Can biotin (Vitamin B7) 10 mg/mL be administered intramuscularly (IM)?

Biotin 10 mg/mL Should NOT Be Administered Intramuscularly

Biotin should be administered either orally or intravenously depending on intestinal function, but intramuscular administration is not supported by current guidelines and should be avoided. 1

Route Selection Algorithm

The ESPEN guidelines establish a clear hierarchy for biotin administration based on clinical context 1:

First-Line: Oral Administration

• Oral biotin is the preferred route for biotin deficiency treatment when intestinal function is intact 1
• Standard oral dosing for deficiency with malabsorption/short bowel syndrome is 10 mg/day 1
• This route is safe, effective, and has no established upper toxicity limit 2

Second-Line: Intravenous Administration

• IV biotin is reserved exclusively for parenteral nutrition-dependent patients who cannot absorb nutrients enterally 1
• IV dosing ranges from 60 mcg/day for maintenance up to 200 mg/day for 2-3 weeks in severe deficiency 1
• No adverse effects have been documented with IV administration of pharmacological doses up to 5 mg/day for prolonged periods 2

Intramuscular Route: Not Recommended

• The American Society for Parenteral and Enteral Nutrition does not mention intramuscular biotin administration in its guidelines, in contrast to other micronutrients like vitamin D where IM routes are explicitly discussed 1
• ESPEN guidelines state that "additional amounts of biotin can be administered either orally, enterally or IV depending on the intestinal function" with no mention of IM administration 2

Critical Clinical Considerations

Why IM Is Not Standard Practice

• Biotin is water-soluble and highly bioavailable orally, eliminating the need for IM injection in most cases 3
• The only scenario requiring parenteral administration is complete intestinal failure requiring total parenteral nutrition 1
• Historical case reports used oral biotin (10 mg daily in three divided doses) even for severe neurologic complications in dialysis patients, demonstrating oral efficacy 4

Safety Concerns with High-Dose Biotin

• While biotin itself has excellent tolerability with no risk of hypervitaminosis 5, high biotin levels (particularly at 10 mg/mL concentration) can interfere with biotin-streptavidin-based laboratory assays 3, 6
• This interference can cause false results in hormone assays and lead to misdiagnosis of endocrine disorders 6

Practical Recommendation

If you have a 10 mg/mL biotin preparation:

• Administer it orally (1 mL = 10 mg dose) for deficiency treatment in patients with malabsorption 1
• Reserve IV administration only for patients on complete parenteral nutrition who cannot receive enteral medications 1
• Do not use the IM route as it lacks guideline support and offers no advantage over oral or IV routes 1