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Drugs reference index «Pyridoxine Hydrochloride (B6)»

Pyridoxine Hydrochloride

( B 6 ) Pronunciation: (peer-ih-DOX-een HIGH-droe-KLOR-ide)Class: Vitamin, water-soluble

Trade Names:Pyridoxine Hydrochloride- Tablets 10 mg- Tablets 25 mg- Tablets 50 mg- Tablets 100 mg- Tablets 200 mg- Tablets 250 mg- Tablets, extended-release 200 mg- Capsules 500 mg- Solution 200 mg per 5 mL

Trade Names:Pyri-500- Tablets 500 mg

Trade Names:Rodex- Capsules 150 mg

Trade Names:Vitabee-6- Injection 100 mg/mL

Hexa-Betalin (Canada)


Vitamin B 6 functions as coenzyme in amino acid, carbohydrate, and lipid metabolism.



Absorbed by passive diffusion in the jejunum and to a lesser extent in the ileum.


Primarily stored in the liver, lesser amount in the muscle and brain. Not protein bound.


Metabolized in the liver and converted to 4-pyridoxic acid metabolite.


Excreted mostly as 4-pyridoxic acid in the urine. The t ½ is 15 to 20 days.

Indications and Usage

Pyridoxine deficiency, including inadequate diet, drug-induced causes (eg, isoniazid, hydralazine, oral contraceptives) or inborn errors of metabolism. Parenteral use is indicated when oral therapy is not feasible.

Unlabeled Uses

Treatment of hydrazine poisoning, PMS, hyperoxaluria type I, nausea and vomiting in pregnancy, sideroblastic anemia associated with high serum iron, carpal tunnel syndrome, tardive dyskinesia.


Standard considerations.

Dosage and Administration

Dietary DeficiencyAdults

PO / IM / IV 10 to 20 mg/day for 3 wk.

Drug-Induced Deficiency Anemia or NeuritisAdults

PO / IM / IV 100 to 200 mg/day for 3 wk; follow with 25 to 100 mg/day.


PO / IM / IV 50 to 200 mg/day.

Vitamin B 6 Dependency SyndromeAdults

PO / IM / IV 600 mg, followed by 30 mg/day for life. Dependency has been noted in adults administered 200 mg/day.

Pyridoxine-dependent infants

IM / IV 10 to 100 mg, followed by 2 to 100 mg/day.

Metabolic DisordersAdults

PO / IM / IV 100 to 500 mg/day.

Isoniazid PoisoningAdults and children

IV 4 g IV followed by 1 g IM every 30 min until pyridoxine dose equal to isoniazid dose has been given.

General Advice

  • Instruct patient to swallow enteric-coated preparation whole and not to break, crush or chew.
  • When giving via IM route, rotate sites.
  • IV preparation may be given undiluted or added to standard compatible IV solutions.


Store all forms of drug at room temperature in tightly closed, light-resistant containers. Avoid freezing injection.

Drug Interactions

Cycloserine, isoniazid, hydralazine, oral contraceptives, penicillamine

Increased need for pyridoxine.


Decreased effect of levodopa. (Interaction does not occur with levodopa/carbidopa in combination with pyridoxine.)


Phenytoin serum levels may be decreased.


Incompatible with alkaline solutions, iron salts and oxidizing agents (parenteral).

Laboratory Test Interactions

May result in false-positive urobilinogen in the spot test using Ehrlich reagent.

Adverse Reactions


Neuropathy; unstable gait; drowsiness; somnolence.


Perioral numbness.


Numbness of feet; decreased sensation to touch, temperature or vibration; paresthesia; low serum folic acid levels; burning/stinging at IM injection site; photoallergic reaction; ataxia.



Category A . ( Category C in doses that exceed the RDA.)


Excreted in breast milk; may inhibit lactation.


Safety and efficacy not established in doses exceeding nutritional requirements.



Ataxia, sensory neuropathy.

Patient Information

  • Emphasize importance of complying with prescribed dietary recommendations.
  • Teach patient about foods high in B 6 (whole grain cereals, meat [eg, liver], potatoes, green vegetables, legumes [eg, lima beans], yeast and bananas).
  • If patient is self-medicating with vitamin supplements, caution that megadosing may cause adverse reactions such as unsteady gait, impaired hand coordination and numbness of feet.

Copyright © 2009 Wolters Kluwer Health.

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