Pyridoxine: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Myanmar prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Vitamin B6 deficiency

Adult: Up to 150 mg daily.

Oral
Homocystinuria, Primary hyperoxaluria, Sideroblastic anaemia

Adult: 200-600 mg daily. Lifelong administration may be needed to avoid recurrence.

Oral
Isoniazid-induced peripheral neuropathy

Adult: 50 mg tid; up to 200 mg daily may be given.

Parenteral
Vitamin B6 deficiency

Adult: 10-20 mg daily for 3 weeks via IV or IM inj, then shift to oral daily therapy for several weeks.

Administration

extended release tab: May be taken with or without food. Swallow whole, do not break/crush/chew.

Incompatibility

Incompatible with alkaline solutions, iron salts and oxidizing agents.

Special Precautions

Pregnancy and lactation.

Adverse Reactions

Significant: Severe peripheral neuropathies (long term, excessively large doses).
Gastrointestinal disorders: Nausea.
General disorders and admin site conditions: Ataxia.
Immune system disorders: Hypersensitivity.
Investigations: Increased AST, decreased serum folic acid levels.
Metabolism and nutrition disorders: Metabolic acidosis.
Nervous system disorders: Headache, hyperesthesia, paraesthesia, seizure (very large IV doses).
Psychiatric disorders: Somnolence.

Pregnancy Category (US FDA)

IV/Parenteral/PO: A

Monitoring Parameters

Monitor CBC, electrolytes, neurological and seizure activity.

Drug Interactions

Concomitant use with cycloserine, hydralazine, isoniazid, penicillamine, estrogens (e.g. oral contraceptives) may increase dose requirement for pyridoxine. May diminish the effect of altretamine, levodopa, phenobarbital, phenytoin.

Lab Interference

May produce false-positive results for urobilinogen in the spot test using Ehrlich's reagent.

Action

Description: Pyridoxine is a water-soluble vitamin which functions as a coenzyme in the metabolism of proteins, carbohydrates and fats. It is essential in haeme formation and GABA synthesis within the CNS. It also aids in the release of glycogen stored in the liver and muscles.
Synonym: vitamin B₆.
Pharmacokinetics:
Absorption: Well absorbed from the gastrointestinal tract.
Distribution: Mainly stored in the liver; low amounts in muscles and brain. Crosses the placenta and enters breast milk.
Metabolism: Converted in the erythrocytes into pyridoxal phosphate and pyridoxamine phosphate (active forms) which are then stored and metabolised in the liver via oxidation into 4-pyridoxic acid and other inactive metabolites.
Excretion: Via urine (as 4-pyridoxic acid and other inactive metabolites). Elimination half-life: 15-20 days.

Chemical Structure

Storage

Tab: Store below 30°C. Protect from excessive heat, moisture and light. Solution for inj: Store between 20-25°C. Protect from light.

MIMS Class

Vitamin B-Complex / with C

ATC Classification

A11HA02 - pyridoxine (vit B6) ; Belongs to the class of other plain vitamin preparations. Used as dietary supplements.

References

Anon. Pyridoxine Hydrochloride. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 29/09/2020.

Anon. Pyridoxine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 29/09/2020.

Apotex NZ Ltd. Apo-Pyridoxine (50mg) data sheet 02 March 2017. Medsafe. http://www.medsafe.govt.nz/. Accessed 29/09/2020.

B-6 Pyridoxine HCL- Pyridoxine Hydrochloride Tablet (Marlex Pharmaceuticals Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 29/09/2020.

Buckingham R (ed). Isoniazid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/10/2020.

Buckingham R (ed). Vitamin B6 Substances. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/09/2020.

Joint Formulary Committee. Pyridoxine Hydrochloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/09/2020.

Prime B6 Tablet (Prime Pharmaceutical Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 29/09/2020.

Pyridoxine HCl Injection, Solution (HF Acquisition Co LLC, DBA HealthFirst). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 29/09/2020.

Pyridoxine, Vitamin B6. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com/. Accessed 29/09/2020.

Rexom Vitamin B6 Tablet (KCK Pharmaceutical Industries Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 29/09/2020.

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