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Alcohol - problem drinking - Management
When should I prescribe thiamine in people who are dependent on alcohol?
- Offer prophylactic oral thiamine to harmful or dependent drinkers if any of the following apply:
- They are malnourished or at risk of malnourishment.
- They have decompensated liver disease.
- They are in acute withdrawal.
- Medically-assisted alcohol withdrawal is planned.
- If the person is in reasonable health with an adequate diet:
- Prescribe oral thiamine 200–300 mg per day (in divided doses) while they are undergoing assisted withdrawal, or are drinking very excessively.
- Prescribe oral thiamine 50 mg per day (as a single dose) during the maintenance stage following withdrawal, and for as long as malnutrition may be present.
- If the person is in poor health with signs of severe malnutrition, consider admitting for intramuscular or intravenous administration of thiamine (Pabrinex®).
- If the person has chronic alcohol dependence, oral thiamine may need to be continued indefinitely.
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