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Vitamins B & C Kyowa Kirin Intravenous high potency logo
Close up of an older person's eye which shows the reflection of a woman drinking, accompanied by 'Look a little deeper. Please look a little deeper and maybe you will find the impact of alcohol misuse that's affecting my mind'

Vitamins B&C Kyowa Kirin Intravenous High Potency, Concentrate for Solution for Infusion

INTRODUCTION

Vitamins B&C Kyowa Kirin Intravenous High Potency, Concentrate for Solution for Infusion (Vitamins B&C Kyowa Kirin IVHP) is a parenteral therapy for rapid treatment of severe depletion or malabsorption of the water soluble vitamins B and C, including those related to alcohol misuse and malnutrition.1

Adverse Events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse Events should also be reported to Kyowa Kirin International UK NewCo Ltd, known as Grünenthal Meds on +44 (0)1896 664000, email PVUK@grunenthalmeds.com

Click here for prescribing information.

Introduction

Wernicke's encephalopathy (WE), a type of alcohol related brain damage (ARBD), is a serious medical emergency caused by thiamine depletion to the brain.2,3

When treated inadequately:

  • Up to 20% will die.4,5
  • 56%-84% develop the irreversible symptoms of Korsakoff’s Syndrome (KS).6
  • 25% of cases will result in long term institutional care.6

When patients present with suspected or established WE, it is not possible to predict the full extent of thiamine depletion, or how far along the path to irreversible brain damage they are.

  • Only a short window of opportunity exists to reverse the neurological effects that can lead to the permanent brain damage and cognitive decline of KS.7
Timeline of effects of thiamine deficiency from 4 days to 14 days onwards

When WE is suspected or established, prompt and adequate administration of thiamine is required at:

  • High concentration1,3,4,8,9
  • Sufficient frequency1,8,10,11
  • Suitable duration1,2,3,8

These are necessary to restore thiamine to the brain, reverse the symptoms of WE, and protect from further neurological damage of this debilitating disease.8

With rapid parenteral release, thiamine can diffuse across the blood brain barrier, providing therapeutic levels to the brain.4

Vitamins B&C Kyowa Kirin IVHP gives you confidence in restoring your patients’ thiamine stores

Vitamins B&C Kyowa Kirin IVHP is a 5 day plan for treating thiamine deficiency, including those related to alcohol abuse and malnutrition.1,2,8  When treated promptly and adequately with Vitamins B&C Kyowa Kirin IVHP, WE can be reversed.4,8

NICE recommends parenteral thiamine (Vitamins B&C Kyowa Kirin IVHP) for Wernicke’s encephalopathy2

Treat patients with a high index of suspicion for Wernicke's encephalopathy for a minimum of 5 days, unless it is excluded
Vitamins B & C Kyowa Kirin IVHP is recommended for harmful or dependent drinkers if they are malnourished/at risk of malnourishment or have decompensated liver disease, and if they attend an emergency department or are admitted to hospital with an acute illness or injury

NICE recommends treatment at the upper end of the BNF dose range, which is:

Vitamins B&C Kyowa Kirin IVHP IV, 2-3 pairs, 3 times a day.2,8

Wernicke’s encephalopathy in non-alcoholic patients12

Wernicke’s in non-alcoholic patients is less recognised and often misdiagnosed.13

Causes of Wernicke’s encephalopathy include:

  • Cancer
  • Gastrointestinal surgery
  • Hyperemesis gravidarum
  • Starvation/fasting
  • Gastrointestinal tract diseases
  • AIDS
  • Malnutrition
  • Dialysis and renal disease
  • Parenteral nutrition
  • Anorexia nervosa
  • Stem cell/bone marrow transplantation

Average:

  • References

    1. Vitamins B&C Kyowa Kirin Intravenous High Potency, Concentrate for Solution for Infusion Summary of Product Characteristics.

    2. National Institute for Health and Care Excellence. Full Guidance June 2010. (updated April 2017). Alcohol use disorders and clinical management of alcohol related physical complications [Clinical Guidance 100].

    3. Thomson AD, et al. Alcohol & Alcoholism. 2013; 48(1):4-8.

    4. Thomson AD, et al. Alcohol & Alcoholism 2002; 37: 513–521.

    5. Thomson AD, Cook CCH. Alcohol & Alcoholism; 1997: 32(3):207-209.

    6. Thomson AD and Marshall EJ. Alcohol & Alcoholism; 2006: 41(2):151-158.

    7. Thomson AD. Alcohol & Alcoholism; 2000: 35(Supp 1):2-7.

    8. Vitamin B substances with ascorbic acid. British National Formulary. https://bnf.nice.org.uk/drugs/vitamin-b-substances-with-ascorbic-acid/ Last accessed June 2024.

    9. Sechi G, Serra A. Lancet Neurology 2007; 6:442–455.

    10. Tallaksen CM, Sande A, Bøhmer T, et al. Eur J Clin Pharmacology. 1993;44(1):73-8.

    11. Latt N and Dore G. Internal Medicine Journal 2014; 44: 911-915.

    12. Buchannan M, Brown A, Cameron M, et al. Best practice guidance – Consensus guidance on the identification and management of Wernicke’s encephalopathy. Guidelines in Practice. 2019.

    13. Hesami O, et al. Ir J Neurol 2012; 11(4): 159-161.

    KKI/GB/PAB/0261 June 2024