pyridoxine (generic name)

a vitamin b complex - treats Hyperkinetic cerebral dysfunction syndrome, Depression, Angioplasty, Pregnancy-induced nausea and vomiting, Immune...
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Interactions

Interactions with Drugs

Preliminary research suggests that pyridoxine could exacerbate amiodarone (Cordarone®)-induced photosensitivity. Other research suggests a protective effect. Due to conflicting information, a firm conclusion cannot be drawn at this time but monitoring may be warranted.

Destruction of normal gastrointestinal flora by antibiotics can cause decreased production of the B vitamins. Clinical significance is unknown.

Cycloserine is an antibiotic that may cause anemia or peripheral neuritis by acting as a pyridoxine antagonist or increasing renal excretion of pyridoxine. Requirements for pyridoxine may be increased in patients receiving cycloserine.

Use of estrogens and estrogen-containing oral contraceptives can interfere with pyridoxine metabolism, reducing serum pyridoxine levels. The need for pyridoxine supplementation has not been adequately studied.

Hydralazine (Apresoline®) can increase pyridoxine requirements. The need for pyridoxine supplementation has not been adequately studied.

Isoniazid (INH, Rifamate®) can increase pyridoxine requirements.

Pyridoxine enhances the metabolism of levodopa (Sinemet®), reducing its anti-parkinsonism effects. Carbidopa and levodopa used together may avoid this interaction.

Penicillamine (Cuprimine®, Depen®) can increase pyridoxine requirements.

Preliminary data suggests that pyridoxine can reduce plasma levels of phenobarbital (Luminal®), possibly by increasing metabolism. Patients taking phenobarbital should avoid high doses of pyridoxine.

Preliminary data suggests that pyridoxine can reduce plasma levels of phenytoin (Dilantin®), possibly by increasing metabolism. Patients taking phenytoin should avoid high doses of pyridoxine.

Theophylline (Theo-Dur®), a medication used for asthma, interferes with pyridoxine metabolism. Study results of supplemental pyridoxine in these patients are inconclusive.

Interactions with Herbs and Dietary Supplements

Theoretically, herbs and supplements with estrogen-like activity may interact with pyridoxine. The need for pyridoxine supplementation has not been adequately studied.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan M. Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cynthia Dacey, PharmD (Northeastern University); Jenna Hollenstein (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Christine Ulbricht, BS (University of Massachusetts); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007 Jan;90(1):15-20.

Clarke R, Armitage J. Vitamin supplements and cardiovascular risk: review of the randomized trials of homocysteine-lowering vitamin supplements. Semin Thromb Hemost 2000;26(3):341-348.

Findling RL, Maxwell K, Scotese-Wojtila L, et al. High-dose pyridoxine and magnesium administration in children with autistic disorder: an absence of salutary effects in a double-blind, placebo-controlled study. J Autism Dev Disord 1997;27(4):467-478.

Leeda M, Riyazi N, de Vries JI, et al. Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol 1998;179(1):135-139.

Lerner V, Miodownik C, Kaptsan A, et al. Vitamin B6 treatment for tardive dyskinesia: a randomized, double-blind, placebo-controlled, crossover study. J Clin Psychiatry 2007 Nov;68(11):1648-54.

Lerner V, Bergman J, Statsenko N, et al. Vitamin B6 treatment in acute neuroleptic-induced akathisia: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2004;65(11):1550-1554.

Miodownik C, Lerner V, Statsenko N, et al. Vitamin B6 versus mianserin and placebo in acute neuroleptic-induced akathisia: a randomized, double-blind, controlled study. Clin Neuropharmacol 2006 Mar-Apr;29(2):68-72.

Miodownik C, Lerner V, Vishne T, et al. High-dose vitamin B6 decreases homocysteine serum levels in patients with schizophrenia and schizoaffective disorders: a preliminary study. Clin Neuropharmacol 2007 Jan-Feb;30(1):13-7.

Nye C, Brice A. Combined vitamin B6-magnesium treatment in autism spectrum disorder. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003497.

Rimm EB, Willett WC, Hu FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 2-4-1998;279(5):359-364.

Sahakian V, Rouse D, Sipes S, Rose N, et al. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study. Obstet Gynecol 1991;78(1):33-36.

Schnyder G, Roffi M, Flammer Y, et al. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA 8-28-2002;288(8):973-979.

Thaver D, Saeed MA, Bhutta ZA. Pyridoxine (vitamin B6) supplementation in pregnancy. Cochrane Database Syst Rev 2006 Apr 19;(2):CD000179.

Woodside JV, Yarnell JW, McMaster D, et al. Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial. Am J Clin Nutr 1998;67(5):858-866.

Wyatt KM, Dimmock PW, Jones PW, et al. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ 5-22-1999;318(7195):1375-1381.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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