UK Clinical Pharmacy Association


Issues for surgery

For supplementation, or treatment, of vitamin B deficiency – risk of deficiency if omitted for prolonged period.

For treatment, or prophylaxis, of Wernicke's encephalopathy – worsening of neurological symptoms and potential irreversible neurological damage if omitted.

Advice in the perioperative period

Elective surgery 


Emergency surgery 


Patients with suspected or known excess alcohol intake

In patients with suspected excess alcohol intake consider commencing Pabrinex® (withhold thiamine whilst on intravenous supplementation).

Post-operative advice

Restart at patient’s usual dose once enteral intake resumes. If prolonged nil-by-mouth period anticipated, consider intravenous supplementation with Pabrinex®.

Interactions with common anaesthetic agents


Interactions with other common medicines used in the perioperative period


Further information

None relevant.


Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. [Accessed on 16th September 2023]

Summary of Product Characteristics – Thiamine 50mg Tablets. Flamingo Pharma (UK) Ltd. Accessed via 16/09/2023 [date of revision of the text March 2019]

Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. [Accessed on 16th September 2023]