Pyridoxine

Registered South African indications:

• Pyridoxine deficiency
• Inhibition of lactation
• Hyperemesis gravidarum

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Pregnancy (if doses > recommended daily allowance)
• Prolonged therapy
• High doses

Forms avail in SA and covered in this monograph: tab

Pyridoxine deficiency

• Oral (tab): 25mg, dly; Treatment duration: 3 weeks

Anaemia induced by pyridoxine deficiency

• Oral (tab): 50-150mg/day, in divided doses

Drug-induced neuropathy

• Oral (tab): Initial: 200mg, dly; for 3 weeks; Maintenance: 25mg, dly

Prophylaxis of peripheral neuropathy secondary to isoniazid

• Oral (tab): 25mg, dly

Treatment of peripheral neuropathy secondary to isoniazid

• Oral (tab): 75mg, dly for 3 weeks; Then 25-50mg, dly

Inhibition or arrest of lactation

• Oral (tab): 200mg, 8hrly; Treatment duration: 6 days

Hyperemesis gravidarum (Additional agent required)

• Oral (tab): 25mg, 8hrly

Prophylaxis of terizidone-induced pyridoxine deficiency

• Oral (tab): 50mg per 250mg of terizidone, dly

Isoniazid poisoning

Known amount of isoniazid ingested

• Oral (tab): 1g for every 1g isoniazid ingested

Unknown amount of isoniazid ingested

• Oral (tab): 5g, as a single dose

Ethylene glycol poisoning (Additional agent required)

• Oral (tab): 100mg, dly

Paed. forms avail. in SA and covered in this monograph: tab

Pyridoxine deficiency

• Oral (tab): 12.5mg, dly; Treatment duration: 3 weeks

Drug-induced neuropathy

• Oral (tab): 50mg, dly; Treatment duration: 3 weeks

Prophylaxis of pyridoxine deficiency secondary to isoniazid

Younger than 5 years

• Oral (tab): 12.5mg, dly; Treatment duration: until completion of TB chemoprophylaxis

Older than 5 years

• See adult dosages

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Give pyridoxine to all children on TB and antiretroviral treatment to prevent peripheral neuropathy

Pregnancy

• Safe
• Data on exposed pregnancies indicate no adverse effects of pyridoxine in therapeutic doses on pregnancy or the health of the foetus or newborn child
• Animal studies are insufficient with respect to effects on pregnancy, embryonal/foetal development, parturition or postnatal development. Caution should be exercised when prescribing to pregnant women

Breastfeeding

• Compatible
• Data indicate no adverse effects of pyridoxine in therapeutic doses during breastfeeding. Inhibition of lactation may occur at doses >600 mg/day when taken immediately postpartum

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not porphyrinogenic (NP)

Drugs in Sport

•  Permitted - No warnings

Central Nervous System Disorders

• Severe peripheral neuritis

• Isoniazid
• Penicillamine
• Oral contraceptives
• Levodopa

None routine

Pyridoxine is converted to pyridoxal 5-phosphate in the body. Pyridoxal 5-phosphate is a coenzyme for the synthesis of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids and aminolevulinic acid.

Pyridoxine is available in several formulations. Please note the list below gives examples of products which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication

Tablet 25mg

• Egoli Pyridoxine (Pharmachem)
• Portfolio Vitamin 6 (Portfolio)
• Pyridoxine 25mg Tablet-VH ( Vortex Healthcare)

Tablet 200mg

• Be-tabs Pyridoxine (Be-tabs)
• Lactosec (Pharmacare)