HSE Recommendations for Pabrinex and Thiamine Prescribing

HSE Recommendations for Pabrinex® and Thiamine Prescribing due to International Supply Disruption of Pabrinex® IV High Potency Concentrate for Solution for Injection – May 2024

Summary Information

  • The Manufacturing Authorisation Holder (MAH) for Pabrinex® IV High Potency Concentrate for Solution for Injection, have advised the Health Products Regulatory Authority (HPRA) there will be a supply disruption from September 2024 until Q3 2025.
  • Pabrinex® IV is licensed in adults for rapid therapy of severe depletion or malabsorption of the water soluble vitamins B and C, particularly in alcoholism where a severe depletion of thiamine can lead to Wernicke’s encephalopathy.1
  • Prescribers are advised to review prescribing to, in order to reserve stock for, only those individuals requiring Pabrinex® for the treatment of life threatening conditions, namely Wernicke’s encephalopathy/Korsakoff psychosis.2
  • All local protocols that include Pabrinex® should be reviewed and updated as appropriate, including electronic prescription order sets.
  • Current available is stock is being managed at wholesale level on an allocation basis to ensure equitable distribution of remaining stock.
  • In addition to this disruption, Pabrinex® Intramuscular (IM) injection (unlicensed in Ireland) will be discontinued. There are no other licensed parenteral alternatives to Pabrinex®.
  • Oral supplementation of thiamine should be used as appropriate, when clinically indicated, as first line choice of supplementation.
  • Though IV / IM thiamine is unlicensed in Ireland, it may be used in place of Pabrinex®, with supplementation of other vitamins as required.
  • Further guidance may be issued as additional information becomes available.
  • See information below for prescribing recommendations for the Treatment of Suspected or Established Wernicke’s Encephalopathy, Prophylaxis of Wernicke’s Encephalopathy Associated with Alcohol Use-Disorders and Refeeding Syndrome in Adult and Paediatric Patients
  • Read full details here:HSE Recommendations for Pabrinex and Thiamine Prescribing (1)