ARCALION

Indications

• Fatigue
• Asthenia
• Cognitive enhancement

Dosage

Children: Refer to the BNF for Children for appropriate dosing in paediatric patients.

Adults: Refer to the BNF for specific dosing recommendations.

Mechanism of action

Sulbutiamine is believed to enhance thiamine levels in the brain. It crosses the blood-brain barrier more effectively than thiamine and is converted into thiamine and its derivatives. These active forms of thiamine play essential roles in glucose metabolism and neuronal function, potentially improving cognitive function and reducing fatigue.

Pharmacodynamics

Sulbutiamine may improve energy metabolism in neurons and enhance cognitive performance. Its action on thiamine pathways contributes to increased acetylcholine synthesis, which is crucial for memory and learning processes. The drug may also exert a mild stimulant effect, promoting alertness and reducing feelings of fatigue.

Pharmacokinetics

Sulbutiamine is well absorbed after oral administration, with peak plasma concentrations occurring within a few hours. It is metabolized in the liver, and its metabolites include thiamine and its derivatives. The elimination half-life is variable, and the drug and its metabolites are excreted primarily in the urine.

Adverse effects

• Headache
• Nausea
• Skin rash
• Fatigue
• Irritability

Precautions

• Use with caution in patients with a history of hypersensitivity to thiamine or its derivatives
• Monitor for potential allergic reactions

Pregnancy

There is limited data on the use of sulbutiamine in pregnancy. Consult relevant guidelines and consider risk versus benefit.

Breast-feeding

Data on the excretion of sulbutiamine in human milk is not available. Caution is advised when administering to breastfeeding women.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Tablets
• Capsules