Pyridoxine

Overview

Vitamin B6. Critical coenzyme for amino acid metabolism and neurotransmitter synthesis (GABA). Mandatory co-prescription for patients on specific tuberculosis drugs.

Maximum Dose

Max 200 mg/day (Chronic doses > 200mg cause paradoxical, severe nerve damage).

Clinical Focus

Must be co-prescribed with Isoniazid (INH) to prevent irreversible peripheral neuropathy.

Bottom Line

Pyridoxine is used for isoniazid-induced neuropathy prevention and treatment of pyridoxine deficiency, but chronic high doses (>200 mg/day) paradoxically cause sensory neuropathy.

Brand Names

Pyroxin

Oral Routes

Tablets (25 mg, 100 mg).

Parenteral

Ampoules for IV injection (Hospital only, stored in ED for toxicology).

Prescribing & PBS

Over The Counter (OTC).

Primary

Prevention of drug-induced peripheral neuropathy, hyperemesis gravidarum, sideroblastic anemia.

Clinical Place

First-line therapy in pregnancy for morning sickness (often combined with Doxylamine).