- Adverse reactions
- Brand names: u.s.
- Dietary considerations
- Dosage forms
- Dosing: geriatric
- Drug interactions
- Ethylene glycol poisoning
- Gyromitrin-containing mushroom (false morel) overdose/toxicity (treatment/prophylaxis)
- Half-life elimination
- Index terms
- Missed dose
- Monitoring parameters
- Nausea and vomiting of pregnancy
- Neurological toxicities (ie, seizures, coma) associated with isoniazid overdose (prevention)
- Neurological toxicities (ie, seizures, coma) associated with isoniazid overdose (treatment)
- Patient education
- Pregnancy considerations
- Use: labeled indications
Well absorbed (IOM 1998)
Frequency not defined.
Central nervous system: Ataxia, drowsiness, headache, neuropathy, paresthesia, seizure (following very large IV doses)
Endocrine & metabolic: Acidosis, folate deficiency
Hepatic: Increased serum AST
Hypersensitivity: Hypersensitivity reaction
Brand names: u.s.
- Neuro-K-250 T.D. [OTC]
- Neuro-K-250 Vitamin B6 [OTC]
- Neuro-K-50 [OTC]
- Neuro-K-500 [OTC]
- Pyri 500 [OTC]
Hypersensitivity to pyridoxine or any component of the formulation
Dietary adequate Intake (AI) (IOM 1998):
1 to 6 months: 0.1 mg/day
7 to 12 months: 0.3 mg/day
Dietary recommended daily allowance (RDA) (IOM 1998):
1 to 3 years: 0.5 mg
4 to 8 years: 0.6 mg
9 to 13 years: 1 mg
14 to 18 years: Females: 1.2 mg; Males: 1.3 mg
19 to 50 years: 1.3 mg
≥51 years: Females: 1.5 mg; Males: 1.7 mg
Pregnancy: 1.9 mg
Lactation: 2 mg
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule, Oral, as hydrochloride:
Neuro-K-250 T.D.: 250 mg [corn free, rye free, starch free, sugar free, wheat free]
Solution, Injection, as hydrochloride:
Generic: 100 mg/mL (1 mL)
Tablet, Oral, as hydrochloride:
Neuro-K-50: 50 mg
Neuro-K-500: 500 mg
Neuro-K-250 Vitamin B6: 250 mg
Pyri 500: 500 mg
Generic: 25 mg, 50 mg, 100 mg, 250 mg
Tablet, Oral, as hydrochloride [preservative free]:
Generic: 25 mg, 50 mg, 100 mg [DSC]
Tablet Extended Release, Oral, as hydrochloride:
Generic: 200 mg
Refer to adult dosing.
Altretamine: Pyridoxine may diminish the therapeutic effect of Altretamine. Specifically when altretamine is used in combination with Cisplatin the response duration may be diminished. Management: Consider avoiding concomitant use of pyridoxine in a altretamine/cisplatin regimen. Although pyridoxine may have beneficial effects on altretamine-associated neurotoxicity, it may reduce the duration of response to altretamine. Consider therapy modification
Barbiturates: Pyridoxine may increase the metabolism of Barbiturates. Apparent in high pyridoxine doses (eg, 200 mg/day) Monitor therapy
Fosphenytoin: Pyridoxine may increase the metabolism of Fosphenytoin. This is most apparent in high pyridoxine doses (e.g., 80 mg to 200 mg daily) Monitor therapy
Levodopa-Containing Products: Pyridoxine may diminish the therapeutic effect of Levodopa-Containing Products. Management: The concomitant use of pyridoxine and levodopa (in the absence of a dopa decarboxylase inhibitor (DDI)) should be avoided. Use of a DDI (eg, carbidopa) with levodopa will essentially eliminate the risk of this interaction. Consider therapy modification
Phenytoin: Pyridoxine may increase the metabolism of Phenytoin. This is most apparent in high pyridoxine doses (e.g., 80 mg to 200 mg daily) Monitor therapy
Ethylene glycol poisoning
The American Academy of Clinical Toxicology guidelines recognize the lack of human clinical data for this use and consider pyridoxine as an adjunctive cofactor therapy in ethylene glycol poisoning without a formal or evidence-based recommendation, especially in patients who may have vitamin deficiencies (eg, patients with alcoholism) [Barceloux 1999].
Urine (as metabolites)
Gyromitrin-containing mushroom (false morel) overdose/toxicity (treatment/prophylaxis)
Clinical experience suggests the utility of pyridoxine in the treatment of seizures from acute gyromitrin-containing mushroom toxicity [Diaz 2005]. Additional data may be necessary to further define the role of pyridoxine in this condition.
Biologic: 15 to 20 days
- Pyridoxine HCl
- Pyridoxine Hydrochloride
- Vitamin B6
Hepatic to pyridoxal phosphate and pyridoxamine phosphate (active forms)
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
For treatment of isoniazid or gyromitrin-containing mushroom toxicity: Anion gap, arterial blood gases, electrolytes, neurological exam, seizure activity
Nausea and vomiting of pregnancy
Clinical experience suggests the utility of pyridoxine in the treatment of nausea and vomiting of pregnancy [Neibyl 2020].
Based on the American Society of Obstetricians and Gynecologists and the Society of Obstetricians and Gynaecologists of Canada practice guidelines, pyridoxine alone or in combination with doxylamine is a safe and effective treatment for nausea and vomiting of pregnancy and should be considered a first-line pharmacologic therapy [ACOG 189 2020], [Campbell [SOGC] 2020].
Neurological toxicities (ie, seizures, coma) associated with isoniazid overdose (prevention)
Clinical experience suggests the utility of pyridoxine in the prevention of isoniazid-induced neurologic toxicities [Hernon 2020]. Additional data may be necessary to further define the role of pyridoxine in this condition.
Neurological toxicities (ie, seizures, coma) associated with isoniazid overdose (treatment)
Data from a single case report suggests that pyridoxine may be beneficial for the treatment of isoniazid-induced seizures and/or coma [Morrow 2006]. Clinical experience also suggests the utility of pyridoxine in the treatment of isoniazid-induced seizures and/or coma [Howland 2020]. Additional data may be necessary to further define the role of pyridoxine in this condition.
What is this drug used for?
• It is used to treat or prevent low vitamin B6.
• It may be given to you for other reasons. Talk with the doctor.
Frequently reported side effects of this drug
Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:
• Numbness feeling
• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition.
This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
Precursor to pyridoxal, which functions in the metabolism of proteins, carbohydrates, and fats; pyridoxal also aids in the release of liver and muscle-stored glycogen and in the synthesis of GABA (within the central nervous system) and heme
When used for the treatment of ethylene glycol poisoning, pyridoxine is theorized to increase the formation of glycine, a nontoxic metabolite (Barceloux 1999).
Water soluble vitamins cross the placenta. Maternal pyridoxine plasma concentrations may decrease as pregnancy progresses and requirements may be increased in pregnant women (IOM 1998). Pyridoxine is used to treat nausea and vomiting of pregnancy (ACOG 189 2020; Neibyl 2020; Campbell [SOGC] 2020).
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Use: labeled indications
Pyridoxine deficiency: Treatment and prevention of pyridoxine (vitamin B6) deficiency.