Pyridoxine

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Pyridoxine
Pyridoxin.svg
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Pyridoxine
Clinical data
Other namesvitamin B6, pyridoxol [1] pyridoxine hydrochloride
AHFS/Drugs.com Monograph
License data
Pregnancy
category
Routes of
administration
By mouth, intravenous (IV), intramuscular (IM), subcutaneous
ATC code
Legal status
Legal status
Pharmacokinetic data
Elimination half-life several weeks (see #Metabolism for details)
Identifiers
  • 4,5-Bis(hydroxymethyl)-2-methylpyridin-3-ol
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.000.548 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C8H11NO3
Molar mass 169.180 g·mol−1
3D model (JSmol)
Melting point 159 to 162 °C (318 to 324 °F)
  • OCc1cnc(C)c(O)c1CO
  • InChI=1S/C8H11NO3/c1-5-8(12)7(4-11)6(3-10)2-9-5/h2,10-12H,3-4H2,1H3 Yes check.svgY
  • Key:LXNHXLLTXMVWPM-UHFFFAOYSA-N

Pyridoxine, is a form of vitamin B6 found commonly in food and used as a dietary supplement. As a supplement it is used to treat and prevent pyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorders, side effects or complications of isoniazid use, and certain types of mushroom poisoning. [4] It is used by mouth or by injection. [4]

Contents

It is usually well tolerated. [4] Occasionally side effects include headache, numbness, and sleepiness. [4] Normal doses are safe during pregnancy and breastfeeding. [4] Pyridoxine is in the vitamin B family of vitamins. [4] It is required by the body to metabolise amino acids, carbohydrates, and lipids. [4] Sources in the diet include fruit, vegetables, and grain. [5]

Medical uses

As a treatment (oral or injection), it is used to treat or prevent pyridoxine deficiency, sideroblastic anaemia, pyridoxine-dependent epilepsy, certain metabolic disorders, side effects of isoniazid treatment and certain types of mushroom poisoning. [4] Isoniazid is an antibiotic used for the treatment of tuberculosis. Common side effect include numbness in the hands and feet. [6] Co-treatment with vitamin B6 alleviates the numbness. [7] Pyridoxine-dependent epilepsy is a type of rare infant epilepsy that does not improve with typical anti-seizure medications. [8]

Pyridoxine in combination with doxylamine is used as a treatment for morning sickness in pregnant women. [9]

Side effects

It is usually well tolerated, though overdose toxicity is possible. [4] Occasionally side effects include headache, numbness, and sleepiness. [4] Pyridoxine overdose can cause a peripheral sensory neuropathy characterized by poor coordination, numbness, and decreased sensation to touch, temperature, and vibration. [10] Healthy human blood levels of pyridoxine are 2.1–21.7 ng/mL. Normal doses are safe during pregnancy and breastfeeding. [4]

Mechanism

Pyridoxine is in the vitamin B family of vitamins. [4] It is required by the body to make amino acids, carbohydrates, and lipids. [4] Sources in the diet include fruit, vegetables, and grain. [5] It is also required for muscle phosphorylase activity associated with glycogen metabolism.

Metabolism

The half-life of pyridoxine varies according to different sources: one source suggests that the half-life of pyridoxine is up to 20 days, [11] while another source indicates half-life of vitamin B6 is in range of 25 to 33 days. [12] After considering the different sources, it can be concluded that the half-life of pyridoxine is typically measured in several weeks. [11] [12]

History

Pyridoxine was discovered in 1934, isolated in 1938, and first made in 1939. [13] [14] It is on the World Health Organization's List of Essential Medicines. [15] Pyridoxine is available both as a generic medication and over the counter product. [4] Foods, such as breakfast cereal have pyridoxine added in some countries. [5]

Related Research Articles

<span class="mw-page-title-main">Riboflavin</span> Vitamin and supplement

Riboflavin, also known as vitamin B2, is a vitamin found in food and sold as a dietary supplement. It is essential to the formation of two major coenzymes, flavin mononucleotide and flavin adenine dinucleotide. These coenzymes are involved in energy metabolism, cellular respiration, and antibody production, as well as normal growth and development. The coenzymes are also required for the metabolism of niacin, vitamin B6, and folate. Riboflavin is prescribed to treat corneal thinning, and taken orally, may reduce the incidence of migraine headaches in adults.

<span class="mw-page-title-main">Vitamin</span> Nutrients required by organisms in small amounts

Vitamins are organic molecules that are essential to an organism in small quantities for proper metabolic function. Essential nutrients cannot be synthesized in the organism in sufficient quantities for survival, and therefore must be obtained through the diet. For example, vitamin C can be synthesized by some species but not by others; it is not considered a vitamin in the first instance but is in the second. Most vitamins are not single molecules, but groups of related molecules called vitamers. For example, there are eight vitamers of vitamin E: four tocopherols and four tocotrienols.

<span class="mw-page-title-main">Pantothenic acid</span> Chemical compound

Pantothenic acid (vitamin B5) is a B vitamin and an essential nutrient. All animals need pantothenic acid in order to synthesize coenzyme A (CoA), which is essential for cellular energy production and for the synthesis and degradation of proteins, carbohydrates, and fats.

Vitamin B<sub>6</sub> Class of chemically related vitamins

Vitamin B6 is one of the B vitamins, and thus an essential nutrient. The term refers to a group of six chemically similar compounds, i.e., "vitamers", which can be interconverted in biological systems. Its active form, pyridoxal 5′-phosphate, serves as a coenzyme in more than 140 enzyme reactions in amino acid, glucose, and lipid metabolism.

<span class="mw-page-title-main">Folate</span> Vitamin B9; nutrient essential for DNA synthesis

Folate, also known as vitamin B9 and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and storage. Folate is required for the body to make DNA and RNA and metabolise amino acids necessary for cell division. As the human body cannot make folate, it is required in the diet, making it an essential nutrient. It occurs naturally in many foods. The recommended adult daily intake of folate in the U.S. is 400 micrograms from foods or dietary supplements.

<span class="mw-page-title-main">Biotin</span> Chemical compound (vitamin B7)

Biotin (also known as vitamin B7 or vitamin H) is one of the B vitamins. It is involved in a wide range of metabolic processes, both in humans and in other organisms, primarily related to the utilization of fats, carbohydrates, and amino acids. The name biotin, borrowed from the German Biotin, derives from the Ancient Greek word βίοτος (bíotos; 'life') and the suffix "-in" (a suffix used in chemistry usually to indicate 'forming'). Biotin appears as a white crystalline solid that looks like needles.

<span class="mw-page-title-main">Anemia</span> Reduced ability of blood to carry oxygen

Anemia or anaemia is a blood disorder in which the blood has a reduced ability to carry oxygen. This can be due to a lower than normal number of red blood cells, a reduction in the amount of hemoglobin available for oxygen transport, or abnormalities in hemoglobin that impair its function. The name is derived from Ancient Greek ἀν- (an-) 'not', and αἷμα (haima) 'blood'. When anemia comes on slowly, the symptoms are often vague, such as tiredness, weakness, shortness of breath, headaches, and a reduced ability to exercise. When anemia is acute, symptoms may include confusion, feeling like one is going to pass out, loss of consciousness, and increased thirst. Anemia must be significant before a person becomes noticeably pale. Additional symptoms may occur depending on the underlying cause. Anemia can be temporary or long term and can range from mild to severe.

Vitamin deficiency is the condition of a long-term lack of a vitamin. When caused by not enough vitamin intake it is classified as a primary deficiency, whereas when due to an underlying disorder such as malabsorption it is called a secondary deficiency. An underlying disorder can have 2 main causes:

<span class="mw-page-title-main">Dietary supplement</span> Product providing additional nutrients

A dietary supplement is a manufactured product intended to supplement a person's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources, or that are synthetic. The classes of nutrient compounds in supplements include vitamins, minerals, fiber, fatty acids, and amino acids. Dietary supplements can also contain substances that have not been confirmed as being essential to life, and so are not nutrients per se, but are marketed as having a beneficial biological effect, such as plant pigments or polyphenols. Animals can also be a source of supplement ingredients, such as collagen from chickens or fish for example. These are also sold individually and in combination, and may be combined with nutrient ingredients. The European Commission has also established harmonized rules to help insure that food supplements are safe and appropriately labeled.

B vitamins are a class of water-soluble vitamins that play important roles in cell metabolism and synthesis of red blood cells. They are a chemically diverse class of compounds; some contain sulfur and B12 contains cobalt. Dietary supplements containing all eight are referred to as a vitamin B complex. Individual B vitamins are referred to by B-number or by chemical name, such as B1 for thiamine, B2 for riboflavin, and B3 for niacin, while some are more commonly recognized by name than by number, such as pantothenic acid (B5), biotin (B7), and folate (B9).

<span class="mw-page-title-main">Iron-deficiency anemia</span> Medical condition

Iron-deficiency anemia is anemia caused by a lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as feeling tired, weak, short of breath, or having decreased ability to exercise. Anemia that comes on quickly often has more severe symptoms, including confusion, feeling like one is going to pass out or increased thirst. Anemia is typically significant before a person becomes noticeably pale. Children with iron deficiency anemia may have problems with growth and development. There may be additional symptoms depending on the underlying cause.

<span class="mw-page-title-main">Isoniazid</span> Antibiotic for treatment of tuberculosis

Isoniazid, also known as isonicotinic acid hydrazide (INH), is an antibiotic used for the treatment of tuberculosis. For active tuberculosis, it is often used together with rifampicin, pyrazinamide, and either streptomycin or ethambutol. For latent tuberculosis, it is often used alone. It may also be used for atypical types of mycobacteria, such as M. avium, M. kansasii, and M. xenopi. It is usually taken by mouth, but may be used by injection into muscle.

<span class="mw-page-title-main">Sideroblastic anemia</span> Medical condition

Sideroblastic anemia, or sideroachrestic anemia, is a form of anemia in which the bone marrow produces ringed sideroblasts rather than healthy red blood cells (erythrocytes). In sideroblastic anemia, the body has iron available but cannot incorporate it into hemoglobin, which red blood cells need in order to transport oxygen efficiently. The disorder may be caused either by a genetic disorder or indirectly as part of myelodysplastic syndrome, which can develop into hematological malignancies.

Pyridoxine/doxylamine, sold under the brand name Diclectin among others, is a combination of pyridoxine hydrochloride (vitamin B6) and doxylamine succinate. It is generally used for nausea and vomiting of pregnancy (morning sickness); even though its efficacy has not been proven and subsequent research has led to the removal of recommendations in medical journals.

Vitamin B<sub><small>12</small></sub> Vitamin used in animal cells metabolism

Vitamin B12, also known as cobalamin, is a water-soluble vitamin involved in metabolism. It is one of eight B vitamins. It is required by animals, which use it as a cofactor in DNA synthesis, and in both fatty acid and amino acid metabolism. It is important in the normal functioning of the nervous system via its role in the synthesis of myelin, and in the circulatory system in the maturation of red blood cells in the bone marrow. Plants do not need cobalamin and carry out the reactions with enzymes that are not dependent on it.

Vitamins occur in a variety of related forms known as vitamers. A vitamer of a particular vitamin is one of several related compounds that performs the functions of said vitamin and prevents the symptoms of deficiency of said vitamin.

<span class="mw-page-title-main">Vegan nutrition</span> Nutritional and human health aspects of vegan diets

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Vitamin B<sub>3</sub> Class of chemically related vitamers

Vitamin B3, colloquially referred to as niacin, is a vitamin family that includes three forms, or vitamers: niacin (nicotinic acid), nicotinamide (niacinamide), and nicotinamide riboside. All three forms of vitamin B3 are converted within the body to nicotinamide adenine dinucleotide (NAD). NAD is required for human life and people are unable to make it within their bodies without either vitamin B3 or tryptophan. Nicotinamide riboside was identified as a form of vitamin B3 in 2004.

Isoniazid/pyridoxine/sulfamethoxazole/trimethoprim (INH/B6/CTX) is a fixed-dose combination medication for the prevention of opportunistic infections in HIV/AIDS. It combines isoniazid, pyridoxine, sulfamethoxazole, and trimethoprim. Specifically it is used to prevent tuberculosis, toxoplasmosis, pneumonia, malaria, and isosporiasis. It is taken by mouth.

Megavitamin-B6 syndrome is a collection of symptoms that can result from chronic supplementation, or acute overdose, of vitamin B6. While it is also known as hypervitaminosis B6, vitamin B6 toxicity and vitamin B6 excess, megavitamin-b6 syndrome is the name used in the ICD-10.

References

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  2. "Pyridoxine Use During Pregnancy". Drugs.com. 27 April 2020. Archived from the original on 4 December 2020. Retrieved 6 May 2020.
  3. "Pyridoxine 50mg Tablets - Summary of Product Characteristics (SmPC)". (emc). 27 April 2015. Archived from the original on 12 October 2013. Retrieved 6 May 2020.
  4. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 "Pyridoxine Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 30 December 2016. Retrieved 8 December 2016.
  5. 1 2 3 "Office of Dietary Supplements - Dietary Supplement Fact Sheet: Vitamin B6". ods.od.nih.gov. 11 February 2016. Archived from the original on 12 December 2016. Retrieved 30 December 2016.
  6. "Isoniazid". The American Society of Health-System Pharmacists. Archived from the original on 20 December 2016. Retrieved 13 August 2021.
  7. Lheureux P, Penaloza A, Gris M (April 2005). "Pyridoxine in clinical toxicology: a review". European Journal of Emergency Medicine. 12 (2): 78–85. doi:10.1097/00063110-200504000-00007. PMID   15756083. S2CID   39197646.
  8. Abend NS, Loddenkemper T (July 2014). "Management of pediatric status epilepticus". Current Treatment Options in Neurology. 16 (7): 301. doi:10.1007/s11940-014-0301-x. PMC   4110742 . PMID   24909106.
  9. Anh NH, Kim SJ, Long NP, Min JE, Yoon YC, Lee EG, et al. (January 2020). "Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials". Nutrients. 12 (1): 157. doi: 10.3390/nu12010157 . PMC   7019938 . PMID   31935866.
  10. "Pyridoxine deficiency and toxicity". MedLink Neurology. www.medlink.com. Archived from the original on 19 July 2020. Retrieved 14 December 2020.
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  12. 1 2 Assessment of vitamin B6 intake in relation to tolerable upper intake levels. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific Committee for Food Safety (PDF). Oslo, Norway. ISBN   978-82-8259-260-4. Archived from the original (PDF) on 17 November 2019. Retrieved 7 December 2019. Eighty to ninety percent of vitamin B6 in the body is found in muscles and estimated body stores in adults amount to about 170 mg with a half-life of 25-33 days.
  13. Squires VR (2011). The Role of Food, Agriculture, Forestry and Fisheries in Human Nutrition - Volume IV. EOLSS Publications. p. 121. ISBN   978-1-84826-195-2. Archived from the original on 11 January 2023. Retrieved 30 June 2020.
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  15. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.