pyridoxine hydrochloride: clinical use

Prescribing considerations

• Confirm the indication and consider all sources of vitamin B6, including non-prescription supplements.
• Review persistent or worsening symptoms rather than escalating treatment without reassessment.
• The selected tablet presentation is not recommended for children.

Contraindications and cautions

• Hypersensitivity to pyridoxine hydrochloride or any formulation excipient.

Monitoring

• Assess clinical response and the underlying cause of deficiency or anaemia as appropriate.
• Ask about new sensory symptoms, weakness or balance disturbance during prolonged treatment or substantial total vitamin B6 exposure.
• Review concomitant levodopa, isoniazid, penicillamine, oral contraceptives and vitamin supplements.

Clinical pharmacology

Pyridoxine is absorbed from the gastrointestinal tract and converted to pyridoxal phosphate and pyridoxamine phosphate. It crosses the placenta, enters breast milk and is eliminated in urine mainly as 4-pyridoxic acid.

Formulation and product differences

• The selected product is a film-coated tablet with a break line intended only to aid swallowing.
• It contains microcrystalline cellulose, sodium starch glycolate, colloidal anhydrous silica and magnesium stearate, with a hypromellose, macrogol, talc and titanium-dioxide coating.
• It should remain in its original packaging for protection from light.

Tablet

Route: Oral

Strengths: 50 mg