Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Frequency Not Defined
Headache
Seizure (from very large IV dose)
Somnolence
Decreased folic acid
Acidosis
Increased hepatic AST
Nausea
Paresthesia
Neuropathy
Warnings
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
Pharmacology
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)
Images
Patient Handout
Formulary
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Adding plans allows you to:
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