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VITAMIN B1
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Vitamin B1 (thiamine) is a water-soluble vitamin needed for carbohydrate metabolism and for the function of the nervous system and heart. Thiamine deficiency most often occurs with chronic alcohol use, malnutrition, prolonged vomiting or long-term use of diuretics; severe forms are beriberi and Wernicke-Korsakoff syndrome.
As a single-ingredient medicine, Vitamin B1 Alkaloid 100 mg/mL solution for injection (Alkaloid d.o.o. Belgrade) is authorised in Serbia and is used only in healthcare institutions. Thiamine is also found in combination medicines with other B vitamins (e.g. Milgamma N, Neurobion forte, Neuro-Vit, Beviplex), which are not covered on this page. The dose and method of administration are decided by the doctor.
Important warning
- After parenteral (injected) thiamine, serious allergic reactions may rarely occur, so the injection is given only to patients who really need it, with equipment for treating anaphylactic shock available.
- Intravenously it is given slowly – as an injection over 10 minutes or an infusion over 30 minutes.
- In patients with borderline thiamine levels, intravenous glucose can worsen the condition – thiamine should be given before glucose.
Vitamin B1 – authorised medicine in Serbia
Key facts
| Active substance | thiamine hydrochloride (vitamin B1) |
|---|---|
| Medicine group | vitamin B1, plain (ATC A11DA01) |
| Strength and form | 100 mg/mL, solution for injection (1 mL ampoule) |
| Route | deep intramuscular or slow intravenous |
| Supply | for use in healthcare institutions only (Z) |
| Marketing authorisation holder | Alkaloid d.o.o. Belgrade |
Authorised medicines in Serbia
According to the medicines register (mediately.co/rs) and the ALIMS summary of product characteristics, one medicine containing thiamine alone is authorised in Serbia:
| Medicine | Strength and form | Pack | Marketing authorisation holder | Supply |
|---|---|---|---|---|
| Vitamin B1 Alkaloid® | 100 mg/mL, solution for injection | 50 ampoules of 1 mL (10 trays of 5 ampoules) | Alkaloid d.o.o. Belgrade | healthcare institution (Z) |
What it is used for
Vitamin B1 Alkaloid is used for the prevention and treatment of disorders caused by thiamine deficiency – beriberi, Wernicke-Korsakoff syndrome and other conditions associated with thiamine deficiency – when oral thiamine is not appropriate. The medicine is intended for adults.
How it is taken / used
- Beriberi – treatment: 10–20 mg intramuscularly or by slow intravenous infusion (over 30 minutes) 3 times a day for up to 2 weeks. In severe, life-threatening forms (e.g. shoshin beriberi) 100–300 mg a day by slow intravenous infusion.
- Wernicke-Korsakoff syndrome – prophylaxis in high-risk patients (e.g. hospitalised for alcohol withdrawal with malnutrition): 250 mg intramuscularly or intravenously once a day for 3–5 days.
- Wernicke-Korsakoff syndrome – treatment: 500–750 mg intravenously 3 times a day for at least 2 days (up to 1000 mg per dose in the first 12 hours); with a good response, continue with 250 mg once a day for 5 days or until further improvement.
- Maintenance therapy continues with thiamine in a suitable oral form.
- No dose adjustment is recommended in the elderly or in kidney or liver impairment, but caution is needed.
When the medicine must not be used
- hypersensitivity to thiamine or to any of the excipients
Warnings and precautions
- Parenteral use should be strictly limited to patients in whom it is necessary, because of possible rare serious allergic reactions during and shortly after administration.
- Equipment for treating anaphylactic shock must be available.
- Intramuscularly it is given deep into a large muscle, with aspiration before injecting; the injection site is changed for repeated doses.
- Closer monitoring may be needed in kidney impairment.
- The medicine contains disodium edetate and less than 1 mmol (23 mg) sodium per dose, that is to say essentially "sodium-free".
Interactions with other medicines
- Thiamine may enhance the effect of neuromuscular blockers (clinical significance unknown).
- 5-fluorouracil prevents the conversion of thiamine into its active form.
- Long-term use of furosemide can cause thiamine deficiency through increased excretion by the kidneys.
- Thiamine can give false-positive results when measuring uric acid and urobilinogen (Ehrlich’s reagent) and can interfere with serum theophylline measurement.
Pregnancy and breastfeeding
Pregnancy: no teratogenic or fetotoxic effects have been seen in clinical practice, but experience is not sufficient to exclude every risk; as a precaution, it is advised not to use this medicine in pregnancy.
Breastfeeding: thiamine passes into breast milk; because of insufficient data, use should be avoided during breastfeeding.
The medicine has no or negligible influence on the ability to drive.
Possible side effects
According to the SmPC (section 4.8), the following side effects are possible, with no frequency given:
Immune system: anaphylactic reaction (which less often presents as breathing difficulty, itching, shock and abdominal pain) and allergic manifestations such as itching. According to section 4.4, serious allergic reactions during and after injection are rare.
At the administration site: tenderness, hardening and pain at the injection site, dermatitis.
Thiamine is practically non-toxic in humans even at higher doses. Report any suspected adverse reaction to your doctor or ALIMS.
When to seek medical help immediately
- difficulty breathing, wheezing, chest tightness during or after the injection
- swelling of the face, lips or throat, hives all over the body, severe itching
- dizziness, fainting or feeling weak after the injection
Pharmacist's Advice
Injectable vitamin B1 is a hospital medicine for states of severe thiamine deficiency – most often in people who have been drinking heavily for a long time or are malnourished. After the injection the patient should remain under observation, because allergic reactions occur during or soon after administration.
When the condition allows, treatment is continued with thiamine by mouth. If you have been taking the diuretic furosemide for a long time or have problems with food intake, talk to your doctor about your need for vitamin B1. For mild dietary needs there are also food supplements with vitamin B1, but they are not a substitute for treating severe deficiency.
Availability and price
Vitamin B1 Alkaloid ampoules are a medicine for use in healthcare institutions and are not available for online purchase at ApotekaOnline, which is why no price is shown. For advice on vitamin B1, contact our pharmacists.
Storage
Store in the original package in order to protect from light. Shelf life is 2 years. Keep out of the reach of children.
Frequently asked questions
Can vitamin B1 injection be bought in a pharmacy?
No. Vitamin B1 Alkaloid ampoules have supply status Z – they are used only in healthcare institutions.
When is a vitamin B1 injection needed?
For disorders due to thiamine deficiency (beriberi, Wernicke-Korsakoff syndrome) when oral use is not appropriate.
Why is thiamine given before glucose?
Intravenous glucose can precipitate or worsen the condition in patients with low thiamine levels.
Is vitamin B1 safe in pregnancy?
As a precaution, the injectable medicine is not recommended in pregnancy because experience is insufficient.
Sources
- ALIMS – Summary of product characteristics for Vitamin B1 Alkaloid, 100 mg/mL, solution for injection
- Mediately – Serbian medicines register
Date sources and register were checked: 6 November 2026.
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