PYRIDOXINE
(Vitamin B6)Standard Prescription
pyridoxine __mg PO Q__H (__mg/kg/24 hr)
Dosages
Deficiency:
Children: 5-25 mg/day PO x 3 weeks.
Adolescents: 10-20 mg/day PO x 3 weeks
Drug Induced Neuritis:
Treatment:
Child: 1-2 mg/kg/dose PO daily (Max: 100 mg/day)
Adult: 100-300 mg PO daily
Prophylaxis:
Child: 1-2 mg/kg/dose PO daily (Max: 50 mg/day)
Adult: 25-50 mg PO daily
Pyridoxine-Dependent Seizures:
Acute Treatment:
Infants: 15 mg/kg/dose PO BID (max 300 mg/24 hrs)
Children & Adolescents: 10 mg/kg/dose PO BID (max 500 mg/24 hrs)
Consider IV route (100 mg/dose) for patients in ICU or intubated (risk of transient apnea).
Maintenance:
7.5-15 mg/kg/dose PO BID or
100 mg PO BID
Maximum: 300 mg/24 hrs (infants),
500 mg/24 hrs (children & adolescents)
Children: 5-25 mg/day PO x 3 weeks.
Adolescents: 10-20 mg/day PO x 3 weeks
Drug Induced Neuritis:
Treatment:
Child: 1-2 mg/kg/dose PO daily (Max: 100 mg/day)
Adult: 100-300 mg PO daily
Prophylaxis:
Child: 1-2 mg/kg/dose PO daily (Max: 50 mg/day)
Adult: 25-50 mg PO daily
Pyridoxine-Dependent Seizures:
Acute Treatment:
Infants: 15 mg/kg/dose PO BID (max 300 mg/24 hrs)
Children & Adolescents: 10 mg/kg/dose PO BID (max 500 mg/24 hrs)
Consider IV route (100 mg/dose) for patients in ICU or intubated (risk of transient apnea).
Maintenance:
7.5-15 mg/kg/dose PO BID or
100 mg PO BID
Maximum: 300 mg/24 hrs (infants),
500 mg/24 hrs (children & adolescents)
Seizure Relapse During Febrile Illness:
Dose may be doubled to maximum
60 mg/kg/24 hrs (children) or 500 mg/24 hrs (adolescents/adults) for up to 3 days
60 mg/kg/24 hrs (children) or 500 mg/24 hrs (adolescents/adults) for up to 3 days
Mechanism of Action
Water soluble vitamin
Forms Supplied
tablet: 25 mg
injection: 100 mg/mL
oral solution (BCCH): 5 mg/mL, 25 mg/mL
injection: 100 mg/mL
oral solution (BCCH): 5 mg/mL, 25 mg/mL
Comments
May be given IM or IV if oral administration is not possible.
IV administration should be administered in controlled environment due to risk of apnea.
Patients on pyridoxine supplementation should have clinical screening for peripheral neuropathy, including assessment of deep tendon reflexes.
Long term ( > 2 months) therapy with large doses ( > 2 g/24 hr) can cause sensory neuropathy.
PO maintenance dose can be used empirically until biochemical/genetic testing confirms/excludes diagnosis
IV administration should be administered in controlled environment due to risk of apnea.
Patients on pyridoxine supplementation should have clinical screening for peripheral neuropathy, including assessment of deep tendon reflexes.
Long term ( > 2 months) therapy with large doses ( > 2 g/24 hr) can cause sensory neuropathy.
PO maintenance dose can be used empirically until biochemical/genetic testing confirms/excludes diagnosis
References
32, 44, 259, 696
Last Edited
2023-01-12 06:34:44