Pyridoxine HCL is usually prescribed for: nutritional supplementation
The only existing dosage form for Pyridoxine HCl is Injection Solution. Absolute Pharmacy injection solutions combine under the strict standards of USP 797 in order to ensure sterile constitution. The endotoxin, potency as well as the pH tests is performed in each batch. Their elaborate procedures ensure the quality and consistency of each compound they dispense.
Pyridoxine, or vitamin B6, is a natural, water-soluble vitamin. Some of the common sources include legumes, cereals, vegetables, meats and eggs. Since it is a rich source of Vitamin B, it is primarily used to fight vitamin B deficiency as well as to prevent or treat the toxicity of isoniazid, cycloserine or hydralazine. It is also efficient in the control sideroblastic anemia related to altered levels of serum iron. It has also been used in neonates to treat seizures and in patients with metabolic disorders such as primary hyperoxaluria, xanthurenic aciduria, primary homocystinuria, and primary cystathioninuria.
Vitamin B6 is composed of pyridoxamine, pyridoxine and pyridoxal. Pyridoxine is converted into erythrocytes at its active moiety, pyridoxal phosphate. On the other hand, pyridoxamine is converted to pyridoxamine phosphate.
These active forms act as coenzymes for over 60 metabolic processes including the metabolism of fat, protein and carbohydrates. When it comes to protein metabolism, its role incorporates amino acid decarboxylation, tryptophan conversion into niacin or serotonin, amino acid transamination and deamination.
Pyridoxine is given orally and by intramuscular or intravenous injection. The liver retains much of it, where it may also be phosphorylated while the muscles and the brain also retain minimal amounts.
The total body retention for adults is between 1630mg. Pyridoxal crosses the placenta, with fetal concentrations 5 times higher than maternal plasma concentrations. The half life of pyridoxine is 1519 days.
For nutritional supplementation in patients receiving NTP:
There are no specific recommendations for adults, children and adolescents (weighing more than 40kg). However, it is recommended to add 10 ml / day of the preparation of adult intravenous parenteral multivitamins.
The recommended dose for neonates, infants, children and adolescents weighing 2.5 to 40 kg is 1 mg / day IV mixed with TPN.2
For neonates less than 2.5 kg, their recommended dose is 0.4 mg / kg / day IV mixed with TPN. Max: 1 mg / day.2
For patients with hepatic / renal impairment, there are no specific guidelines available for dose adjustments in hepatic impairment so it appears that no dose adjustment is required.
1.Perrheral solutions of pyridoxine contain unstable concentrations of aluminum. Patients with renal impairment as seen in preterm infants risk toxicity as a result of aluminum buildup. The concentration of aluminum in parenteral solutions can be obtained by direct inquiry from the manufacturer.
Though considered non-toxic in regular doses, Pyridoxine has been associated with cases of nausea / vomiting, paresthesia, headache, hyperesthesia, drowsiness and low levels of folic acid in vaying degrees of intensity.
Chronic and excessive doses (26 g / day) are known to cause severe sensory peripheral neuropathy or a neuronopathy syndrome. On a more extreme end, convulsions have been reported in neonates following the administration of large doses of pyridoxine during pregnancy.
Points to Remember..
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