Pyridoxine

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Administration

  • Type: Water soluble vitamin
  • Routes of Administration: Oral, IV/IM
  • Common Trade Names: Vitamin B6

Adult Dosing

  • Seizures associated with overdose of INH or ingestion of gyromitra mushrooms [1] [2]
    • Known quantity ingested: Give IV pyridoxine 1:1 with amount ingested, up to 5 grams
    • Unknown quantity ingested: 5 grams
    • IV Infusion rate is 0.5 g/min until the seizures stop or the maximum dose is reached. Remainder of dose infused over 4 to 6 hours

Pediatric Dosing

  • Seizures associated with overdose of INH
    • Known quantity ingested: Give IV pyridoxine 1:1 with amount ingested, up to 5 grams
    • Unknown quantity ingested: 70mg/kg up to 5 gm (adult dose) [3]
    • Then give 1 gram IM q30min until total dose required reached[4]
  • Gyromitra ingestion
    • 70mg/kg initial dose

Special Populations

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Mechanism of Action

Comments

See Also

References

  1. Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med. 2005;28(2):175.
  2. Howland MA, “Antidotes in Depth: Pyridoxine,” Goldfrank's Toxicologic Emergencies, 10th ed, Flomenbaum NE, Goldfrank LR, Hoffman RS, et al, eds, New York, NY: McGraw-Hill Companies, Inc, 2015, 872-5.
  3. Minns, A. et al. Isoniazid-Induced Status Epilepticus in a Pediatric Patient After Inadequate Pyridoxine Therapy. Pediatric Emergency Care. 2010:26(5)380-381
  4. Pyridoxine. www.Drugs.com. http://www.drugs.com/dosage/pyridoxine.html