. Thiamine is distributed into breast milk at a rate of about 100—200 mcg daily from normal dietary intake. There is little excretion of thiamine or its metabolites at physiologic doses. Following large doses, saturation occurs, with subsequent renal excretion as pyrimidine.
Small oral doses are readily absorbed from the GI tract, but absorption of large doses is limited. Administration with food reduces the rate of absorption.
Following IM administration of thiamine, vitamin B1, absorption is rapid and complete.