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pyridoxine (a vitamin B6)

(see also pyridoxal & pyridoxamine) Function: derivatives are cofactors in: - aminotransferases - many intermediary reactions b) amino acid metabolism c) phospholipid metabolism d) glycogen metabolism Indications: - B vitamin, prevention of pyridoxine deficiency - prophylaxis against peripheral neuropathy induced by isoniazid - homocysteinemia - homocystinuria - cystathioninuria [5] - GABA AT deficiency - hyperoxaluria [5] - sideroblastic anemia - nausea/vomiting - seizures [5] - may improve generalized anxiety, social anxiety & visual processing* [7] * increased surround suppression of visual contrast detection [7] Dosage: 1) RDA: male: 1.7-2 mg; female: 1.4-1.6 mg 2) isoniazid prophylaxis: 25-50 mg PO QD 3) anxiety & increased surround suppression of visual contrast detection: 100 mg/day [7] Adverse effects: 1) pyridoxine neuropathy (2-3 g/day, +/- reversible) a) as little as 200 mg/day chronically is neurotoxic [2] b) 500 mg/day is safe [3] 2) unstable gait 3) somnolence 4) supplementation of folic acid 0.8 mg, vit B12 0.4 mg & vit B6 40 mg QD a) increases risk of cancer b) increases risk of dying of cancer c) increases all cause mortality d) hazzard ratio 1.2-1.4, number needed to harm 40-90 [4] e) increases mainly driven by folic acid + vitamin B12 f) vitamin B6 not associated with any significant effects g) editorialist proposes folic acid as culprit 5) vitamin B6 > 20 mg/day associated with increased risk of lung cancer in men [2] Drug interactions: - decrease in L-dopa effectiveness by increasing peripheral metabolism - high doses of both vit B6 & vit B12 associated with 50% higher risk of high fracture in postmenopausal women [6]

Related

pyridoxal (a vitamin B6) pyridoxamine (a vitamin B6) pyridoxine deficiency (vitamin B6 deficiency) pyridoxine in serum pyridoxine neuropathy; megavitamin-B6 syndrome

Specific

4-pyridoxate; 4-pyridoxic acid; 4-pyridoxinic acid; 4-pyridoxylic acid; 3-hydroxy-5-(hydroxymethyl)-2-methylpyridine-4-carboxylate

General

alcohol B vitamin picoline

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category A safety in lactation ?

Database Correlations

PUBCHEM cid=1054 Kegg map/map00750

References

  1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 Department of Veterans Affairs, VA National Formulary
  2. Brasky TM, White E, Chen CL. Long-Term, Supplemental, One-Carbon Metabolism-Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort. J Clin Oncol. 2017 Aug 22:JCO2017727735. PMID: 28829668
  3. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 2200
  4. Ebbing M et al Cancer incidence and mortality after treatment with folic acid and vitamin B12. JAMA 2009 Nov 18; 302:2119. PMID: 19920236 - Drake BF and Colditz GA Assessing cancer prevention studies - A matter of time. JAMA 2009 Nov 18; 302:2152 PMID: 19920243
  5. Deprecated Reference
  6. Meyer HE, Willett WC, Fung TT, Holvik K, Feskanich D. Association of high intakes of vitamins B6 and B12 from food and supplements with risk of hip fracture among postmenopausal women in the Nurses' Health Study. JAMA Netw Open 2019 May 3; 2:e193591. PMID: 31074816 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733176
  7. Field DT, Cracknell RO, Eastwood JR et al High-dose Vitamin B6 supplementation reduces anxiety and strengthens visual surround suppression. Human Psychopharmacology: Clinical & Experimental. 2022 July 19:e2852 PMID: 35851507 https://onlinelibrary.wiley.com/doi/10.1002/hup.2852

Substructures

pyridine

Component-of

5-OH tryptophan/magnesium oxide/melatonin/pyridoxine acetaminophen/pamabrom/pyridoxine alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/docosahexaenoate/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/thiamine/zinc oxide alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/ferrous fumarate/folic acid/nicotinamide/pantothenate/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/thiamine/zinc oxide alpha tocopherol/ascorbate/biotin/biotin/cobalamin/ergocalciferol/folic acid/multivitamin/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine/vitamin a/vitamin k alpha tocopherol/ascorbate/biotin/cholecalciferol/cobalamin/folic acid/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine/vitamin a/vitamin k alpha tocopherol/ascorbate/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/cupric oxide/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide alpha tocopherol/ascorbate/calcium citrate/carbonyl iron/cholecalciferol/docosahexaenoate/folic acid/nicotinamide/potassium iodide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide alpha tocopherol/ascorbate/calcium citrate/carbonyl iron/cholecalciferol/folic acid/nicotinamide/potassium iodide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide alpha tocopherol/ascorbate/calcium phosphate/cholecalciferol/docosahexaenoate/ferrous fumarate/folic acid/pyridoxine/sodium docusate alpha tocopherol/ascorbate/calcium phosphate/docosahexaenoate/eicosapentaenoate/ferrous fumarate/folic acid/pyridoxine alpha tocopherol/ascorbate/calcium phosphate/docosahexaenoate/eicosapentaenoate/folic acid/pyridoxine alpha tocopherol/ascorbate/calcium phosphate/docosahexaenoate/ferrous fumarate/folic acid/pyridoxine/sodium docusate alpha tocopherol/ascorbate/carbonyl iron/cholecalciferol/cobalamin/folic acid/nicotinamide/pyridoxine/riboflavin/thiamine alpha tocopherol/ascorbate/cholecalciferol/docosahexaenoate/ferrous fumarate/folic acid/pyridoxine/sodium docusate alpha tocopherol/cyanokit/folic acid/magnesium oxide/pyridoxine alpha tocopheryl acetate/ascorbate/beta carotene/cobalamin/ergocalciferol/folic acid/nicotinic acid/pantothenate/pyridoxine/retinol/riboflavin/thiamine alpha tocopheryl acetate/ascorbate/calcium carbonate/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/potassium iodide/pyridoxine/retinol/riboflavin/thiamine/vitamin d/zinc sulfate alpha tocopheryl acetate/ascorbate/cholecalciferol/cobalamin/nicotinamide/pyridoxine/riboflavin/thiamine/vitamin a ascorbate/beta carotene/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide ascorbate/bioflavonoid/choline bitartrate/cobalamin/inositol/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/calcium carbonate/cobalamin/dextran/folic acid/iron dextran/nicotinic acid/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/calcium carbonate/cobalamin/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/vitamin a/vitamin e/zinc oxide ascorbate/biotin/calcium carbonate/cobalamin/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/vitamin a/vitamin e/zinc/zinc oxide ascorbate/biotin/cholecalciferol/cobalamin/folic acid/nicotinic acid/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese sulfate/nicotinic acid/pantothenate/polysaccharide iron complex/pyridoxine/riboflavin/thiamine/zinc sulfate ascorbate/biotin/cobalamin/folic acid/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/cobalamin/folic acid/nicotinic acid/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/ferrous fumarate/folic acid/iron/methylcobalamin/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/folic acid/methylcobalamin/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine ascorbate/biotin/folic acid/methylcobalamin/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/zinc citrate ascorbate/calcium carbonate/cholecalciferol/choline bitartrate/cobalamin/docosahexaenoate/eicosapentaenoate/ferrous fumarate/folic acid/nicotinic acid/potassium iodide/pyridoxine/riboflavin/thiamine/vitamin e/zinc oxide ascorbate/calcium carbonate/cholecalciferol/fatty acid omega 3/folic acid/linoleate/pyridoxine/vitamin e ascorbate/calcium citrate/carbonyl iron/cholecalciferol/folic acid/pyridoxine ascorbate/cholecalciferol/cobalamin/copper sulfate/ferrous fumarate/folic acid/kelp/magnesium oxide/magnesium sulfate/nicotinamide/pyridoxine/riboflavin/vitamin a/zinc sulfate ascorbate/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinic acid/polysaccharide iron complex/potassium iodide/pyridoxine/riboflavin/thiamine/vitamin a/vitamin e/zinc oxide ascorbate/cholecalciferol/cobalamin/nicotinic acid/pyridoxine/riboflavin/sodium fluoride/thiamine/vitamin a/vitamin e ascorbate/citrate/pyridoxine ascorbate/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese sulfate/nicotinamide/pantothenate/polysaccharide iron complex/pyridoxine/riboflavin/thiamine/zinc sulfate ascorbate/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese sulfate/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/zinc sulfate ascorbate/cobalamin/copper sulfate/ferrous fumarate/folic acid/manganese sulfate/nicotinamide/pantothenate/polysaccharide iron complex/pyridoxine/riboflavin/thiamine/zinc sulfate ascorbate/cobalamin/copper/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese/manganese sulfate/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/zinc sulfate ascorbate/cobalamin/folic acid/nicotinic acid/pyridoxine/riboflavin/sodium fluoride/thiamine/vitamin a/vitamin d/vitamin e ascorbate/cobalamin/nicotinic acid/pyridoxine/riboflavin/thiamine/vitamin a/vitamin d/vitamin e ascorbate/ferrous sulfate/nicotinic acid/pyridoxine/riboflavin/thiamine/vitamin a/vitamin d/vitamin e azelaic acid/folic acid/nicotinamide/pyridoxine/zinc oxide caffeine/cobalamin/ibuprofen/pyridoxine/riboflavin/thiamine calcium carbonate/cobalamin/folic acid/pyridoxine calcium glycerophosphate/pyridoxine/sodium monofluorophosphate calcium glycerophosphate/pyridoxine/sodium monofluorophosphate/toothpaste cholecalciferol/cobalamin/fatty acid omega 3/folic acid/phytosterol/pyridoxine cholecalciferol/cobalamin/folic acid/pyridoxine/riboflavin chromium/chromium picolinate/pyridoxine cider vinegar/kelp/phosphatidylcholine/pyridoxine cobalamin/docosahexaenoate/eicosapentaenoate/folic acid/phytosterol/policosanol/pyridoxine cobalamin/docosahexaenoate/eicosapentaenoate/folic acid/phytosterol/pyridoxine cobalamin/docosahexaenoate/eicosapentaenoate/pyridoxine cobalamin/fatty acid omega 3/folic acid/phytosterol/pyridoxine cobalamin/folic acid/pyridoxine cobalamin/magnesium sulfate/manganese sulfate/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine/zinc sulfate cobalamin/magnesium sulfate/manganese/manganese sulfate/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine/zinc sulfate cobalamin/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine cobalamin/pyridoxine/riboflavin cobalamin/pyridoxine/thiamine doxylamine/pyridoxine (Diclegis, Bendectin) Folgard Rx 2.2 (folate, B12, B6) folic acid/methylcobalamin/pyridoxine Herbal Rescue magnesium oxide/pyridoxine melatonin/pyridoxine Nephro-Vite (vitamin B & C) nicotinamide/panthenol/pyridoxine/riboflavin/thiamine nicotinamide/pyridoxine/riboflavin/thiamine pyridoxine/salicylic acid/zinc gluconate Souvenaid; Fortasyn 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