Pyridoxine

Pyridoxine, is a form of vitamin B6 found commonly in food and used as a dietary supplement. 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.[4] It is used by mouth or by injection.[4]

Pyridoxine
Pyridoxine
Clinical data
Other namesvitamin B6, pyridoxol[1] pyridoxine hydrochloride
AHFS/Drugs.comMonograph
License data
Pregnancy
category
Routes of
administration		By mouth, intravenous (IV), intramuscular (IM), subcutaneous
ATC code
Legal status
Legal status
Identifiers
  • 4,5-Bis(hydroxymethyl)-2-methylpyridin-3-ol
CAS Number
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.000.548
Chemical and physical data
FormulaC8H11NO3
Molar mass169.180 g·mol−1
3D model (JSmol)
Melting point159 to 162 °C (318 to 324 °F)
  • OCc1cnc(C)c(O)c1CO
  • 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

It is usually well tolerated.[4] Occasionally side effects include headache, numbness, and sleepiness.[4] Normal doses are safe during pregnancy and breastfeeding.[4] Pyridoxine is in the vitamin B family of vitamins.[4] It is required by the body to metabolise amino acids, carbohydrates, and lipids.[4] Sources in the diet include fruit, vegetables, and grain.[5]

Medical uses

As a treatment (oral or injection), it is used to treat or prevent pyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorders, side effects of isoniazid treatment and certain types of mushroom poisoning.[4] Isoniazid is an antibiotic used for the treatment of tuberculosis. Common side effect include numbness in the hands and feet.[6] Co-treatment with vitamin B6 alleviates the numbness.[7] Pyridoxine-dependent epilepsy is a type of rare infant epilepsy that does not improve with typical anti-seizure medications.[8]

Pyridoxine in combination with doxylamine is used as a treatment for morning sickness in pregnant women.[9]

Side effects

It is usually well tolerated, though overdose toxicity is possible.[4] Occasionally side effects include headache, numbness, and sleepiness.[4] Pyridoxine overdose can cause a peripheral sensory neuropathy characterized by poor coordination, numbness, and decreased sensation to touch, temperature, and vibration.[10] Healthy human blood levels of pyridoxine are 2.1 - 21.7 ng/mL. Normal doses are safe during pregnancy and breastfeeding.[4]

Mechanism

Pyridoxine is in the vitamin B family of vitamins.[4] It is required by the body to make amino acids, carbohydrates, and lipids.[4] Sources in the diet include fruit, vegetables, and grain.[5] 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.[11][12] It is on the World Health Organization's List of Essential Medicines.[13] Pyridoxine is available both as a generic medication and over the counter product.[4] Foods, such as breakfast cereal have pyridoxine added in some countries.[5]

References
  1. Dryhurst G (2012). "Electrochemistry of Biologically Important Pyridines". Electrochemistry of Biological Molecules. Elsevier. p. 562. ISBN 9780323144520. Archived from the original on 30 December 2016.
  2. "Pyridoxine Use During Pregnancy". Drugs.com. 27 April 2020. Retrieved 6 May 2020.
  3. "Pyridoxine 50mg Tablets - Summary of Product Characteristics (SmPC)". (emc). 27 April 2015. Retrieved 6 May 2020.
  4. "Pyridoxine Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 30 December 2016. Retrieved 8 December 2016.
  5. "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.
  6. "Isoniazid". The American Society of Health-System Pharmacists. Retrieved 13 August 2021.
  7. Lheureux P, Penaloza A, Gris M (April 2005). "Pyridoxine in clinical toxicology: a review". European Journal of Emergency Medicine. 12 (2): 78–85. doi:10.1097/00063110-200504000-00007. PMID 15756083. S2CID 39197646.
  8. 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.
  9. Anh NH, Kim SJ, Long NP, Min JE, Yoon YC, Lee EG, et al. (January 2020). "Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials". Nutrients. 12 (1): 157. doi:10.3390/nu12010157. PMC 7019938. PMID 31935866.
  10. "Pyridoxine deficiency and toxicity". MedLink Neurology. www.medlink.com. Retrieved 14 December 2020.
  11. Squires VR (2011). The Role of Food, Agriculture, Forestry and Fisheries in Human Nutrition - Volume IV. EOLSS Publications. p. 121. ISBN 9781848261952.
  12. Harris H (2012). Advances in Human Genetics 6. Springer Science & Business Media. p. 39. ISBN 9781461582649.
  13. 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.
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