Thiamine

Water-Soluble (B1)·Vitamins & Minerals

Prevention and treatment of Wernicke-Korsakoff syndrome in chronic alcoholism, severe malnutrition, hyperemesis gravidarum

VITAMINBetamin100 mg tabletS4TGA

Max Dose

1500 mg/day

Route

IV or IM FIRST

Anaphylaxis

IV RISK

Glucose

GIVE AFTER

Rapid Summary

Overview

Vitamin B1. Essential coenzyme for carbohydrate metabolism. The absolute critical, time-sensitive therapy to prevent Wernicke's Encephalopathy in alcoholics.

Maximum Dose

Max 1500 mg/day (500mg TDS IV for active Wernicke's).

Clinical Focus

You MUST give Thiamine BEFORE administering any IV Glucose/Dextrose to a malnourished patient, or you will trigger irreversible brain damage.

Bottom Line

Thiamine is essential for preventing and treating Wernicke's encephalopathy in alcohol use disorder, but must be given IV before any glucose administration to avoid precipitating irreversible brain damage.

Formulation & Access

Brand Names

Betamin

Oral Routes

Tablets (100 mg).

Parenteral

Ampoules (100 mg/1 mL) for IM or IV infusion. Do NOT push fast IV.

Prescribing & PBS

Over The Counter (PO). Hospital supply (IV/IM).

Indications & Use

Primary

TGA

Prevention and treatment of Wernicke-Korsakoff syndrome in chronic alcoholism, severe malnutrition, hyperemesis gravidarum.

Clinical Place

Emergency rescue therapy. Must be administered immediately upon presentation in susceptible patients.

Quick reference

Class & Role

Water-Soluble (B1) — Vitamin B1.

Route / Formulation

Tablets (100 mg). (Betamin)

Usual Dose & Max

IV 500 mg TDS in 100mL Normal Saline over 30 mins, for 3-5 days. Max 1500 mg/day (500mg TDS IV for active Wernicke's).

Key Indication Doses

Active Wernicke's Encephalopathy: IV 500 mg TDS in 100mL Normal Saline over 30 mins, for 3-5 days. Prophylaxis (Alcohol Withdrawal): IM / IV 300 mg OD for 3-5 days, then switch to oral. Oral Maintenance: PO 100 mg OD to TDS.

Best Uses

Avoid / Cautions

Previous true anaphylaxis to IV thiamine. Essential for hyperemesis gravidarum to prevent maternal Wernicke's.

Key Risks

Immunological: Anaphylaxis (Rare, but classically associated with rapid IV push of thiamine. Must be diluted and infused over 30 mins). Tissue: Pain at injection site (IM injections are highly painful).

Key Interactions

NONE — Safe to combine with all standard ward medications.

Monitoring

Observe for 30 minutes during the first IV infusion for signs of anaphylaxis (wheeze, hypotension, rash). Assess for the classic Wernicke's triad: Confusion, Ataxia, Ophthalmoplegia (nystagmus/gaze palsy).

Clinical Pearl

Glucose metabolism consumes Thiamine. If you give an alcoholic a bag of IV Dextrose or a high-carb meal *before* giving them Thiamine, you will consume their last remaining molecules of B1, plunging them into permanent Korsakoff's dementia. Thiamine FIRST, glucose SECOND.

Access

Betamin100 mg tablet

Brand: Betamin
Formulation: Tablets (100 mg)