Dosing and uses of vitamin B6, Nestrex (pyridoxine)
Adult dosage forms and strengths
tablets
- 10mg
- 25mg
- 50mg
- 100mg
- 200mg
- 250mg
- 500mg
tablets, extended release
- 200mg
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/d; Nursing: 2 mg/d
Pyridoxine Deficiency
10-100 mg IV/Im
2.5-10 mg/d PO
Nausea in Pregnancy
75 mg PO qd
Seizures (Orphan)
Treatment of pyridoxine dependent seizures
Orphan indication sponsor
- NBI Pharmaceuticals, Inc; 1087 Stoneridge Drive; Bozeman, MT 59718
Other Indications & Uses
Morning sickness, sideroblastic anemia
See also pyridoxine Ad
Pediatric dosage forms and strengths
tablets
- 10mg
- 25mg
- 50mg
- 100mg
- 200mg
- 250mg
- 500mg
tablets, extended release
- 200mg
RDa
Upto 6 months old: 0.1 mg/d
6-12 months old: 0.3 mg/d
1-3 years old: 0.5 mg/d
4-8 years old: 0.6 mg/d
9-13 years old: 1 mg/d
14-18 years old (male) 1.3 mg/d; (female) 1.2 mg/d
UL: 1-3 years old: 30 mg/d; 4-8 years old: 40 mg/d; 9-13 years old: 60 mg/d; 14-18 years old: 80 mg/d
Pyridoxine-Responsive Seizures
10-100 mg IV/Im
vitamin B6, Nestrex (pyridoxine) adverse (side) effects
Frequency not defined
Sensory neuropathies
Unstable gait
Paresthesias
Decr sensation
Decreased folic acid
Warnings
Contraindications
Hypersensitivity
Cautions
Long-term large doses may induce neuropathy
Do not give IV to heart dz pts.
Pregnancy and 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/d can lead to nerve damage & photosensitivity
Pharmacology of vitamin B6, Nestrex (pyridoxine)
Absorption: readily
Distribution: stored mainly in liver, also muscle & brain
Half-Life: 15-20 d
Metabolism: liver
Excretion: urine
