Usage
- Benfotiamine is primarily prescribed to treat and prevent vitamin B1 (thiamine) deficiency. It’s also used to manage diabetic neuropathy (nerve damage due to diabetes), potentially alleviate symptoms of alcohol use disorder, and sometimes considered for other conditions like Alzheimer’s disease and beriberi, though more research is needed for these uses.
- Pharmacological Classification: Vitamin supplement.
- Mechanism of Action: Benfotiamine is a fat-soluble form of thiamine (vitamin B1), providing better bioavailability than thiamine itself. It’s converted to thiamine in the body, which is crucial for carbohydrate metabolism and nerve function. Benfotiamine is thought to inhibit the formation of advanced glycation end-products (AGEs), implicated in diabetic complications.
Alternate Names
- S-benzoylthiamine O-monophosphate
- Benphothiamine
- Betivina
- Benzoylthiamine monophosphate
- Benfotiamina
- Benfotiaminum
How It Works
- Pharmacodynamics: Benfotiamine improves thiamine levels in the body, thus supporting nerve function and carbohydrate metabolism. It may also have antioxidant and anti-inflammatory properties.
- Pharmacokinetics: Benfotiamine is absorbed more effectively than thiamine. It’s converted to thiamine and its phosphate esters. It’s unknown how long it stays in the body. The elimination pathways are not fully understood.
Dosage
Standard Dosage
Adults:
- Typical dosages range from 150-600 mg daily, often divided into two doses. Dosages up to 900mg have been used in some studies. Some sources suggest starting with a loading dose of 300 mg twice daily for the first month, followed by a maintenance dose of 150-450 mg daily.
- No official standard dosage has been established for any condition.
Children:
- Benfotiamine is generally not recommended for children under 12 years old due to limited safety data.
Special Cases:
- Elderly Patients: Dose adjustment may be necessary based on individual health and kidney function.
- Patients with Renal Impairment: Caution is advised, and dose adjustment may be needed.
- Patients with Hepatic Dysfunction: Caution is advised, and dose adjustment may be needed.
- Patients with Comorbid Conditions: Individualized dosing based on the specific condition and overall health status is necessary.
Clinical Use Cases
- Dosage recommendations for specific clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations haven’t been established.
Dosage Adjustments
- Adjustments are based on patient-specific factors like renal/hepatic function and other health conditions.
Side Effects
Common Side Effects
- Stomach discomfort (nausea, bloating, stomach pain)
- Skin rashes
- Diarrhea
- Headache
- Increased liver enzymes (in high doses)
- Increased blood pressure (in high doses)
- Sinus bradycardia (in high doses)
Rare but Serious Side Effects
- Allergic reactions (rash, itching, swelling, anaphylaxis)
Long-Term Effects
- Limited data available on long-term effects.
Adverse Drug Reactions (ADR)
- Allergic reactions requiring immediate medical attention.
Contraindications
- Hypersensitivity to benfotiamine or thiamine.
- Sulfur sensitivity.
Drug Interactions
- Fluorouracil (an anti-cancer drug) may interact and potentially decrease benfotiamine effectiveness.
- Furosemide (a diuretic) might also reduce benfotiamine efficacy.
- Medications for high blood pressure or diabetes may require dose adjustments when taken with benfotiamine.
- Orlistat (a weight-loss drug) may reduce benfotiamine absorption.
- Alcohol should be avoided.
Pregnancy and Breastfeeding
- Insufficient data on safety during pregnancy and breastfeeding. Use with caution and only under medical supervision if benefits outweigh the risks.
Drug Profile Summary
- Mechanism of Action: Improves thiamine levels, supporting nerve function and carbohydrate metabolism; may have antioxidant and anti-inflammatory effects.
- Side Effects: Generally well-tolerated; common side effects include gastrointestinal issues, skin rashes, and headaches. Allergic reactions are rare but possible.
- Contraindications: Hypersensitivity to benfotiamine or its components, sulfur sensitivity.
- Drug Interactions: Limited interactions documented, but caution is advised with certain medications (fluorouracil, furosemide, antidiabetics, antihypertensives, orlistat).
- Pregnancy & Breastfeeding: Insufficient safety data; use with caution under medical supervision.
- Dosage: 150-600 mg daily (up to 900 mg in some studies), often divided into two doses.
- Monitoring Parameters: Thiamine levels, blood glucose levels (especially in patients with diabetes).
Popular Combinations
- Often combined with other B vitamins, particularly B6 and B12, for managing diabetic neuropathy.
- Sometimes combined with alpha-lipoic acid for potential synergistic effects in managing diabetic neuropathy.
Precautions
- General Precautions: Assess for allergies, pre-existing conditions, and concomitant medications before prescribing.
- Specific Populations: Pregnant and breastfeeding women should consult their doctor. Not recommended for children under 12.
- Lifestyle Considerations: Avoid alcohol.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Benfotiamine?
A: The recommended dosage varies but is generally 150-600 mg per day for adults. Some studies have used doses up to 900 mg daily. There’s no officially established dosage.
Q2: What are the common side effects of Benfotiamine?
A: Common side effects include stomach discomfort, skin rash, nausea, diarrhea, headache, and increased liver enzymes, blood pressure, and sinus bradycardia at higher doses.
Q3: Is Benfotiamine safe during pregnancy?
A: Insufficient data exists regarding its safety during pregnancy and breastfeeding. Consult a doctor before use.
Q4: How does Benfotiamine work in diabetic neuropathy?
A: Benfotiamine is believed to improve thiamine levels and inhibit the formation of AGEs, thought to contribute to nerve damage in diabetes.
Q5: Can Benfotiamine interact with other medications?
A: Yes, potential interactions exist with medications like fluorouracil, furosemide, anti-diabetics, and others. Consult a physician for guidance.
Q6: What are the contraindications for Benfotiamine?
A: Contraindications include hypersensitivity to benfotiamine or thiamine, and sulfur sensitivity.
Q7: Is Benfotiamine addictive?
A: No, benfotiamine is not known to be addictive.
Q8: What is the difference between Benfotiamine and Thiamine?
A: Benfotiamine is a fat-soluble derivative of thiamine with better bioavailability.
Q9: How long does Benfotiamine stay in the body?
A: The exact duration is unknown. Elimination pathways are not fully understood.
Q10: Can Benfotiamine be used in children?
A: It is generally not recommended for children under 12 due to insufficient safety data. Consult a pediatrician before considering its use in children.
