Prescribing Briefing – Vit B Complex Preparations
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What we know:
- Wernicke’s encephalopathy (WE) is an acute neurological state comprising of mental confusion, ataxia and ophthalmoplegia which may develop in harmful or dependent drinkers due to thiamine deficiency. Thiamine deficiency is common in these people due to factors such as poor diet, poor absorption of nutrients and a high demand for the vitamin (a coenzyme in alcohol metabolism).
- NICE Clinical Guideline 115 (2014)recommends prescription of prophylactic oral thiamine for problem drinkers in specific situations, but does not specifically recommend prescription of vitamin B compound strong.
Actions for staff:
- Due to lack of evidence on their efficacy and safety, vitamin B complex preparations (vitamin B compound and vitamin B compound strong tablets) should not be prescribed for prevention of Wernicke’s encephalopathy in alcoholism.
- Vitamin B complex preparations should not be prescribed for preventing deficiency or for maintenance treatment following deficiency.
- Vitamin B complex preparations should not be prescribed as dietary supplements. People who wish to use them for dietary supplementation should be advised to purchase them over the counter.
- Vitamin B compound strong tablets may be prescribed on a short term basis (10 days) for people at risk of refeeding syndrome (NICE Clinical Guideline 32; 2017). This applies to people who are not harmful or dependent drinker
Any further intel, questions or concerns? Please email clinicalalerts@viaorg.uk
Please follow this link to download briefing in full.