Thiamine injection is in short supply from the
Manufacturer. Bon Secours Pharmacy has pulled all available inventories into the
Pharmacy Department to assure product is available for patient needs.
Pharmacists may contact you to reserve supplies for patients that do not meet
the alternative management guidelines below.
13 February 2007
Products Affected — Description
hydrochloride (vitamin B1) for injection 100 mg/mL, 1 mL vials (NDC
63323-0013-02), Abraxis Bioscience
Reasons for the Shortage
cannot provide a reason for the shortage.1
Abraxis is the sole supplier of thiamine injection.
Oral preparations of
thiamine are not affected by this shortage.
Estimated Resupply Dates
Abraxis estimates supplies will be available in mid-March 2007. The company has
no emergency supplies available.1
Implications for Patient Care
Thiamine treats and prevents
thiamine deficiency disorders, such as Wernicke's encephalopathy syndrome,
beriberi, pellagra-associated peripheral neuritis, and pregnancy-associated
neuritis if accompanied by severe vomiting.2
Thiamine supplementation is also commonly used in chronic alcoholic and
Oral administration is the
preferred route for thiamine, although intravenous or intramuscular
administration is preferred for medical emergencies, such as Wernicke's
encephalopathy or high-output heart failure due to beriberi.2
Patients with malabsorption syndromes may also require parenteral thiamine.
Alternative Agents & Management
During a previous shortage
of thiamine injection, the American Society for Parenteral and Enteral
Nutrition (A.S.P.E.N.) recommended the following: reserve thiamine injection
for patients who cannot take thiamine orally; patients with medical
emergencies, such as Wernicke's encephalopathy; and comatose patients
presenting to the emergency department with unknown etiology.4
Consider switching patients
to oral therapy when possible.
(personal communication) February 13, 2007.
Thiamine Hydrochloride. In:
AHFS Drug Information.
Bethesda, MD: American Society of Health-System Pharmacists; 2004: 3502-3503.
American Society for
Parenteral and Enteral Nutrition (A.S.P.E.N.) Pharmacy Practice Section.
Thiamine Shortage Alert, available at
http://www.nutritioncare.org/thiamine.html (accessed May 2, 2001).
13, 2007, by Erin R. Fox, PharmD, Drug Information Specialist. Created by Erin
R. Fox, PharmD, Drug Information Specialist, and Michelle Wheeler, Pharm.D.
Copyright 2007, Drug Information Service, University of Utah, Salt Lake City,
Tiotropium inhalation powder is recommended for
addition to formulary. It is more effective than ipratropium inhalation aerosol
and salmeterol inhalation powder when compared by FEV1, PEFR,
functional residual capacity, duration of action, tachyphylaxis, health related
quality of life, and concomitant use of bronchodilators. It has a low incidence
of side effects with dry mouth being most common. It is 3.3 times more expensive
than ipratropium. It is administered once daily. Patients should not receive
tiotropium and ipratropium concurrently.