Wernicke’s encephalopathy can be difficult to diagnose, and the consequences of leaving it untreated can be devastating. Pabrinex is a combination of water-soluble vitamins B and C, which is used parenterally to rapidly treat severe depletion or malabsorption, particularly after alcoholism. As thiamine does not exist as a licensed parenteral product, Pabrinex is widely used to treat and prevent Wernicke’s encephalopathy, and in refeeding syndrome. An alternative approach is to use an unlicensed IV thiamine product.