Uses
Thiamine Deficiency
Treatment of thiamine deficiency syndromes (e.g., beriberi, Wernicke’s encephalopathy syndrome).
Dietary Requirements
Adequate intake needed to prevent thiamine deficiency (beriberi).
Adequate thiamine intake can be accomplished through consumption of foodstuffs. 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.
Recommended Dietary Allowance (RDA) in adults based on erythrocyte transketolase activity, urinary thiamine excretion, and other findings.
Requirements slightly lower in women than men based on women's size and average energy utilization.
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.
RDA for children 1–18 years of age based on data in adults.
Metabolic Disorder
Has been used in thiamine-responsive maple syrup urine disease† and subacute necrotizing encephalomyelopathy† (Leigh's disease).
Dosage and Administration
Administration
Usually administered orally. May be administered by IV or IM injection when indicated or when oral administration is not feasible.
For solution and drug compatibility information, see Compatibility under Stability.
Dosage
Available as thiamine hydrochloride; dosage expressed in terms of the salt.
Pediatric Patients
Thiamine Deficiency
Oral
Noncritically ill children: 10–50 mg daily, given in divided doses.
IM or IV
Critically ill children (e.g., infantile beriberi): 10–25 mg.
Dietary and Replacement Requirements
Oral
Infants ≤6 months of age: Recommended AI is 0.2 mg (0.03 mg/kg) daily.
Infants 7–12 months of age: Recommended AI is 0.3 mg (0.03 mg/kg) daily.
Children 1–3 years of age: RDA is 0.5 mg daily.
Children 4–8 years of age: RDA is 0.6 mg daily.
Children 9–13 years of age: RDA is 0.9 mg daily.
Boys 14–18 years of age: RDA is 1.2 mg daily.
Girls 14–18 years of age: RDA is 1 mg daily.
RDAs not expected to meet the needs of those with malabsorption syndrome or undergoing hemodialysis or peritoneal dialysis.
Adults
Thiamine Deficiency
Oral
Noncritically ill adults: 5–30 mg daily, as a single dose or 3 divided doses, for 1 month.
IV followed by IM
Wernicke's syndrome: Initially 100 mg IV, followed by 50–100 mg IM daily until patient can consume a balanced diet.
IV or IM
Critically ill thiamine-deficient adult or patient with malabsorption syndrome: 5–100 mg 3 times daily.
IM
Beriberi: 10–20 mg 3 times daily for up to 2 weeks.
Dietary and Replacement Requirements
Oral
Men ≥19 years of age: RDA is 1.2 mg daily.
Women ≥19 years of age: RDA is 1.1 mg daily.
RDAs not expected to meet the needs of those with malabsorption syndrome or undergoing hemodialysis or peritoneal dialysis.
Prescribing Limits
Single doses >30 mg not likely to be utilized.
Special Populations
Pregnant Women
RDA for pregnant women is 1.4 mg daily.
Thiamine intake >1.4 mg daily needed by women who are pregnant with >1 fetus.
Requirements increased in pregnant women to cover increased energy utilization and growth in the maternal and fetal compartments.
Lactating Women
RDA for lactating women is 1.5 mg daily.
Thiamine intake >1.5 mg daily needed by women who are nursing >1 infant.
Requirements increased in lactating women to ensure adequate concentration of the vitamin in milk.
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