vitamin B6, Nestrex (pyridoxine) dosing, indications, interactions, adverse effects, and more

Sections

Sections pyridoxine
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Nutrition
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablets

25mg
50mg
100mg
250mg
500mg

tablets, extended release

200mg

capsule

250mg

RDA

Males

<50 years old: 1.3 mg/day
>50 years old: 1.7 mg/day

Females

<50 years old: 1.3 mg/day
>50 years old: 1.5 mg/day
Pregnant: 1.9 mg/day
Lactation: 2mg

Pyridoxine Deficiency

10-20 mg/day IV/IM for 3 weeks

2.5-10 mg/day PO

Nausea in Pregnancy

10-25 mg PO q8hr

Prevention of Peripheral Neuropathy

Patients treated with isoniazid for Mycobacterium tuberculosis: 25-50 mg/day PO

Seizures (Orphan)

Treatment of pyridoxine dependent seizures

Orphan indication sponsor

NBI Pharmaceuticals, Inc; 1087 Stoneridge Drive; Bozeman, MT 59718

Dosage Forms & Strengths

tablets

25mg
50mg
100mg
200mg
250mg
500mg

tablets, extended release

200mg

capsule

250mg

RDA

<6 months: 0.1 mg/day

6-12 months: 0.3 mg/day

1-3 years: 0.5 mg/day

3-8 years: 0.6 mg/day

8-13 years: 1 mg/day

13-18 years: 1.3 mg/day (male); 1.5 mg/day (female)

Isoniazid-Induced Seizures/Coma

Dose of pyridoxine is equal to amount of isoniazid ingested

Administer at rate of 0.5-1 g/min until seizures stop or maximum initial dose (70 mg/kg) administered; may administer q5-10min PRN to control persistent seizure activity and/or CNS toxicity

Interaction Checker

Enter a drug name and pyridoxine

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Contraindicated

Serious - Use Alternative

Significant - Monitor Closely

Minor

All Interactions Sort By:

Contraindicated (0)

Serious - Use Alternative (1)

selinexor
selinexor, pyridoxine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

Monitor Closely (11)

azithromycin
azithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
cisplatin
pyridoxine decreases effects of cisplatin by unknown mechanism. Use Caution/Monitor. Use of pyridoxine, vitamin B6 with cisplatin and altretamine (hexamethylmelamine) may not be advisable.
clarithromycin
clarithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
dichlorphenamide
dichlorphenamide, pyridoxine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.
erythromycin base
erythromycin base will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
erythromycin ethylsuccinate
erythromycin ethylsuccinate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
erythromycin lactobionate
erythromycin lactobionate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
erythromycin stearate
erythromycin stearate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
levodopa
pyridoxine decreases levels of levodopa by increasing metabolism. Use Caution/Monitor.
omadacycline
pyridoxine will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
roxithromycin
roxithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

Minor (62)

amikacin
amikacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
amiodarone
pyridoxine increases toxicity of amiodarone by unspecified interaction mechanism. Minor/Significance Unknown. Increased risk of photosensitivity.
aztreonam
aztreonam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
cefadroxil
cefadroxil will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cefamandole
cefamandole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cefotetan
cefotetan will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cefpirome
cefpirome will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ceftibuten
ceftibuten will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cephalexin
cephalexin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
chlorhexidine oral
chlorhexidine oral will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ciprofloxacin
ciprofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
clindamycin
clindamycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
conjugated estrogens
conjugated estrogens decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
conjugated estrogens, vaginal
conjugated estrogens, vaginal decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
dapsone
dapsone will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
demeclocycline
demeclocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
doxycycline
doxycycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ertapenem
ertapenem will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
estradiol
estradiol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estrogens conjugated synthetic
estrogens conjugated synthetic decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estrogens esterified
estrogens esterified decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estropipate
estropipate decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
ethotoin
pyridoxine decreases levels of ethotoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
fleroxacin
fleroxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
fosfomycin
fosfomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
fosphenytoin
pyridoxine decreases levels of fosphenytoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
gemifloxacin
gemifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
gentamicin
gentamicin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
hydralazine
hydralazine decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown.
isoniazid
isoniazid decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown. If INH dose >10 mg/kg/day, supplement 50 100mg pyridoxine/day.
levofloxacin
levofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
linezolid
linezolid will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
meropenem
meropenem will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
meropenem/vaborbactam
meropenem/vaborbactam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
mestranol
mestranol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
metronidazole
metronidazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
minocycline
minocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
moxifloxacin
moxifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
neomycin PO
neomycin PO will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
nitrofurantoin
nitrofurantoin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ofloxacin
ofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
oxytetracycline
oxytetracycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
paromomycin
paromomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
penicillamine
penicillamine decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown.
phenobarbital
pyridoxine decreases levels of phenobarbital by increasing metabolism. Minor/Significance Unknown.
phenytoin
pyridoxine decreases levels of phenytoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
pivmecillinam
pivmecillinam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
quinupristin/dalfopristin
quinupristin/dalfopristin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
streptomycin
streptomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfadiazine
sulfadiazine will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfamethoxazole
sulfamethoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfisoxazole
sulfisoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
teicoplanin
teicoplanin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
temocillin
temocillin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
tetracycline
tetracycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
theophylline
theophylline decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
ticarcillin
ticarcillin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
tigecycline
tigecycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
tobramycin
tobramycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
trimethoprim
trimethoprim will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
vancomycin
vancomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

amikacin
Minor (1)amikacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
amiodarone
Minor (1)pyridoxine increases toxicity of amiodarone by unspecified interaction mechanism. Minor/Significance Unknown. Increased risk of photosensitivity.
azithromycin
Monitor Closely (1)azithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
aztreonam
Minor (1)aztreonam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
bazedoxifene/conjugated estrogens
Minor (1)bazedoxifene/conjugated estrogens decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
cefadroxil
Minor (1)cefadroxil will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cefamandole
Minor (1)cefamandole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cefotetan
Minor (1)cefotetan will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cefpirome
Minor (1)cefpirome will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ceftibuten
Minor (1)ceftibuten will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cephalexin
Minor (1)cephalexin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
chlorhexidine oral
Minor (1)chlorhexidine oral will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ciprofloxacin
Minor (1)ciprofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
cisplatin
Monitor Closely (1)pyridoxine decreases effects of cisplatin by unknown mechanism. Use Caution/Monitor. Use of pyridoxine, vitamin B6 with cisplatin and altretamine (hexamethylmelamine) may not be advisable.
clarithromycin
Monitor Closely (1)clarithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
clindamycin
Minor (1)clindamycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
conjugated estrogens
Minor (1)conjugated estrogens decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
conjugated estrogens, vaginal
Minor (1)conjugated estrogens, vaginal decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
dapsone
Minor (1)dapsone will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
demeclocycline
Minor (1)demeclocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
dichlorphenamide
Monitor Closely (1)dichlorphenamide, pyridoxine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.
doxycycline
Minor (1)doxycycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ertapenem
Minor (1)ertapenem will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
erythromycin base
Monitor Closely (1)erythromycin base will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
erythromycin ethylsuccinate
Monitor Closely (1)erythromycin ethylsuccinate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
erythromycin lactobionate
Monitor Closely (1)erythromycin lactobionate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
erythromycin stearate
Monitor Closely (1)erythromycin stearate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
estradiol
Minor (1)estradiol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estrogens conjugated synthetic
Minor (1)estrogens conjugated synthetic decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estrogens esterified
Minor (1)estrogens esterified decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estropipate
Minor (1)estropipate decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
ethotoin
Minor (1)pyridoxine decreases levels of ethotoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
fleroxacin
Minor (1)fleroxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
fosfomycin
Minor (1)fosfomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
fosphenytoin
Minor (1)pyridoxine decreases levels of fosphenytoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
gemifloxacin
Minor (1)gemifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
gentamicin
Minor (1)gentamicin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
hydralazine
Minor (1)hydralazine decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown.
isoniazid
Minor (1)isoniazid decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown. If INH dose >10 mg/kg/day, supplement 50 100mg pyridoxine/day.
levodopa
Monitor Closely (1)pyridoxine decreases levels of levodopa by increasing metabolism. Use Caution/Monitor.
levofloxacin
Minor (1)levofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
linezolid
Minor (1)linezolid will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
meropenem
Minor (1)meropenem will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
meropenem/vaborbactam
Minor (1)meropenem/vaborbactam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
mestranol
Minor (1)mestranol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
metronidazole
Minor (1)metronidazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
minocycline
Minor (1)minocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
moxifloxacin
Minor (1)moxifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
neomycin PO
Minor (1)neomycin PO will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
nitrofurantoin
Minor (1)nitrofurantoin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
ofloxacin
Minor (1)ofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
omadacycline
Monitor Closely (1)pyridoxine will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
oxytetracycline
Minor (1)oxytetracycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
paromomycin
Minor (1)paromomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
penicillamine
Minor (1)penicillamine decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown.
phenobarbital
Minor (1)pyridoxine decreases levels of phenobarbital by increasing metabolism. Minor/Significance Unknown.
phenytoin
Minor (1)pyridoxine decreases levels of phenytoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
pivmecillinam
Minor (1)pivmecillinam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
quinupristin/dalfopristin
Minor (1)quinupristin/dalfopristin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
roxithromycin
Monitor Closely (1)roxithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
selinexor
Serious - Use Alternative (1)selinexor, pyridoxine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
streptomycin
Minor (1)streptomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfadiazine
Minor (1)sulfadiazine will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfamethoxazole
Minor (1)sulfamethoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfisoxazole
Minor (1)sulfisoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
teicoplanin
Minor (1)teicoplanin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
temocillin
Minor (1)temocillin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
tetracycline
Minor (1)tetracycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
theophylline
Minor (1)theophylline decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
ticarcillin
Minor (1)ticarcillin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
tigecycline
Minor (1)tigecycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
tobramycin
Minor (1)tobramycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
trimethoprim
Minor (1)trimethoprim will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
vancomycin
Minor (1)vancomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

Frequency Not Defined

Headache

Seizure (from very large IV dose)

Somnolence

Decreased folic acid

Acidosis

Increased hepatic AST

Nausea

Paresthesia

Neuropathy

Contraindications

Hypersensitivity

Cautions

Long-term large doses associated with induced neuropathy

Use caution in patients with impaired renal function and neonates (some parental products contain aluminum)

May cause dependence/withdrawal

Pyridoxine deficiency rare (enaluate for other deficiencies)

Dependence and withdrawal associated with >200 mg/day

Pregnancy & Lactation

Pregnancy Category: A/C-when exceeding RDA recommendations

Lactation: Safe

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Nutrition

Sources: Beef liver, pork, baked potato, spinach, banana, cereals, milk, fish, avocado

Function: Cofactor in enzymatic reactions

Deficiency: Inflammation of mouth, lips, tongue; anxiety, depression, confusion; anemia; rarely seizures

Deficiency may be caused by some medications (isoniazid, alcohol, penicillamine, theophylline)

Reduced by: Estrogens, stewing/boiling

Toxicity: >200 mg/day can lead to nerve damage & photosensitivity

Mechanism of Action

Precursor of pyridoxal; plays a role in metabolism of proteins, carbohydrates, and fats; aids in the sythesis of GABA

Aids in release of liver and muscle stored glycogen

Pharmacokinetics

Absorption (parenteral/enteral): Well absorbed

Half-life: 15-20 days

Excretion: Urine

Metabolism: Liver to pyridoxal phosphate and pyridoxamine phosphate (active forms)

BRAND	FORM.	UNIT PRICE	PILL IMAGE
pyridoxine (vitamin B6) injection -	100 mg/mL vial
Vitamin B-6 oral -	50 mg tablet
Vitamin B-6 oral -	50 mg tablet
Vitamin B-6 oral -	50 mg tablet
Vitamin B-6 oral -	100 mg tablet
Vitamin B-6 oral -	25 mg tablet
Vitamin B-6 oral -	100 mg tablet
pyridoxine (vitamin B6) oral -	100 mg tablet
pyridoxine (vitamin B6) oral -	100 mg/2.5 mL liquid
pyridoxine (vitamin B6) oral -	50 mg tablet

Patient Handout

Select a drug:

NO MONOGRAPH AVAILABLE AT THIS TIME

USES: Consult your pharmacist.

HOW TO USE: Consult your pharmacist.

SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Consult your pharmacist.

DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: No monograph available at this time.

MISSED DOSE: Consult your pharmacist.

STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Create Your List of Plans

Adding plans allows you to:

View the formulary and any restrictions for each plan.
Manage and view all your plans together – even plans in different states.
Compare formulary status to other drugs in the same class.
Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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