Drug Database
TH

thiamine-cobaltichlorophyllate (Midoriamin)

✓ Approved

Nisshin Pharma · Small Molecule · Small Molecule

What is thiamine-cobaltichlorophyllate?

thiamine-cobaltichlorophyllate is a small molecule developed by Nisshin Pharma. It is approved for therapeutic indications via unknown.

Drug Profile

Brand NamesMidoriamin
CompanyNisshin Pharma
Drug ClassSmall Molecule
RouteUnknown
StatusApproved
Sources: ClinicalTrials.gov, Nisshin Pharma

Therapeutic Indications

thiamine-cobaltichlorophyllate is developed for 2 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Gastrointestinal disordersDuodenal ulcer✓ Approved
Gastrointestinal disordersGastric ulcer✓ Approved

Related Research Articles

PubMedFrontiers in surgery2026-07-15

Wernicke encephalopathy in non-alcoholic patients following gastrointestinal procedures: a systematic review.

Abu-Qasem Hala H, Thalib Husna Irfan HI, Ghazi Zainab Shoeb ZS, Tageldin Reem R et al.

Wernicke encephalopathy (WE) is a serious neurological disorder often linked to alcohol use but can also occur under non-alcoholic conditions, particularly following gastrointestinal (GI) procedures. Existing reviews predominantly focus on bariatric surgery, leaving significant gaps regarding other major GI procedures. This study aimed to systematically review and synthesize evidence on the incidence, clinical characteristics, diagnostic methods, management strategies, and outcomes of WE in non-alcoholic adults following gastrointestinal procedures. A PRISMA-compliant systematic review was conducted. PubMed, Scopus, Web of Science, and Embase were searched for studies published between 2000 and 2025 that reported Wernicke encephalopathy in non-alcoholic adults following gastrointestinal procedures. Two reviewers independently screened and selected studies. Quality assessment was performed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklist. The review included 13 studies involving 1,036 patients. Diverse procedures, including bariatric, oncologic, and emergency gastrointestinal surgeries, were associated with WE, with vomiting identified as the most common precipitating factor. The classical triad of confusion, ataxia, and oculomotor dysfunction appeared in only a minority of patients, while most patients presented with atypical features such as cognitive deficits and polyneuropathy. Magnetic resonance imaging demonstrated characteristic changes in the thalami, mammillary bodies, and periaqueductal gray in confirmed cases. Rates of mortality varied considerably across studies, ranging from 0.3% in bariatric cohorts to 40% in oncologic patients. Early intravenous thiamine was associated with favorable outcomes, although dosing protocols varied considerably across studies. WE following gastrointestinal procedures presents significant diagnostic challenges. Prophylactic thiamine supplementation should be strongly considered in high-risk patients, particularly those with malnutrition, prolonged fasting, or persistent vomiting. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251164201, PROSPERO CRD420251164201.

PMID 42453365
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PubMedRSC advances2026-07-15

Synergistic bactericidal mechanism of carvacrol and ε-polylysine against Staphylococcus aureus: dysregulation of cellular homeostasis and metabolism.

Zang Xiangyu X, Du Chen C, Wan Shuai S, Ma Shengtao S et al.

This study aims to explore the synergistic bactericidal interaction of carvacrol (CAR) combined with ε-polylysine (ε-PL) against Staphylococcus aureus and its underlying mechanism. The combination of CAR (12.50 µg mL-1) and ε-PL (7.66 µg mL-1) exhibited synergistic bactericidal and antibiofilm activities, primarily attributed to combined destruction of the bacterial cell membrane, as evidenced by increased membrane permeability, time-dependent depolarization, and reduced cell surface hydrophobicity after 3 h of treatment. Membrane damage facilitated intracellular accumulation of CAR, which rapidly triggered energy depletion and early metabolic disturbances. Using metabolomics, the combination after 0.5 h was found to primarily perturb three key pathways, including tryptophan metabolism, cofactor biosynthesis (thiamine, biotin, nicotinamide), and nucleotide metabolism. These early metabolic changes, along with ATP decline, occurred prior to full membrane depolarization, oxidative stress, and pH imbalance at 3 h. Ultimately, the synergy caused irreversible energy depletion, membrane disruption, and severe oxidative damage. Furthermore, the combination reduced S. aureus counts by approximately 1.0 log10 CFU g-1 in raw beef under refrigeration, supporting its practical potential. This study for the first time constructs a complete temporal mechanism chain from initial membrane damage and rapid metabolic disorder to downstream cellular dysfunction for the CAR-ε-PL synergy, providing a novel theoretical basis for developing natural antimicrobial strategies in food preservation.

PMID 42453950
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PubMedIntestinal Failure (New York, N.Y.)2026-07-15

Refeeding syndrome: Applicability of ASPEN criteria in patients with intestinal failure.

Solar Héctor H, Ortega Mariana Laura ML, Blengini Lucía L, Cáceres Camila C et al.

Refeeding syndrome (RS) is defined as the reduction in serum levels of phosphorus, potassium, magnesium and/or thiamine, associated with the initiation of nutritional intake in patients with prolonged periods of low intake. In patients with intestinal failure (IF), risk factors for RS may be present. The aims of our study were to determine how many IF patients were at risk of RS, to determine how many of them developed RS and the accuracy of ASPEN risk criteria. A retrospective, observational, cross-sectional study was conducted. From January 2020 to July 2024 adult patients with IF diagnosis who started parenteral nutrition were included. The variables analyzed were sex, age, percentage of weight loss, BMI, pathophysiological classification of the IF, and serum values of potassium, magnesium, and phosphorus. Risk was classified as none, significant or moderate and the development as none, mild, moderate or severe. A total of 86 adult patients were included, 20.9 % had no risk criteria for RS, 2.3 % had moderate risk, and 76.7 % had significant risk. Fifty percent of patients with no risk criteria and 54.4 % of patients who did have risk criteria developed RS. In 63.0 % IF patients it was mild, 26.1 % moderate and severe in 10.9 %. According to the pathophysiological classification of IF, there were no differences between the groups (p > 0.9). In this cohort of IF patients, 53.5 % developed RS. ASPEN criteria did not predict the development of 50 %. Sensitivity was 0.8 and specificity 0.23.

PMID 42453759
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PubMedInternational review of neurobiology2026-07-14

Therapeutic targeting of brain bioenergetics in Alzheimer's disease addressing insulin resistance, glucose hypometabolism, and mitochondrial dysfunction.

Jangra Jatin J, Mahindru Isha I, Kumar Rajnish R

Alzheimer's disease (AD) is a progressive, age-associated multifactorial neurodegenerative disorder characterised by cognitive decline, synaptic dysfunction, and neuronal loss. Despite over a century of research, effective disease-modifying therapies remain elusive owing to its conundrum pathophysiology. In recent years, AD is increasingly recognised as a complex metabolic disorder characterised by impaired cerebral glucose metabolism, insulin resistance, and mitochondrial dysfunction. These interconnected metabolic disturbances emerge early in the disease state and collectively potentiate other pathologies such as accumulation of amyloid-β (Aβ) plaques, tau hyperphosphorylation, oxidative stress, neuroinflammation, and synaptic dysfunction, thereby establishing bioenergetic failure as a primary factor governing AD progression rather than a downstream phenomenon. While traditional drug development strategies targeting Aβ have failed in clinical trials (limited to monoclonal antibodies), emerging therapeutic models integrating energy failure, thiamine signalling, and insulin-like growth factor (IGF) signalling as upstream events show significant promise in countering downstream neurodegeneration. This chapter summarises the mechanistic framework linking bioenergetic breakdown to AD pathology, with potential therapeutic opportunities aimed at restoring mitochondrial function, enhancing glucose utilisation, and correcting insulin signalling, further opening new avenues for multimodal interventions and identification of progressive metabolic dysfunction biomarkers to aid diagnostic processes.

PMID 42442919
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PubMedNPJ biofilms and microbiomes2026-07-14

Genome-resolved discovery of Candidatus Vitaminotrophota reveals carbon fixation and multi-vitamin biosynthetic potential in hot springs.

Xie Yuan-Guo YG, Cao Xing-Ru XR, Qi Yan-Ling YL, Chen Lei L et al.

Geothermal environments harbor abundant microbial diversity, yet rare lineages remain poorly resolved, limiting understanding of ecosystem function and evolutionary innovation under energy limitation. Here, we describe Candidatus Vitaminotrophota, a previously unrecognized bacterial phylum represented by 35 metagenome-assembled genomes (MAGs) from Tengchong hot spring sediments, China. Phylogenomic analyses support a coherent internal taxonomy comprising one order, two families and four candidate genera. Metabolic reconstruction indicates a predominantly anaerobic, mixotrophic lifestyle, with widespread carbon fixation potential via the Wood-Ljungdahl pathway and a noncanonical CODH/ACS architecture featuring divergent acsA paralogs. Nitrogenase structural genes (nifHDK) occur in two genera, suggesting diazotrophic potential in part of the lineage. All MAGs encode complete or near-complete cobalamin and pantothenate biosynthesis pathways, and most retain conserved thiamine pathway components, alongside transport systems consistent with corrinoid and metal acquisition. Ca. Vitaminotrophota dominated community-level cobalamin biosynthetic potential in several samples, reaching 99.11% and accounting for >50% in nearly half of the samples. Conserved flagellar and chemotaxis gene sets suggest capacity to navigate steep physicochemical gradients. These findings expand the phylogenetic and functional landscape of geothermal bacteria and identify Ca. Vitaminotrophota as a candidate contributor to carbon fixation and vitamin-mediated metabolic interactions in nutrient-limited hot springs.

PMID 42443209
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PubMedA&A practice2026-07-13

Severe Perioperative Lactic Acidosis and Hyperglycemia Responsive to Thiamine in a Patient With Prior Semaglutide Use and Restrictive Dieting: A Case Report.

Kataria Sandeep S, Pylypiv Oksana O, Fahrenkrog Mitchell M

Thiamine deficiency is a rare but potentially fatal cause of type B lactic acidosis, classically associated with alcoholism or severe malnutrition. Restrictive dieting and weight-loss regimens, including glucagon-like peptide-1 (GLP-1) receptor agonist use, may unmask thiamine deficiency under perioperative stress. We report a young, nondiabetic woman on a restrictive diet who developed severe lactic acidosis and hyperglycemia after total abdominal hysterectomy, with worsening lactate despite hemodynamic stability and adequate hydration. Empiric intravenous thiamine produced rapid normalization of both lactate and glucose. Preoperative nutritional risk assessment and early empiric thiamine should be considered in similar perioperative presentations.

PMID 42439433
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