Pyridoxine

Pyridoxine
Pyridoxine
Names
Other namesVitamin B6,[1] pyridoxol[2] pyridoxine hydrochloride
IUPAC name
  • 4,5-Bis(hydroxymethyl)-2-methylpyridin-3-ol
Clinical data
Drug classVitamin
Main usesPyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorders, complications of isoniazid, mushroom poisoning[3][1]
Side effectsHeadache, numbness, sleepiness[3]
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Pregnancy
category
  • AU: Exempt[4]
  • US: A (No risk in human studies)[4]
    Routes of
    use    		By mouth, intravenous (IV), intramuscular (IM), subcutaneous
    Defined daily dose160 mg (by mouth)
    160 mg (parenteral)[5]
    External links
    AHFS/Drugs.comMonograph
    Legal
    License data
    Legal status
    Chemical and physical data
    FormulaC8H11NO3
    Molar mass169.180 g·mol−1
    3D model (JSmol)
    Melting point159 to 162 °C (318 to 324 °F)
    SMILES
    • OCc1cnc(C)c(O)c1CO
    InChI
    • InChI=1S/C8H11NO3/c1-5-8(12)7(4-11)6(3-10)2-9-5/h2,10-12H,3-4H2,1H3 checkY
    • Key:LXNHXLLTXMVWPM-UHFFFAOYSA-N

    Pyridoxine, also known as vitamin B6, is a form of vitamin B6 found commonly in food and used as dietary supplement.[1] As a supplement it is used to treat and prevent pyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorders, side effects or complications of isoniazid use, and certain types of mushroom poisoning.[3][1] It is used by mouth or by injection.[3]

    It is usually well tolerated.[3] Occasionally side effects include headache, numbness, and sleepiness.[3] Normal doses are safe during pregnancy and breastfeeding.[3] Pyridoxine is in the vitamin B family of vitamins.[3] It is required by the body to make amino acids, carbohydrates, and lipids.[3] Sources in the diet include fruit, vegetables, and grain.[7]

    Pyridoxine was discovered in 1934, isolated in 1938, and first made in 1939.[8][9] It is on the World Health Organization's List of Essential Medicines.[10] Pyridoxine is available both as a generic medication and over the counter product.[3] The wholesale cost in the developing world is about US$0.59–3.54 per month.[11] Foods, such as breakfast cereal have pyridoxine added in some countries.[7]

    Medical uses

    As a supplement it is used to treat and prevent pyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorders, problems from isoniazid, and certain types of mushroom poisoning.[3][1] Pyridoxine-dependent epilepsy is a type of rare epilepsy that does not improve with typical antiseizure medications.[12] Pyridoxine is used by mouth or by injection.[3]

    Pyridoxine in combination with doxylamine is used as a treatment for morning sickness in pregnant women. It has been used in hydrazine exposure with unclear effect.[13]

    Dosage

    The defined daily dose is 160 mg (by mouth) or 160 mg (by injection)[5] To prevent toxicity due to isoniazid 10 mg is used in people over 5 kg while 5 mg is used in people under 5 kg.[14] To treat toxicity from isoniazid 50 mg three times per day is used in adults and 50 mg once per day in children.[14]

    Side effects

    It is usually well tolerated, though overdose toxicity is possible.[3] Occasionally side effects include headache, numbness, and sleepiness.[3] Pyridoxine overdose can cause a peripheral sensory neuropathy characterized by poor coordination, numbness, and decreased sensation to touch, temperature, and vibration.[15] Healthy human blood levels of pyridoxine are 2.1 - 21.7 ng/mL.

    Pregnancy and breastfeeding

    Normal doses are safe during pregnancy and breastfeeding.[3]

    Mechanism

    Pyridoxine is in the vitamin B family of vitamins.[3] It is required by the body to make amino acids, carbohydrates, and lipids.[3] Sources in the diet include fruit, vegetables, and grain.[7] It is also required for muscle phosphorylase activity associated with glycogen metabolism.

    History

    Pyridoxine was discovered in 1934, isolated in 1938, and first made in 1939.[8][9] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[10] Pyridoxine is available as a generic medication and over the counter.[3] The wholesale cost in the developing world is about US$0.59–3.54 per month.[11] Foods, such as breakfast cereal have pyridoxine added in some countries.[7]

    Society and culture

    Cost

    The wholesale cost in the developing world is about US$0.59–3.54 per month[11]

    • Pyridoxine costs (US)
      Pyridoxine costs (US)
    • Pyridoxine prescriptions (US)
      Pyridoxine prescriptions (US)

    References

    1. 1 2 3 4 5 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 496. hdl:10665/44053. ISBN 9789241547659.
    2. ↑ Dryhurst, Glenn (2012). Electrochemistry of Biological Molecules. Elsevier. p. 562. ISBN 9780323144520. Archived from the original on 30 December 2016.
    3. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 "Pyridoxine Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 30 December 2016. Retrieved 8 December 2016.
    4. 1 2 "Pyridoxine Use During Pregnancy". Drugs.com. 27 April 2020. Archived from the original on 4 December 2020. Retrieved 6 May 2020.
    5. 1 2 "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 10 October 2020. Retrieved 15 September 2020.
    6. ↑ "Pyridoxine 50mg Tablets - Summary of Product Characteristics (SmPC)". (emc). 27 April 2015. Archived from the original on 12 October 2013. Retrieved 6 May 2020.
    7. 1 2 3 4 "Office of Dietary Supplements - Dietary Supplement Fact Sheet: Vitamin B6". ods.od.nih.gov. 11 February 2016. Archived from the original on 12 December 2016. Retrieved 30 December 2016.
    8. 1 2 Squires, Victor R. (2011). The Role of Food, Agriculture, Forestry and Fisheries in Human Nutrition - Volume IV. EOLSS Publications. p. 121. ISBN 9781848261952. Archived from the original on 25 December 2020. Retrieved 30 June 2020.
    9. 1 2 Harris, Harry (2012). Advances in Human Genetics 6. Springer Science & Business Media. p. 39. ISBN 9781461582649. Archived from the original on 9 July 2021. Retrieved 30 June 2020.
    10. 1 2 World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
    11. 1 2 3 "Vitamin B6". International Drug Price Indicator Guide. Archived from the original on 22 January 2018. Retrieved 8 December 2016.
    12. ↑ Abend, NS; Loddenkemper, T (July 2014). "Management of pediatric status epilepticus". Current Treatment Options in Neurology. 16 (7): 301. doi:10.1007/s11940-014-0301-x. PMC 4110742. PMID 24909106.
    13. ↑ "Hydrazine (EHC 68, 1987)". www.inchem.org. Archived from the original on 14 March 2010. Retrieved 20 November 2018.
    14. 1 2 "PYRIDOXINE = VITAMIN B6 oral - Essential drugs". medicalguidelines.msf.org. Archived from the original on 29 August 2021. Retrieved 24 August 2020.
    15. ↑ "Pyridoxine deficiency and toxicity | MedLink Neurology". www.medlink.com. Archived from the original on 19 July 2020. Retrieved 24 August 2020.
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