Thiosina

• Treatment and prevention of thiamine deficiency (Vitamin B1 deficiency), including beriberi.
• Treatment of Wernicke’s encephalopathy and prevention of progression to Korsakoff’s psychosis.
• Prophylaxis of deficiency states in patients with malnutrition, chronic alcoholism, or malabsorption syndromes.
• Adjunctive therapy in metabolic disorders such as maple syrup urine disease.
• Supportive therapy in septic shock and lactic acidosis (off-label).
• Treatment of neuropathies related to diabetes mellitus and other causes (off-label).

• Adults: Oral supplementation typically 1.1 to 1.2 mg daily for prevention; 50 to 100 mg parenterally daily for treatment of deficiency states.
• Wernicke’s encephalopathy: 200 mg IV or IM every 8 to 12 hours until clinical improvement, then oral maintenance.
• Pediatrics: Doses vary by age and weight, generally 0.3–0.5 mg daily for prevention; 10–25 mg parenterally for treatment.
• Administer IV doses slowly to reduce risk of adverse reactions.
• Oral doses can be given with food to minimize gastrointestinal irritation.

Thiamine acts as a coenzyme (thiamine pyrophosphate) critical for carbohydrate metabolism, facilitating enzymatic decarboxylation of alpha-keto acids and supporting energy production in mitochondria. It is essential for nerve function and neurotransmitter synthesis, and supplementation reverses metabolic disturbances caused by deficiency.

• Rapid absorption in the small intestine via active transport.
• Distributed widely, crossing the blood-brain barrier.
• Converted intracellularly to active phosphorylated derivatives.
• Plasma half-life approximately 1.5 days.
• Excreted primarily unchanged by the kidneys.

• Category A — Safe for use during pregnancy.
• Excreted in breast milk in small amounts; considered safe for nursing infants.

• Vitamin Supplement (Vitamin B1)
• Water-soluble vitamin

• Known hypersensitivity to thiamine or any formulation component.

• Anaphylactic reactions possible with parenteral administration; monitor patients closely.
• Caution in patients with asthma or history of hypersensitivity.
• Use cautiously in patients at risk of allergic reactions.

• Common: Injection site pain, mild gastrointestinal upset.
• Rare but serious: Anaphylaxis, angioedema, bronchospasm.

• Diuretics may increase thiamine excretion.
• Phenytoin may reduce thiamine absorption.
• Alcohol impairs thiamine metabolism and absorption.
• No significant CYP450 interactions.

• Emphasis on prompt parenteral administration for suspected Wernicke’s encephalopathy.
• Increased use in critically ill patients with lactic acidosis.
• Recommendations for supplementation after bariatric surgery.

• Store at 20–25°C, protect from moisture and light.
• Do not freeze.
• Keep injections in original packaging until use.