Pyridoxine (injection): Difference between revisions
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|drugClass=[[nutritive agent]] of the [[vitamin B]] family | |drugClass=[[nutritive agent]] of the [[vitamin B]] family | ||
|indicationType=treatment | |||
|indication=inadequate dietary intake, drug-induced deficiency, as from [[isoniazid]] ([[INH]]) or [[oral contraceptives]], inborn errors of metabolism, e.g., vitamin B6 dependent convulsions or vitamin B6 responsive anemia. The parenteral route is indicated when oral administration is not feasible as in anorexia, nausea and vomiting, and preoperative and postoperative conditions. It is also indicated when gastrointestinal absorption is impaired. | |indication=inadequate dietary intake, drug-induced deficiency, as from [[isoniazid]] ([[INH]]) or [[oral contraceptives]], inborn errors of metabolism, e.g., vitamin B6 dependent convulsions or vitamin B6 responsive anemia. The parenteral route is indicated when oral administration is not feasible as in anorexia, nausea and vomiting, and preoperative and postoperative conditions. It is also indicated when gastrointestinal absorption is impaired. | ||
|adverseReactions=decreased [[folic acid]], [[paresthesia]] and [[somnolence]] | |adverseReactions=decreased [[folic acid]], [[paresthesia]] and [[somnolence]] | ||
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| Name = Pyridoxine | | Name = Pyridoxine | ||
| ImageFile_Ref = {{chemboximage|correct|??}} | | ImageFile_Ref = {{chemboximage|correct|??}} | ||
| ImageFile = Pyridoxine | | ImageFile = Pyridoxine Structure.png | ||
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| ImageName = Pyridoxine | | ImageName = Pyridoxine | ||
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|mechAction=Natural substances that have vitamin B6 activity are pyridoxine in plants and pyridoxal or pyridoxamine in animals. All 3 are converted to pyridoxal phosphate by the enzyme pyridoxal kinase. The physiologically active forms of vitamin B6 are pyridoxal phosphate (codecarboxylase) and pyridoxamine phosphate. Riboflavin is required for the conversion of pyridoxine phosphate to pyridoxal phosphate. | |mechAction=*Natural substances that have vitamin B6 activity are pyridoxine in plants and pyridoxal or pyridoxamine in animals. All 3 are converted to pyridoxal phosphate by the enzyme pyridoxal kinase. The physiologically active forms of vitamin B6 are pyridoxal phosphate (codecarboxylase) and pyridoxamine phosphate. Riboflavin is required for the conversion of pyridoxine phosphate to pyridoxal phosphate. | ||
Vitamin B6 acts as a coenzyme in the metabolism of protein, carbohydrate, and fat. In protein metabolism, it participates in the decarboxylation of amino acids, conversion of tryptophan to niacin or to serotonin (5-hydroxtryptamine), deamination, and transamination and transulfuration of amino acids. In carbohydrate metabolism, it is responsible for the breakdown of glycogen to glucose-1-phosphate. | Vitamin B6 acts as a coenzyme in the metabolism of protein, carbohydrate, and fat. In protein metabolism, it participates in the decarboxylation of amino acids, conversion of tryptophan to niacin or to serotonin (5-hydroxtryptamine), deamination, and transamination and transulfuration of amino acids. In carbohydrate metabolism, it is responsible for the breakdown of glycogen to glucose-1-phosphate. | ||
|structure=The chemical name is 2-methyl-3-hydroxy-4,5-bis (hydroxymethyl) pyridine hydrochloride. The structural formula is: | |structure=*The chemical name is 2-methyl-3-hydroxy-4,5-bis (hydroxymethyl) pyridine hydrochloride. The structural formula is: | ||
[[file:Pyridoxine Structure.png|thumb|none|450px]] | [[file:Pyridoxine Structure.png|thumb|none|450px]] | ||
|PK=The total adult body pool consists of 16 to 25 mg of pyridoxine. Its half-life appears to be 15 to 20 days. Vitamin B6 is degraded to 4-pyridoxic acid in the liver. This metabolite is excreted in the urine. | |PK=*The total adult body pool consists of 16 to 25 mg of pyridoxine. Its half-life appears to be 15 to 20 days. Vitamin B6 is degraded to 4-pyridoxic acid in the liver. This metabolite is excreted in the urine. | ||
*The need for pyridoxine increases with the amount of protein in the diet. The tryptophan load test appears to uncover early vitamin B6 deficiency by detecting xanthinurea. The average adult minimum daily requirement is about 1.25 mg. The ‘‘Recommended Dietary Allowance’’ of the National Academy of Sciences is estimated to be as much as 2.2 mg for adults and 2.5 mg for pregnant and lactating women. The requirements are more in persons having certain genetic defects or those being treated with isonicotinic acid hydrazide (INHJ) or oral contraceptives. | |||
The need for pyridoxine increases with the amount of protein in the diet. The tryptophan load test appears to uncover early vitamin B6 deficiency by detecting xanthinurea. The average adult minimum daily requirement is about 1.25 mg. The ‘‘Recommended Dietary Allowance’’ of the National Academy of Sciences is estimated to be as much as 2.2 mg for adults and 2.5 mg for pregnant and lactating women. The requirements are more in persons having certain genetic defects or those being treated with isonicotinic acid hydrazide (INHJ) or oral contraceptives. | |howSupplied=*[[file:How Supplied - Pyridoxine .png|thumb|none|450px]] | ||
|howSupplied=[[file:How Supplied - Pyridoxine .png|thumb|none|450px]] | |storage=*Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. | ||
|storage=Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. | |||
|packLabel=[[file:Pyridoxine FDA Label.png|thumb|none|450px]] | |packLabel=[[file:Pyridoxine FDA Label.png|thumb|none|450px]] | ||
|alcohol=Alcohol-Pyridoxine hydrochloride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication. | |alcohol=Alcohol-Pyridoxine hydrochloride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication. | ||
Revision as of 15:38, 24 February 2015
{{DrugProjectFormSinglePage |authorTag=Alberto Plate [1] |genericName=Pyridoxine hydrochloride |aOrAn=a |drugClass=nutritive agent of the vitamin B family |indicationType=treatment |indication=inadequate dietary intake, drug-induced deficiency, as from isoniazid (INH) or oral contraceptives, inborn errors of metabolism, e.g., vitamin B6 dependent convulsions or vitamin B6 responsive anemia. The parenteral route is indicated when oral administration is not feasible as in anorexia, nausea and vomiting, and preoperative and postoperative conditions. It is also indicated when gastrointestinal absorption is impaired. |adverseReactions=decreased folic acid, paresthesia and somnolence |blackBoxWarningTitle=TITLE |blackBoxWarningBody=Condition Name: (Content) |fdaLIADAdult======Dietary Deficiency=====
- Pyridoxine Hydrochloride Injection may be administered intramuscularly or intravenously. In cases of dietary deficiency, the dosage is 10 to 20 mg daily for 3 weeks. Follow-up treatment is recommended daily for several weeks with an oral therapeutic multivitamin preparation containing 2 to 5 mg pyridoxine. Poor dietary habits should be corrected, and an adequate, well balanced diet should be prescribed.
Vitamine B6 Dependency Syndrome
- The vitamin B6 dependency syndrome may require a therapeutic dosage of as much as 600 mg a day and a daily intake of 30 mg for life.
Drug-Induced Deficiency
- In deficiencies due to INH, the dosage is 100 mg daily for 3 weeks followed by a 30 mg maintenance dose daily.
Poisoning
- In poisoning caused by ingestion of more than 10 g of INH, an equal amount of pyridoxine should be given — 4 g intravenously followed by 1 g intramuscularly every 30 minutes.
|offLabelAdultGuideSupport======Hemopoietic stem cell transplant - Tuberculosis; Prophylaxis=====
- Dosage: 25 to 50 mg orally once daily for 9 months in combination with Isoniazid (INH) Isoniazid 5 mg/kg/day orally or intramuscularly for 9 months (ie, for 270 doses); maximum dose, 300 mg/day [1]
|offLabelAdultNoGuideSupport======AIDS Virus Infection Associated With Pregnancy=====
Treatment and Prophylaxis of Peripheral Polyneuropathy
- Dosage: 60 mg/day for 4 weeks[2]
Hydrazine Intoxication
- Dosage: 5 g IV diluted in 500 mL of 5% dextrose[3]
Pregnancy Morning Sickness
- Dosage: 30 milligrams/day
|offLabelPedGuideSupport======Hemopoietic stem cell transplant - Tuberculosis; Prophylaxis=====
- Dosage: 25 to 50 mg orally once daily for 9 months in combination with Isoniazid (INH) Isoniazid 5 mg/kg/day orally or intramuscularly for 9 months (ie, for 270 doses); maximum dose, 300 mg/day [4]
|offLabelPedNoGuideSupport======Hyperhomocysteinemia, Associated with Sickle Cell Disease=====
- Dosage: 6 mg (4.6-10.0 US 1998 RDA)[5].
Treatment of infantile spasms with high-dosage vitamin B6
- Dosage[6]
- Week 1: 100 mg/day PO q24h
- Week 2-5: 300 mg/day PO q24h
|contraindications=A history of sensitivity to pyridoxine or to any of the ingredients in Pyridoxine Hydrochloride Injection, USP is a contraindication. |warnings=This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration. |clinicalTrials=Paresthesia, somnolence, and low serum folic acid levels have been reported. |drugInteractions=Pyridoxine supplements should not be given to patients receiving levodopa, because the action of the latter drug is antagonized by pyridoxine. However, this vitamin may be used concurrently in patients receiving a preparation containing both carbidopa and levodopa. |FDAPregCat=A |useInPregnancyFDA=The requirement for pyridoxine appears to be increased during pregnancy. Pyridoxine is sometimes of value in the treatment of nausea and vomiting of pregnancy. |useInNursing=The need for pyridoxine is increased during lactation. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when pyridoxine hydrochloride is administered to a nursing woman. |overdose=Pyridoxine given to animals in amounts of 3 to 4 g/kg of body weight produces convulsions and death. In man, a dose of 25 mg/kg of body weight is well tolerated. |drugBox=
Pyridoxine (injection)
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- ↑ "Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplantation Recipients: A Global Perspective" (PDF).
- ↑ Okada H, Moriwaki K, Kanno Y, Sugahara S, Nakamoto H, Yoshizawa M; et al. (2000). "Vitamin B6 supplementation can improve peripheral polyneuropathy in patients with chronic renal failure on high-flux haemodialysis and human recombinant erythropoietin". Nephrol Dial Transplant. 15 (9): 1410–3. PMID 10978399.
- ↑ Nagappan R, Riddell T (2000). "Pyridoxine therapy in a patient with severe hydrazine sulfate toxicity". Crit Care Med. 28 (6): 2116–8. PMID 10890675.
- ↑ "Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplantation Recipients: A Global Perspective" (PDF).
- ↑ van der Dijs FP, Fokkema MR, Dijck-Brouwer DA, Niessink B, van der Wal TI, Schnog JJ; et al. (2002). "Optimization of folic acid, vitamin B(12), and vitamin B(6) supplements in pediatric patients with sickle cell disease". Am J Hematol. 69 (4): 239–46. PMID 11921017.
- ↑ Pietz J, Benninger C, Schäfer H, Sontheimer D, Mittermaier G, Rating D (1993). "Treatment of infantile spasms with high-dosage vitamin B6". Epilepsia. 34 (4): 757–63. PMID 8330589.