Pyridoxine Deficiency Follow-up
- Author: Richard E Frye, MD, PhD; Chief Editor: George T Griffing, MD more...
Prophylactic administration of pyridoxine should be provided when a patient is using certain medications, such as isoniazid (30-450 mg/d, which may be based gram for gram) and penicillamine (100 mg/d).
Estrogen-induced reduction in tryptophan metabolism may require supplementation of 20-25 mg/d.
Care should be taken when supplementing pyridoxine, because high pyridoxine states can cause a neuropathy characterized by ataxia and burning pain in the feet, beginning approximately 1 month to 3 years following supplementation. Although this usually occurs at very high supplementation doses, complications have been reported with doses as low as 50 mg/d.
Care should be taken when prescribing pyridoxine supplementation to postpartum women who are breastfeeding, because high doses of pyridoxine can cause hypolacticemia.
Injecting pyridoxine into an infant or neonate can cause a precipitous decrease in blood pressure.
Pyridoxine has the highest adverse outcome per toxic exposure for any vitamin, although no deaths have been reported.
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